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8 strategies to increase wellness, cope with physician burnout

LAS VEGAS — Physicians can reclaim the joy in their practice and apply strategies to mitigate their risk of burnout, according to an expert here at the Clinician Wellness Preconference at the Cardiometabolic Risk Summit.

Lislotte N. Dyrbye, MD, MHPE, FACP, from the Mayo Clinic, explained that excessive workload, work inefficiency, flexibility, work-life integration and meaning in work are key drivers of physician burnout. She asked physicians to consider whether they could modify aspects of their behavior to decrease their risk for distress.

"We want not only the absence of burnout, but the presence of high quality of life," she said. "That's what the World Health Organization defines as optimal health. It's more than the absence of disease — it's the presence of wellness."

She listed eight strategies for physicians looking for individual coping and wellness tips to combat burnout.

1. Optimize meaning in work

"Meaning in work is critical to long-term satisfaction," Dyrbye said. Whether it's being a healer, expert, teacher of the next generation, building a practice, advancing research... of all those things you do, which do you find the most meaningful?"

Dyrbye encouraged physicians to think about which work activity was most meaningful to them and what percentage of their time is spent doing that activity. She noted that physicians who spend less than 20% of their time on meaningful activity are at higher risk of burnout.

2. Avoid overcommitment

To achieve a work-life balance, say 'yes' with intention, Dyrbye said. Consider 'what's meaningful to me?'

She recommended identifying both personal and professional values and goals, which will help guide decisions.

3. Reduce work-home conflicts

Dyrbye urged physicians to think back to the last time they dealt with a work-life conflict. Was it solved in favor of work, in favor of home, or were both responsibilities met?

She noted that physicians who tend to side in favor of work experienced higher rates of burnout.

"What contributes to your work-life balance?" Dyrbye asked. "Workload? Lack of workplace flexibility? Factors outside your control? Poor planning?"

She stressed the importance of devising strategies that meet both responsibilities and suggested reaching out to other physicians to see how they handle work-life conflicts.

4. Take vacation

Dyrbye, joking that many physicians fail to take all of their allotted vacation days, said that it is an essential strategy that substantially reduces burnout.

"People who feel good and function well are less likely to develop mental health problems," she said. "By having these experiences, by taking your vacation, that's actually a very practical approach to maintaining your well-being."

5. Exercise

Dyrbye reported that individuals who followed the CDC guidelines for exercise were less likely to have burnout and more likely to have a high quality of life.

Those guidelines, she said, consist of 150 minutes per week of moderately intense exercise or 75 minutes of vigorous exercise in addition to strength training each major muscle group at least twice per week.

6. Build relationships

"Nurturing relationships leads to a greater quality of life," Dyrbye said. "Social support builds resiliency."

She suggested building relationships both at work and at home, even with something as simple as sending thank you notes to those who have given their support or help.

7. Avoid delayed gratification

Consider what activity you enjoy outside of work, Dyrbye said. What steps can you take to add that activity to your life?

8. Reduce hours

She ended with a recommendation for the reduction of full-time equivalency. It can affect your salary and the number of patients you see, Dyrbye said, but it does help.

Dyrbye acknowledged that it can be difficult to incorporate all eight strategies.

She concluded: "If you can't do all eight, pick one that would have an impact." – by Chelsea Frajerman Pardes

Disclosures: Dyrbye reported financial or material support from CWS, Inc. Licensed technology.

Reference:

Dyrbye LN. Presented at: Cardiometabolic Risk Summit Fall Pre-Conference; Oct. 13, 2016; Las Vegas.