Expert Commentary

ObGyn burnout: ACOG takes aim

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Being mindful of wellness strategies and practice efficiencies can help ObGyns avoid burnout’s deleterious effects—and thrive both personally and professionally. Read on for expert advice and proactive strategies for your practice.

In this Article

  • Developing outside passions
  • Thomas Gellhaus, MD, encourages mentorship
  • 7 steps to prevent burnout


 

References

Physician burnout is a serious issue, especially in the often high-pressure world of obstetrics and gynecology. In the July 2016 issue of OBG Management, we briefly looked at studies showing that 1) ObGyns experience high rates of burnout, 2) rates of burnout are increasing over time, and 3) women, the majority gender in ObGyn, experience higher rates of burnout than their male counterparts. Between 2011 and 2014, rates of physician burnout increased from 45.5% to 54.4%.1 In 2016, 51% of ObGyns reported experiencing burnout, with women reporting a rate of 55% compared with 46% for men.2

Numerous studies show that burnout is associated with increased likelihood of physician suicide, decisions to leave the practice of medicine, and poorer health, including obesity. These statistics ring alarm bells that we cannot ignore, especially as they may signal real concern for patient care.

The top causes of physician burnout, according to a Medscape survey, are2:

  • too many bureaucratic tasks
  • spending too many hours at work
  • increasing computerization of practice
  • income not high enough.

Physician burnout is not a one-size-fits-all condition. Not everyone experiences it similarly. Likewise, there are many strategies you can use to prevent and overcome burnout.

Experts offer guidance on preventing burnout

The 3 ObGyn leaders profiled in this article offer insight, inspiration, and opportunities to help you regain the joy of practice. The American Medical Association (AMA) also offers an online practice-based initiative that includes strategies to help improve professional satisfaction.

Take burnout by the horns
As Assistant Dean for Graduate Medical Education and Professor of Clinical Biologic Sciences, Charles E. Schmidt College of Medicine, at Florida Atlantic University in Boca Raton, Florida, Roger P. Smith, MD, has developed an authoritative focus on the symptoms and effects of physician burnout. Recently, Dr. Smith taught a clinical seminar titled “Burnout: A constant threat” at the American College of Obstetricians and Gynecologists (ACOG) 2016 Annual Clinical and Scientific Meeting in Washington, DC, where he reviewed the causes and symptoms of burnout as well as strategies to minimize and avoid it. His work shows that burnout is pervasive and is becoming more so. Dr. Smith indicates that burnout is not any more common to one part of the country or one type of ObGyn care than any other, although it is becoming more commonly recognized among younger physicians.

As with other nonphysical ailments, symptoms of burnout may have affected ObGyns over many generations—symptoms that people did not discuss with their families or colleagues or that were easily dismissed.

Dr. Smith is opening the door for unreserved conversations about burnout in the physician community. He suggests ways for practices to focus on physician wellness and for individual ObGyns to recognize and take steps to overcome burnout signs. To hear Dr. Smith’s expert discussion on burnout, tune in to his audio interview, “Is burnout on the rise and what are the signs ObGyns should be on the lookout for?

Develop a passion outside of medicine
Jeffrey M. Rothenberg, MD, MS, experienced serious burnout in 1997 after 3 infants in his high-risk obstetrical unit died in the same week. Like many ObGyns, he tries to not bring work-related issues home, but that week Dr. Rothenberg’s wife Joani, an accomplished art therapist, recognized her husband’s anguish. Soon, she enrolled him in a glass-blowing class to give him a needed break from the pressures of his practice. Dr. Rothenberg’s life was transformed. “Initially it was an escape,” he says about his venture into the art world. “Unlike the OR or in labor and delivery, no one could get hurt but me; it wasn’t life and death—it was something outside of what I do for a living and allowed me to disconnect from my chosen profession—if even for a little bit.”

Still a practicing ObGyn and currently the Designated Institutional Official at St. Vincent in Indianapolis, Dr. Rothenberg is now an accomplished glass artist with his work in public and private collections around the world. Because he feels so passionately that physicians should have a creative outlet, he helps medical students discover their own forms of self-expression through the Creative Arts Therapy Student Interest Group in the Office of Medical Student Service-Learning at Indiana University, where he serves as a mentor. There, he teaches medical students the importance of taking care of themselves as well as their patients. Dr. Rothenberg has made integrating the arts and humanities an integral part of the Indiana University School of Medicine curricula, and he helped establish the Visual Thinking Strategy program, which teaches nursing and medical students better communication skills using the power of observation gained through the arts. In honor of this work, Dr. Rothenberg received a 2015 Arnold P. Gold Foundation Humanism in Medicine Award.

For Dr. Rothenberg, glass has been the perfect medium. “It’s a very tactile art form, and I like doing things with my hands, as a surgeon—there’s a real affinity there—taking materials that are dangerous to touch and coaxing them into forms and shapes that are either artistic or functional is a challenge—but definitely stress reducing,” he says. He also found striking similarities between the operating room and the glass studio, which both involve teamwork, good communication skills, and repetition.

“I think that every healer needs an avocation in addition to his or her chosen vocation. Especially in medicine, both for patients and healers, we all deal with some amazingly complex and difficult situations—often at the intersection of life and death—that go beyond verbalizing and may have no right or wrong answer—just a bad and a worse choice. Given that backdrop, having another way to express yourself or an avenue for a kind of emotional catharsis... is very, very helpful. I think it’s important for our learners, in particular, to embrace the humanistic side of medicine. After all, medicine is so much more than just a science. It’s more of an art, and I think they can really bond with both patients and other providers alike if they have something else in common—something that they can talk about that is outside of medicine. We have very stressful jobs and we need to model to our trainees and to each other that it is important to take care of ourselves. It’s important for a healer to have a passion, a creative outlet,” he explains.

Dr. Rothenberg uses the art of glass works to provide a “needed break” from his practice pressures.

“Finding something separate from medicine helps physicians reduce stress. It doesn’t have to be art—it can be golf, running, cooking, or reading—but just find something you’re passionate about and do it. It will become a way to take care of yourself. For me it has been art, and I truly believe that through engaging in the arts and humanities, physicians can become better, more empathetic healers,” he says. “Practicing an art form gives you a tool for self-expression and provides a way to process emotions you may not fully understand, or ones that have been so overwhelming that they can only be expressed indirectly. Taking the time to care for yourself will directly translate into being a better caregiver for our patients—besides, it’s fun!”

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