BLOG: Sidestep burnout with empathy

ByJohn D. Kelly IV, MD

The burnout epidemic rages on and it is endemic in the entire medical universe, explaining the increasing rate of absenteeism and turnover among physicians.

Most predict that many of the stressors physicians encounter – electronic medical records, declining reimbursement and insurance hassles – will not vanquish any time soon. Thus, we are well advised to improve our response to stress. A scientifically proven means of mitigating stress and cultivating wellbeing is to practice empathy and compassion. These traits enable us to connect more deeply with our patients and subsequently help us to become less consumed with our own “stuff.” The result: less stress.

Dan Goleman, author of Emotional Intelligence: Why It Can Matter More Than IQ, defines empathy as “sensing others’ feelings and perspectives, and taking an active interest in their concerns” and further describes three types of empathy:

cognitive empathy - seeing the world through another person’s eyes;
emotional empathy -feeling what the other person feels; and
empathic concern (compassionate empathy) - understanding and feeling a person’s situation and also feeling moved to help.

Practicing these empathic virtues places us into the world of others, so that we can experience what they are experiencing and what they are feeling. We lose our ego and are moved to act to ease the suffering of another. Judgment is replaced by compassion, separation is replaced by joining and fulfillment rises dramatically by both parties.

The evidence

Bentley and colleagues conducted a study in which they trained PGY-1 psychiatry residents in a brief course focused on relational mindfulness and empathy training. After 8 weeks, the residents demonstrated a downward trend in burnout metrics and a significant increase in empathy. In addition, the resident physicians noted that they had increased ability to care for themselves, their patients and their families.

Develop self-compassion

We cannot give what we don’t have. We have to first care for ourselves and understand, with a compassionate mindset, what we are experiencing in the moment. Understand that we are a flawed composite of genetics and experience and we are doing the best we can in any given situation. Self-reproach will only encourage more deep feelings of inadequacy and spur on more dysfunctional behaviors. Be your best friend and treat yourself as you would your most treasured patient. In addition, resist the urge to over work as this leads to isolation and only compounds stress.

Forge strong boundaries

Compassion fatigue may ensue when one does not take time to recharge. Be sure to always remind yourself that when the well is dry you are no longer effective as a healer. Set firm limits to what you can effectively deliver in a single day and take daily time to refresh.

Added dividends

In their handbook of leadership: Resonant Leadership: Renewing Yourself and Connecting with Others Through Mindfulness, Hope, and Compassion, Boyatzis and McKee introduce the principle that we can only influence others successfully once we have mastered our own emotions. Once we attain inner peace, we can help resonate this internal quietude to others. Emotions are contagious.

I have written on the role orthopedic surgeons assume as leaders – in surgery, clinic, the classroom, lab and at home. The call to lead is best answered when we tame the demon of burnout through empathy and compassion. In doing so, we are sowing the seeds of a wonderful culture both at work and at home that resonates with peace.

Try this

Gain knowledge in communication skills with patients. The American Academy of Orthopaedic Surgeons Communication Skills Workshop is a high-yield endeavor in increasing empathic listening skills and encouraging connection with patients.

Before you judge someone, whether a patient or staff member, pause and try to experience what that person may be experiencing at that moment. Most obnoxious behaviors are essentially a cry for help.

Become your own strongest ally and become aware of subtle cues that you are overworked. Pushing through exhaustion is folly. Only rest and the engagement of enjoyable activities will restore balance.

References:

Boyatzis RE, et al. Resonant leadership: Renewing yourself and connecting with others through mindfulness, hope, and compassion. Harvard Business Press, 2005.

Goleman D. Emotional intelligence. Bantam, 1995.

Linzer M, et al. Am J Med. 2001;111(2):170-175.

vanOyen Witvliet C, et al. Psychol Sci. 2001 Mar;12(2):117-123.