Eric Chung, MS2, FIU Herbert Wertheim College of Medicine

Special thank you to Dr. James Benenati (Miami Cardiac and Vascular Institute), Dr. Ripal Gandhi Ripal (Miami Cardiac and Vascular Institute), and Dr. Eduardo Franca (Intellirad Imaging) who kindly offered their time and wisdom for this article.

It is common for students and residents to experience “burnout” during medical training.  Burnout is a constellation of symptoms such as depersonalization, exhaustion, and a lack of control. It can be highly detrimental to work productivity, and can ultimately impact the well-being of patients.

In a recent Medscape survey, physicians from 27 specialties were polled to grade the severity of their burnout. Topping the list was emergency medicine with nearly 60% of physicians reporting feeling burnt out. Diagnostic radiology ranked 18th with nearly 50% of DR physicians reporting burnout. While there were no respondents in the field of IR, one would expect the prevalence of burnout in IR to be similar to that in DR or perhaps even higher. Ultimately, the survey showed an increasing prevalence of burnout in all specialties since 2013.

The increase in burnout is often attributed to work-related stressors, excessive responsibilities, work-life imbalances, and a lack of social support. We interviewed IR physicians to get a sense of their well-being.

Have you ever felt burned out? If so, how did you overcome this? Attendings generally reported mixed incidences regarding burnout throughout their careers. However, in Dr. Benenati’s experience: burnout is often felt after a hard weekend call when you must work the next week without any significant break.  This was not an issue until the past few years but as one gets older, although there is still enthusiasm for work, the endurance becomes an issue with the long hours and lack time off after call.” It is apparent that burnout is not an acute problem in its timing, but rather the culmination of long-term wear. Dr. Benenati added: I’ve overcome this [burnout] with mindfulness activities such as meditation, stretching and yoga and with exercise.” While burnout may unfortunately be a consequence of high stress and a lack of work-life balance, appropriate treatment is essential to improve mental well-being. The definition of wellness may vary from individual to individual, so it is important to identify what wellness means to you. Strategies for improving personal well-being may include exercise, a healthy diet, adequate sleep, vacation time, and re-evaluating personal goals. These health maintenance techniques are important for enhancing overall quality of life. It is critical that we, as physicians and physicians-in-training, practice the healthy lifestyle that we preach to our patients.

Are there aspects of IR that you believe contributes to physician burnout quicker than in DR and other specialties? Call is what largely contributes to physician burnout, especially those in busy practices or within a hospital. Physicians who work in a hospital setting often feel a lack of independence. Dr. Eduardo Franca expressed: “There is no doubt that the call burden is the most taxing part of my job. Our group has a pretty good IR/DR call balance, but our DR guys do not fully grasp the stress related to a 2am phone call about a GI bleeder.” Additionally, the wide-scope of services that IR provides may result in feeling that they are being “dumped” on. Lastly, wearing lead for extended periods on a daily basis can be physically demanding and result in fatigue.

How have physicians changed their IR and DR practice ratios to combat burnout? Dr. Ripal Ghandi suggested that the flexibility is based on practice type: One can choose a practice depending on the type of practice they desire.  If one desires 100% or predominantly IR practice, this is certainly feasible, especially in the academic setting, VA, and large private groups.  On the other hand, in many smaller private groups, it is expected that physicians do both IR and DR.  The breakdown of IR versus DR can be modified and one can try to choose a group which suits their needs.” This is variable and dependent on the physician’s specific practice and personal preferences. In the academic setting or large private groups, it can be expected for physicians to practice entirely on IR. On the other hand, smaller private groups require physicians to be diagnosticians as well as interventionalists. As a result, there is usually less flexibility.

These perspectives from practicing IR physicians can help individuals make more informed decisions about specialty and work-life balance. However, the healthcare system must also address the problem of physician burnout, especially given the current physician shortage and increased demand for healthcare access. First, leaders must assess their organization’s current state: are their physicians burned out? What are the main causes of burnout at their institution? Leaders can then implement methods for intervention. As the decreased workload, increased time off, mandatory mental-health wellness sessions, and meditation have all been shown to decrease stress. Enacting these changes may not only benefit the well-being of physicians but our patients as well.

 

References:

  1. Parks, T. (2017, February 03). Report reveals severity of burnout by specialty. Retrieved October 18, 2017, from https://wire.ama-assn.org/life-career/report-reveals-severity-burnout-specialty
  2. Peckham, C., & Grisham, S. (2017, January 11). Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and Burnout. Retrieved October 18, 2017, from https://www.medscape.com/features/slideshow/lifestyle/2017/overview
  3. Swensen, S., Shanafelt, T., & Mohta, N. S. (2016, December 8). Why Physician Burnout Is Endemic & How Health Care Must Respond. Retrieved October 18, 2017, from
  4. Krisberg, K. (2016, September 15). Medical School Burnout. Retrieved October 18, 2017, from https://news.aamc.org/medical-education/article/medical-school-burnout/
  5. Know the Signs of Job Burnout. (2015, September 17). Retrieved October 18, 2017, from http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642

 

 

Physician Contacts:

Dr. James Benenati JamesB@baptisthealth.net

Dr. Ripal Gandhi Ripal gandhi@baptisthealth.net

Dr. Eduardo Franca efranca@intelliradimaging.com

Categories: Med Student Section