ASH Clinical News ACN_4.13_full issue_Web | Page 58

Physician Burnout
environments, and allowing physicians to better care for
themselves and their patients.
A primary goal of the initiative is to give physicians
more control over their work environments. In 2015, the
group published guidelines for how to integrate physi-
cians into the decision-making process with administra-
tive leadership of hospitals and health systems. 15 “There’s
a huge degree of separation between who makes deci-
sions and the people that are practicing medicine. The
culture is top-down,” said Dr. Singavi.
clinician well-being and resilience. Accessed September 26, 2018, from https://nam.edu/
journey-construct-encompassing-conceptual-model/.
7. Fox S, Lydon S, Byrne D, et al. A systematic review of interventions to foster physician resil-
ience. Postgrad Med J. 2018;94:162-70.
8. Thomas L, Harry E, Quirk R, et al. Evidence-based interventions for medical student, trainee
and practicing physician wellbeing: a CHARM annotated bibliography. November 2017.
9. National Academy of Medicine. Action Collaborative on Clinician Well-Being and
Resilience. Accessed September 26, 2018, from https://nam.edu/initiatives/
clinician-resilience-and-well-being/.
10. Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: primary care physician
workload assessment using EHR event log data and time-motion observations. Ann Fam
Med. 2017;15:419-26.
11. Addesso LC, Nimmer M, Visotcky A, et al. Impact of medical scribes on provider efficiency in
the pediatric emergency department. Acad Emerg Med. 2018 August 1. [Epub ahead of print]
12. The Schwartz Center. “Schwartz Rounds.” Accessed September
26, 2018, from http://www.theschwartzcenter.org/
supporting-caregivers/.
13. Dyrbye LN, West CP, Sinsky CA, et al. Medical licensure questions
and physician reluctance to seek care for mental health conditions.
Mayo Clin Proc. 2017;92:1486-93.
14. American Medical Association press release. “AMA Adopts Policy
to Improve Physician Access to Mental Health Care.” Accessed
September 26, 2018, from https://www.ama-assn.org/ama-
adopts-policy-improve-physician-access-mental-health-care-0.
15. American Medical Association press release. “AHA and AMA Offer
New Guiding Principles on Integrated Leadership.” Accessed
September 26, 2018, from https://www.ama-assn.org/
aha-and-ama-offer-new-guiding-principles-integrated-leadership.
A Values-Based Approach
Dr. Shanafelt called the work being
done at the national level “exciting,”
but he also stressed the importance
of individualizing organizational
approaches. In his work at Stanford,
his team has looked at the factors
contributing to burnout within the
entire organization, as well as iden-
tifying specific issues it can tackle in
each department.
Different departments may
require different approaches. “For
example, bone marrow transplant
physicians do not have the same
challenges that radiologists have, or
that family medicine doctors have,
or that oncologic surgeons have,” he
said. “Although some policy changes
will benefit all of those groups, like
those top-of-the-house decisions,
there are other things that we need
to understand about the specific
challenges that the bone marrow
transplant physician is dealing with
in that local unit.”
Physician burnout has been
a problem for decades. It’s been
getting progressively worse, but as
physicians and stakeholders team
up to combat its causes, doctors and
patients finally have reasons to be
optimistic.
“Physicians have to play a role
in reorganizing care by reasserting
the values that are important to us
and looking at new ways to create
opportunities to address them,” said
Dr. Lown. “Let’s focus on the values
of our profession. Let’s put connec-
tion, relationship, patient care, and
service back at the center in a way
that’s meaningful to the people who
are providing it.”
—By Emma Yasinski ●
REFERENCES
1. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and
self-reported patient care in an internal medicine residency
program. Ann Intern Med. 2002;136:358-67.
2. Maslach C, Jackson SE. The measurement of experienced
burnout. J Organ Behav. 1981;2:99-113.
3. T’Sarumi OO, Ashraf A, Tanwar D, Hicks A. Physician suicide:
a silent epidemic. Abstract 227. Presented at the 2018
American Psychiatric Association Annual Meeting, May 5,
2018; New York, NY.
4. Epstein RM, Krasner MS. Physician resilience: what it
means, why it matters, and how to promote it. Acad Med.
2013;88:301-3.
5. American Medical Association. “Improving Physician
Resiliency.” Accessed September 26, 2018,
from https://www.stepsforward.org/modules/
improving-physician-resilience.
6. Brigham T, Barden C, Dopp AL, et al. A journey to construct
an all-encompassing conceptual model of factors affecting
56
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