Diane W. Shannon, MD, MPH, is a former primary care physician with more than 20 years of experience as a professional health care writer and author, including collaborating with me as co-author of our book, Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Her impressive skill at research and writing were key to the quality of final product. While she continues to advocate for needed system change through her writing, her focus has expanded to include helping individual physicians.
Dr. Shannon’s primary work now is as a coach for physicians who are struggling with burnout, serving primarily women physicians. Through coaching, she helps physicians create workable lives so they can show up as their best selves at home and at work. At the upcoming Healthcare Burnout Symposium, she will present a session titled, “Addressing Burnout among Women in Healthcare: Why, What, and How”. Recognizing that women in healthcare experience higher rates of burnout than their male colleagues, she will help participants to:
expand their understanding of the specific challenges that women in healthcare face,
identify specific supportive actions steps to implement in their organizations, and
learn practices to improve their own wellbeing.
A Growing Intensity of Burnout
I asked Dr. Shannon what she is seeing in her coaching practice these days as the waves of the pandemic continue to batter the health care workforce. She painted a concerning picture, noting that in the past six months the intensity of burnout in her clients in accelerating as they find that the job is becoming nearly impossible.
While her clients still love the actual patient care, they describe their reality with a sense of desperation, with statements like, “I have no idea how to do this anymore. I can’t close my charts. My inbox has taken over my live. I need to get out.”
Factors Driving the Worsening Burnout Epidemic
Dr. Shannon sees intrinsic and extrinsic factors driving this. The intrinsic factors haven’t changed, they’ve just become more of a challenge as the extrinsic factors grow in number and severity.
She finds a combination of perfectionism and self-doubt as the intrinsic factors in many of her clients. Physicians are in some ways preselected for perfectionism, without which it would be hard for anyone to get into and through medical school.
Self-doubt in physicians likely has at least two root causes:
medical students and residents are often told, either directly or indirectly, that they are not good enough, often driven by academic medicine’s culture that intimidates students into thinking they will never be good enough to care for patients flawlessly; these messages can trigger imposter syndrome
additionally for physicians of diverse backgrounds, they receive subtle, and at times not-so-subtle, messages that they are in an environment where they don’t “really” belong.
Worsening Extrinsic Factors – More than Just the Pandemic
The extrinsic factors have been changing over the past twenty years and have accelerated during the pandemic. These include:
greater demands to do more with less, increased pressure for productivity while reducing support staff and other resources
expectations to adapt to major changes such as rapid conversion to telemedicine without adequate training
a change to Open Notes in which patients now have access to their lab results before their physicians, which for non-significant abnormal findings leads anxious patients to call or email the physician before the physician is able to send the patient a reassuring message
antagonistic encounters with patients who are anti-vaccines and/or anti-masks
The Leadership Perspective
Most of Dr. Shannon’s clients are physicians directly caring for patients. In discussing the organizations in which they work, many express a prevailing sense that healthcare leaders, particularly non-clinicians in the C-suite, either don’t understand the physicians’ challenges, or worse, they don’t care.
One client was told recently that the system would no longer fund her scribe, and she had two weeks (during the end-of-year holidays) to decide whether to pay for it herself or discontinue the service. She was not given an easy way to determine what the additional personal expense would be.
Not all systems are as uncaring. One healthcare system in New England funded a 2-month women’s support group that Dr. Shannon facilitated. The doctors who participated found it highly valuable as a place they could come together, develop connection, share strategies and tips, and feel validated.
To Learn More
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