Elements Leading to Physician Burnout (Part 2)

Physician work-related stress is a significant problem.^1–3 U.S. physicians report higher than normal burnout rates⁷and increased health problems, including alcohol use problems,^5,6 excess weight,^7,8 poor sleep,⁹ less exercise,^8, and low career satisfaction.¹⁰ Physicians experience the burnout triad of:

Emotional exhaustion (and depression) – discussed in Part 1 of this series
Interpersonal disengagement (Depersonalization) – Part 2
Low sense of personal accomplishment¹¹ – discussed in Part 3 of this series

Interpersonal Disengagement (Depersonalization)

Interpersonal disengagement involves distancing from other people. Healthcare providers may express it as decreased empathy or compassion with patients, which is a problem because the bond with patients impacts the accuracy of diagnosis and treatment choices, as well as the overall success of clinical interventions from the intangible benefit of human connection.³⁰^–32 It may involve isolating from peers, which is problematic because medicine is a uniquely interactional profession that depends on discussions with peers for clinical guidance and support. We thus identify interpersonal disengagement as the most critical element to assess and impact.

Decreased contact with peers and distancing from patients leads to increased feelings of isolation³³^–35 and unrewarding interactions with patients. As seen in COVID-19 and the rest of medicine, the desire to heal is strong, and that desire ebbs as patient interactions become less effective and rewarding.

It is essential to catch interpersonal disengagement at an early stage. However, the busy nature of medical practice hinders detection by peers. Separation from peers, too, hinders the ability of peers to recognize this downward spiral. Patients are unlikely to call out a physician who appears aloof or distracted and may assume that the doctor is merely having a tough day.

The pandemic has worsened preexisting problems with patient interaction due to safety precautions and treatments.³⁶ Healthcare providers who use detachment to cope with overwhelming emotions about patient suffering, frustration over limited treatments, and high mortality experience an increased impact on patient rapport.³⁷ Alienation from family caused by bringing homework (such as documentation) impinged on shared time together before the pandemic. The pandemic magnified this alienation due to precautions taken to protect loved ones from catching the COVID-19 virus.³⁸

In Part 3 of this series, we will discuss a changing sense of personal accomplishment and regret.

How can Lift help?

While interpersonal disengagement, or depersonalization, is part of the burnout triad, we reject the view that these terms are crushing weights that you cannot handle or that you must build up a barrier in defense. This element of burnout is not out of your control. At Clinical Tools, we propose solutions that lift health care providers up, empower them, and build upon their existing strengths, talents, and experience. Start with who you are, lift yourself, your colleagues, and the healthcare profession up.

References