Combatting Burnout: Rx for Healthcare Professionals

By Robert Graham

I became a doctor to help people and to reduce their suffering. Not to see how many patients I could possibly squeeze into one day to “maximize my productivity.” Over 10 years as an integrative medicine physician, I’ve been keenly aware of the effects of stress, burnout, anxiety and depression among my patients, and I have taught and prescribed meditation, yoga and other stress reduction techniques to them.

During the past five years, I have witnessed a big problem in this country with our healthcare providers, nurses and doctors. Actually, we have an epidemic occurring in medicine. No, not cancer, not obesity, not Zika... but physician suicide and burnout.  

Nearly 500 doctors commit suicide each year. That’s double the rate of the population average. It is a silent epidemic, yet, we in the “halls of medicine” see it, hear it and feel it every day. But why don’t our patients and the public know how we’re suffering? No one seems to be talking about it.

The Mayo Clinic found that 54% of doctors reported that they felt burned out in 2014 - that number was 46% in 2011. In fact, all healthcare professionals exhibit high rates of burnout. The Physicians Foundation Survey reported 58% of physicians are unwilling to recommend healthcare as a profession to their kids/peers, and over 60% would retire today if they had the ability to do so.

Recently, Surgeon General, Dr. Vivek Murthy expressed his deep concern stating, “If physicians aren't happy, they can't heal others.”

Thankfully, doctors are resilient (we can handle almost anything), but the facts are deeply troublesome. Burned out healthcare workers are at higher risk for substance abuse and unethical behaviors. They tend to make more errors and lose their sense of empathy - something called “compassion fatigue.” They leave clinical practice due in part to emotional exhaustion, cynicism, hostility and negative self-evaluation. For over a decade, unrelenting job pressures, heightened by recent administrative and official mandates, cause doctors (and nurses) to experience the emotional, mental and physical exhaustion characteristic of burnout.

“As I think about the emotional well-being for our country, I am particularly interested in how to cultivate emotional well-being for healthcare providers. If healthcare providers aren't well, it's hard for them to heal the people for whom they are caring." says Dr. Murthy. I couldn’t agree more.

Unfortunately little is known about treating burnout. However, promising research points to mindfulness, the ability to be fully present and attentive in the moment, as a possible remedy. A few studies indicate that mindfulness training can help doctors become more focused, more empathetic and less emotionally exhausted. They may even feel more satisfied with their jobs.

For many doctors, it’s not the lack of interest that prevents them from incorporating mindfulness into their clinical practices; it’s the time required to complete a standard training.  While more work needs to be done, a growing body of research supporting mindfulness training as a way to improve the health of both healthcare providers and their patients.

Mindfulness training is one type of fix. The bigger question is to make sure that hospitals and other healthcare environments create better conditions for a happier workforce, including both doctors and patients.

So how do you grow a more mindful healthcare organization? Sometimes it starts with just a single seed. Whether in the boardroom or the operating room, stress is a plague on business and medicine alike.

In the past five years, my wife Julie, a yoga, meditation and positive psychology teacher and I have brought mindfulness into a large healthcare organization through multiple avenues. These include a rooftop garden, yoga classes, stress reduction classes, cooking classes, “mindful minutes” in the operating room, and a research study among doctors – all aimed at demonstrating the intrinsic benefits of mindfulness practices on self care.

These initiatives have set the groundwork for future research into the potential for mindfulness to increase empathy, reduce errors, increase patient satisfaction and provide better patient care. This comprehensive approach may provide much needed relief from stress and anxiety, while campaigning for systemic changes.

Things have to change. Sadly, little emphasis has been placed on clinicians’ well-being, and institutions are just beginning to recognize the impact of burnout on patient care and institutional expenses. In an era when many physicians suffer professional burnout, a mindful practice may be the way physicians can heal themselves — and their patients.

Understanding the complexities of physician burnout, patient care outcomes, clinician retention and institutional costs will help healthcare organizations develop programs that improve work satisfaction, quality of life and patient care within this demanding profession.

I'm not sure what's best, and maybe one size does not fit all, but it's time to build a safety net so that we can keep our workforce functioning well. We need our physicians at their best to reduce mistakes, not feel indifferent to patients and certainly not harm themselves. It’s just as important as any other aspect of workplace safety: We must care for ourselves first. You can’t pour from an empty cup. We need a FRESH start. Maybe mindfulness can pave that path.

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Posted by Robert Graham- 20 July, 2018


Dr. Graham, MD, MPH, ABOIM, FACP is Board Certified in Internal and Integrative Medicine. He completed his medical degree from the School of Medicine at Stony Brook and his residency in Internal Medicine at Lenox Hill Hospital. Dr. Graham received a MPH from the Harvard School of Public Health and completed 3 fellowships in General Internal Medicine, Integrative Medicine and Medical Education at Harvard Medical School. He is the former Director of Integrative Health and Wellness at Northwell Health. His integrative medicine practice FRESHMedNYC focuses on Food, Relaxation, Exercise, Sleep and Happiness, that’s F.R.E.S.H. Dr. Graham, MD, MPH, ABOIM, FACP is Board Certified in Internal and Integrative Medicine. He completed his medical degree from the School of Medicine at Stony Brook and his residency in Internal Medicine at Lenox Hill Hospital. Dr. Graham received a MPH from the Harvard School of Public Health and completed 3 fellowships in General Internal Medicine, Integrative Medicine and Medical Education at Harvard Medical School. He is the former Director of Integrative Health and Wellness at Northwell Health. His integrative medicine practice FRESHMedNYC focuses on Food, Relaxation, Exercise, Sleep and Happiness, that’s F.R.E.S.H. Dr. Graham is a guest writer for the Whil Blog.