In mechanical terms, “burnout” describes a reduction in operating efficiency or failure of machinery caused by physical stress or insufficient fuel. A similar situation occurs when a human is placed in a highly responsible role and subjected to work-related emotional stressors. In the case of radiologists and technologists, healthcare information systems that do not adequately support the medical team may contribute to burnout and hamper productivity. Improved technology applied with compassion could be the mechanic that gets the equipment of our healthcare system running smoothly again.
How big is the burnout problem?
The World Health Organization (WHO) recognizes burnout as an occupational phenomenon, defining it as:
"Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. Three dimensions characterize it:
- feelings of energy depletion or exhaustion;
- increased mental distance from one's job, or feelings of negativism or cynicism related to one's career; and
- reduced professional efficacy.
Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”1
A 2019 survey indicated that only 25% of radiologists are happy at work, with 45% reporting that they are burned out.2 The concern surrounding burnout is humanitarian on two levels – compassion for the well-being of affected medical professionals and the impact of burnout on the risk of medical errors and patient experience.
The impact of burnout
Radiologists who experience burnout on the job attribute it to:2
- too much time spent in the workplace
- general lack of respect from colleagues and administrators
- feeling unnecessary and unappreciated
- no sense of control over demands of the position
While more than half of radiologists who report being burned out believe it has no effect on the patients,3 there is still a downside. Burnout can cause errors, carelessness when documenting patient notes, and a sense of exasperation and frustration about patients.3 These sentiments are not directed at patients alone, however. Radiologists also report their relationship with staff suffers.
Acknowledging a problem with burnout is rare for most doctors, let alone seeking treatment. A staggering 67% of radiologists do not seek professional help for their burnout symptoms, rather attribute it to nothing other than general physician malaise affecting all medical personnel.2 Left untreated, burnout can lead to a darker place where as many as 10% of radiologists have suicidal thoughts.2
Stacey Funt, MD, a former full-time radiologist, provides a first-hand account of the workplace stress those in her profession subject themselves to: "I was once quite sick, but we were very short-staffed, so I went to work and read films [while] hooked up to an IV. And no one around me thought that was odd."3
Ms. Funt, and fellow burnout colleagues, likely experienced these common symptoms as outlined in the Maslach Burnout Inventory:3
- emotional exhaustion
- depersonalization
- reduced sense of personal accomplishment
How can burnout be combated?
Dr. Bryan Bohman states, "It is imperative to change the culture. Physicians, by nature, will make that superhuman effort to provide outstanding patient care, regardless of obstacles, but it can take a toll."3
Bohman advocates for and encourages administrators to let radiologists know they have their support. Like any other employee, they need their work to be recognized, and they need help in removing obstacles that make their work more difficult. Bohman suggests encouraging radiologists to get out of the workplace and focus on activities they enjoy.3
Administrators can also help remove the taboo that still surrounds mental health issues in the workplace, according to Dr. Claire Bender of the Mayo Clinic.4 “Many physicians won’t even admit in a survey when they’re depressed because it may come back to haunt them by limiting career advancement,” she remarks.
Radiologists must take heed and manage their own stress in order to thwart the ill effects of burnout.4
- Practice self-care: simply take care of themselves, eat well, exercise, and get adequate sleep
- Don’t suffer in silence: reach out to colleagues who appear to be suffering from burnout
- Seek professional help: the effects of burnout can ultimately result in suicidal thoughts. Talk to a therapist before symptoms become life-threatening
What it will take to oil medical system machinery
A National Academies of Sciences, Engineering, and Medicine committee outlined six actionable objectives, to address clinician burnout, taking a structural/organizational approach, rather than focusing on the individual. These steps involve:5
- Tackle issues early in the education and career path, through scholarships, access to affordable loans, and workload supervision.
- Create positive work environments where burnout levels are effectively monitored, and the well-being of the radiology team is a priority.
- Reduce burnout stigma with policies that protect the personal health information of radiologists and technologists, and encourage greater use of resources such as mental health services and employee assistance programs.
- Place constraints on administrative burdens imposed by policies, regulations, and laws.
- Coordinate efforts to research system-level strategies.
- Improve technology solutions – usability, relevance, and flow of information.
When the machinery of a car breaks down, it leaves people stranded and inconvenienced. When a radiologist faces burnout, the consequences for countless patients depending on the doctor's expertise can be much more severe. Technological solutions that integrate seamlessly into collaborative workflows will increase efficiency, enhance the quality of care, and help radiology teams re-discover their passion for the practice.
References:
- Burnout an "occupational phenomenon": International Classification of Diseases. World Health Organization. https://www.who.int/mental_health/evidence/burnout/en/ October 28, 2019.
- Medscape Radiologist Lifestyle, Happiness & Burnout Report 2019. https://www.medscape.com/slideshow/2019-lifestyle-radiologist-6011151. October 28, 2019.
- Slow Burn. https://www.radiologytoday.net/archive/rt419p24.shtml. Vol. 20 No. 4 P. 24
- Battling Burnout and Its Consequences. https://acrbulleting.org/topics/practice-management/1032-tackling-radiology-burnout. Undated
- To Ensure High-Quality Patient Care, the Health Care System Must Address Clinician Burnout Tied to Work and Learning Environments, Administrative Requirements. The National Academies of Sciences, Engineering, Medicine. http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25521. October 28, 2019.
