Self-Care for Healthcare Providers

Alisa Burpee, PhD

September 2019

Disclosures

• Alisa Burpee maintains a private practice in Seattle, WA. She does not have any financial relationships with commercial interests.

Learning Objectives

• Define burnout and prevalence rates

• Identify warning signs and symptoms of burnout

• Create a self-care regimen that can be implemented to promote wellness and sustainability

What did you learn about the potential for burnout and how to care for yourself as a

physician?

Burnout and Compassion Fatigue

• What is it?

• Physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding or stressful situations

• Disillusionment and negative feelings

• Loss of sense of meaningful work

• Reduced sense of accomplishment

• Skepticism and distrust

How common is burnout in physicians?

• According to several studies, approximately 50% of American doctors exhibit signs of burnout (an increase of about 10% since 2011)

• Satisfaction with work-life balance also declined between 2011 and 2014

• Possible consequences include:

• negative effects on patient care

• professionalism

• physicians' own care and safety

• viability of health-care systems

Early signs

• Illness: frequent colds, headaches, fatigue

• Reduced tolerance to pain or patient contact

• Lowered resilience, moodiness

• Sleep disturbance

• Escape fantasies

• Taking work home

• Self-esteem tied to patient outcomes

• Less empathy

• Hopelessness, pessimism, dread

• Detachment from patients perceived as draining

• Disregard for professional boundaries or ethics

• Job dissatisfaction and reduced performance

Contributing factors

• Healthcare reform

• Inadequate reimbursement

• Patient volume

• Insufficient time with patients

• Electronic medical records

• Time spent on administrative tasks

• Ineffective technology

• Stress of higher status

• Perfectionism and ambition

Ways to practice self-care

• Relax and recharge

• Solitude or social support

• Regular exercise, good nutrition, adequate opportunity to sleep

• Create a life outside your work

• Hobbies, friendships, loved ones, creativity, spirituality

• Boundaries

• Work reasonable hours

• Be present at both work and play

• Consult

• Therapy

• Increase self-understanding and development, relieve stress

Mindful Self-Compassion

• A growing body of evidence suggests that even brief mindfulness and self-compassion-based skills training can significantly reduce burnout rates

Exercise

Self-Compassion in Daily Life

Discussion & Questions

References• Cass & Duska. (Feb 2016). Why are OBGYNS burning out? Contemporary OB/GYN, Modern Medicine Network. Retrieved from:

https://www.contemporaryobgyn.net/obstetrics-gynecology-womens-health/why-are-obgyns-burning-out

• Germer & Neff. (2019). The mindful self-compassion program. Retrieved from: https://self-compassion.org/the-program/• Grace, M. K., & VanHeuvelen, J. S. (2019). Occupational variation in burnout among medical staff: Evidence for the stress of higher

status. Social Science & Medicine, 232, 199–208. https://doi-org.ezproxy.spu.edu/10.1016/j.socscimed.2019.05.007

• Neff, Kristin. (2019). Self-compassion. Retrieved from: https://self-compassion.org/.• Nguyen, M. C., Gabbe, S. G., Kemper, K. J., Mahan, J. D., Cheavens, J. S., & Moffatt-Bruce, S. D. (2019). Training on mind-body skills:

Feasibility and effects on physician mindfulness, compassion, and associated effects on stress, burnout, and clinical outcomes. The Journal of Positive Psychology. https://doi-org.ezproxy.spu.edu/10.1080/17439760.2019.1578892

• Manzella, Christiane. (2019). Maternal mental health intensive online: Perinatal mood and anxiety disorders. Online Training. Seleni.org/maternal mental health training.

• Marchalik, Daniel. (June 2019). Why are so many doctors burning out? Washington Post. Retrieved from https://www.washingtonpost.com/health/why-are-so-many-doctors-burning-out-tons-of-real-and-electronic-paperwork/2019/05/31/3335ca78-346c-11e9-af5b-b51b7ff322e9_story.html

• McGuire, Tona; Prince, Stacey; & Wash, Heidi. “Sustaining Ourselves: A Discussion for Early Career Psychologists to Develop and Maintain Long and Fulfilling Careers.” WSPA Early Career Psychologist Panel Discussion, 23 February 2108, Plaza 600, Seattle, WA.

• Rothenberger, D. (June 2017). Physician burnout and well-being. A systematic review and framework for action. Diseases of the Colon & Rectum. 60(6):567–576, DOI: 10.1097/DCR.0000000000000844

• Shanafelt et al. (Dec 2015). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proceedings, 90(12):1600-13. doi: 10.1016/j.mayocp.2015.08.023

• West, Dyrbye, Erwin, & Shanafelt. (Nov 2016). Intervention to prevent and reduce physician burnout: A systematic review and meta-analysis. Lancet, 388, (10057). doi: 10.1016/S0140-6736(16)31279-X