The Free Press, Mankato, MN

December 1, 2012

Mayo Clinic Health System taking steps to combat physician burnout

By Robb Murray
Free Press Staff Writer

— A new study shows that nearly 45 percent of physicians are experiencing some signs of burnout.

But at the Mayo Clinic Health System in Mankato, they’re trying to stay ahead of the curve. There’s a concerted effort to let physicians know there is a place they can go for help. It’s the kind of thing that, 20 years ago, probably wouldn’t have existed in medicine.

Today, though, there’s growing recognition that grueling hours and a growing workload can take a toll on a physician.

“There is a shift,” says Mayo physician Panagiotis Panagiotakis. “You cannot be 100 percent all the time. It’s a job where you deal with human pain all the time and it’s very stressful.”

Burnout can come in many forms. Detachment, diminishing empathy and emotional exhaustion are all signs of burnout.

The Archives of Internal Medicine study, which was published in August, surveyed more than 7,000 physicians. Nearly half reported at least one symptom of burnout. The specialties most at risk were family medicine, general internal medicine and emergency medicine.

“It’s because of the number of patients, the clerical tasks, the management of patients,” Panagiotakis says. “The family physician is really a quarterback. I used to work in internal med. You have to work with patients over the long haul and deal with insurance. It’s very easy to become cynical after a while.”

And burned out.

Mayo has a program that is systemwide and lets doctors know right away when they come on board that there’s a place they can go for help if they’re feeling symptoms of burnout.

Mayo psychologist Lisa Hardesty said Mayo recently surveyed its own doctors to see how burned out they were and found Mankato had some of the best results, or the least amount of burnout symptoms overall among doctors.

Some doctors self-refer to get help, while others are referred by colleagues. In either case, it’s a confidential program that offers a full range of burnout response remedies. And the work environment, Hardesty said, is one that is accepting of physicians who seek help.

Said Panagiotakis, “The reason I joined 61⁄2 years ago is that I had a sense that I could work with anybody here.”

At one time there may have been a stigma about getting help for exhaustion or burnout. Now, though, Panagiotakis said the medical community has come a long way.

He compared it to soldiers returning from war over the years. After World Wars I and II, soldiers were expected to come home and simply forget the horrors they’d seen and transition into society. Decades later, afflictions such as post-traumatic stress disorder are accepted medical realities. So, too, is physician burnout.

“We’re seeing changes,” he said. “The overall culture has been shifting. If you have untreated burnout, you’re going to have bad outcomes. This study is starting to open some eyes.”

Hardesty agreed.

“It’s one of the most robust studies we’ve seen on this topic,” she said.

Mayo’s approach to dealing with burnout issues is actually twofold. Since 2002 they have been offering help through a so-called provider relations program, which connects physicians with services. And in the last year they’ve added a consultative service, which allows doctors to seek advice from other medical professionals.

The consultative portion hasn’t been used that much yet. But it’s new, and Mayo’s own research suggests the Mankato location may produce fewer physician clients for that service.

“We knew when we started the consultative services that we wouldn’t have doctors lining up saying we’re burned out,” Hardesty said. “But I think there is a shift in medicine. It’s easier for a resident to say ‘I’m tired, I’m going to go home and I’m not going to deliver this baby tonight.’”