The impact of physician stress is underestimated

On Healthcare Finance News, you'll find a short article titled, "Impact of physician stress is underestimated." The article is based on a report from Physician Wellness Services (PWS) and Cejka Search.

PWS’ and Cejka’s survey results are based on 2,069 completed surveys. Among the findings:

• 87 percent of respondents said they are moderately-to-severely stressed/burned out on an average day.
• 63 percent said they were more stressed or burned out than they were three years ago; 34.3 percent said they were much more stressed than they were three years ago.

The pace of delivering health care is only getting faster. There are increasing demands to deliver higher value while physician reimbursement declines in many cases. It's no wonder that burnout is becoming ubiquitous and that a growing number of physicians are looking for ways to escape from clinical medicine.

On LinkedIn, you'll find some physicians discussing the issue of burnout and physician help. Go to the American College of Physician Executives (ACPE) group on LinkedIn and you'll find a discussion titled, "How to get docs the help they need?"

Some physicians have poor coping mechanisms and they turn to substance abuse, alcohol, gambling, and other destructive behaviors. As a result, physician help programs in each state are kept busy managing and monitoring physicians who have exhibited addictive behaviors.

A recent article in Archives of Surgery titled, "Substance Abuse Among Surgeons: The Perils of Losing Your Credentials" reminds all of us that "Alcohol and drug abuse are a significant issue among physicians in general and surgeons in particular."

Cancer surgeons' distress and well-being

There are two recent articles in the Ann Surg Oncol titled, "Cancer surgeons' distress and well-being." Some interesting findings regarding career-related stress, coping mechanisms, and work-life balance.

Cancer surgeons' distress and well-being, I: the tension between a culture of productivity and the need for self-care.

Among the 72 surgeons who responded (response rate of 73%), we found that 42% of surgeons reported burnout and 27% psychiatric levels of distress, while 30% used alcohol and 13% used sleep medications as a possible means to cope. Only one third of surgeons reported high quality of life across physical, emotional, spiritual, and intellectual domains.

Cancer surgeons' distress and well-being, II: modifiable factors and the potential for organizational interventions.

Among the 72 surgeons who responded (response rate of 73%), surgeons identified high stress from medical lawsuits, pressure to succeed in research, financial worries, negative attitudes to gender, and ability to cope with patients' suffering and death. Workplace features requiring greatest change were the reimbursement system, administrative support, and schedule. Work-life balance and relationship issues with spouse or partner caused high stress. Strongest correlations with distress were a desire to change communication with patients and the tension between the time devoted to work versus time available to be with family. Surgeons' preferences for interventions favored a fitness program, nutrition consultation, and increased socialization with colleagues, with less interest in interventions conventionally used to address psychological distress.

10 Careers With High Rates of Depression

Those of us who work in the health care industry need to remember that workers in the health care industry have some of the highest rates of depression. Why is this the case? Why do physicians, nurses, pharmacists, dentists, therapists, surgeons, and other health care professionals struggle with depression?

Here are some of the reasons why:

• High-risk and high-stress occupations (when you have a person's life in your hands, that's a lot of stress)
• Long work hours (how do you like those 12-hr shifts?)
• Irregular sleep patterns (especially for medical and surgical interns and residents)
• Social isolation (because you are simply too busy all the time)
• Dealing with sickness and death (whether you work in the ICU or in a hospice facility, you're dealing with sickness and death all the time)
  

Here's a snippet from a Health.com article titled, "10 Careers With High Rates of Depression."

“There are certain aspects of any job that can contribute to or exacerbate depression,” says Deborah Legge, PhD, a licensed mental health counselor in Buffalo. "Folks with the high-stress jobs have a greater chance of managing it if they take care of themselves and get the help they need.”

Depression can lead physicians and other health care professionals to make poor decisions. Some get involved with alcohol and substance abuse. Others may fall victim to other types of addictions. Some pursue dangerous outlets to escape their depression. Others feel trapped and disabled.

The AMA/CMA/BMA International Conference on Physician Health 2010 is happening this week. If you suspect that you may be struggling with depression, make sure to seek professional help.

Federation of State Physician Health Programs (FSPHP)

I've worked with physicians who've needed help for mental health and/or substance abuse problems.  Some have lost their medical license. Others have been asked to leave medical school. 

Almost every state has a physician health/assistance program (PHP or PAP) that also provides services and advocacy support for medical students, residents, physician assistants, and physicians who may have suffer from mental health problems, substance abuse, drinking, addictions, legal problems, etc. These physicians are often "impaired" and they may lose their ability to practice medicine. They may lose hospital privileges. They may get dismissed from medical school. They may be asked to leave residency. They may lose their medical license.  If they're treatable, then perhaps they can regain entry into the medical system.