Finding Balance Again in Medicine

Miechia Esco, MD, PhD, RPVI, FACS

“What happened?” she asked, tears welling in her eyes.

Unhealthy. Exhausted. Fog-brained, inefficient, apathetic, depressed—how did these terms come to describe her? Had she not initially excelled in her career, created a loving family, loyal friendships and a great golf swing? Years after being entrusted with caring for the critically ill, the hours, days and months on-end and the ever-escalating bureaucratic hurdles overcame the things she valued and used to balance her life.

Dr. Roper, a successful critical care physician, now exhibits what the World Health Organization (WHO) describes as an “occupational phenomenon” in the workplace: burnout.

For healthcare executives at large health systems, regional hospitals, single-institution facilities, practice management groups and even clinics, addressing burnout is an urgent priority, one directly impacting their overall mission of improving quality of care and patient experience as well as retaining physicians and advanced practitioners.

In fact, 61% of healthcare facility executives rated addressing physician and advanced practitioner burnout as “very important” in terms of top priorities for the next 12-24 months, according to a LocumTenens.com May 2019 survey of 260 healthcare facility executives.

Reducing stress and burnout is critical to a healthcare facility’s ability to retain physicians and advanced practitioners (approximately 75% of healthcare executives ranked both as “very important”) especially over the next 12-24 months. Some of the consequences of clinician burnout are increased costs, higher prevalence of medical errors and dissatisfied patients.

The annual cost of physician burnout is estimated to be about $4.6 billion, according to research published in Annals of Internal Medicine.

According to a 2019 report of 15,000 physicians, 44% of respondents reported feeling the effects of burnout. From a clinician perspective, above all else, the pursuit of balance in their lives is the no. 1 overall career goal, even more so than generating income—according to another 2019 survey of 545 physicians and advanced practitioners.

Seeking more balance and flexibility is a unifying theme across all physicians and advanced practitioners, regardless of their career stage. As part of the survey, five clinician segments emerged, all at various points of their careers (from early stage just coming out of residency to mid-career to nearing retirement).

Overall, work-life balance was the clear no. 1 career goal for 4 out of the 5 segments, followed by income generation and then location of where they worked. This is a departure from the past, where maximizing earning potential was the primary career motivator.

For physicians and advanced practitioners who are at different stages of their careers, adding more balance to their lives is critical. Like Dr. Roper, this is driven by a desire to spend more time with family and friends, get back into being active, living well and experiencing life outside the hospital.

One way clinicians are taking back control of their schedules is leveraging locum tenens. It frees up precious hours which can be reallocated to inject freedom back into their lives. In fact, it’s so important that more than half of the survey respondents said flexibility was the primary reason they would seek out locum tenens opportunities—more than earning higher pay.

Executives and administrators at healthcare facilities share a similar feeling. According to the survey, they ranked “reducing stress and better work-life balance” as among the top 3 benefits of locum tenens staffing, among a list of 19 different benefits.

From a healthcare facility perspective, the shift now is toward comprehensive programs to apply both treatment options as well as preventative measures to address and prevent burnout, including:

• Formalizing an ongoing assessment of physician and advanced practitioner staff to measure the level of burnout within different specialties within the healthcare facility
• Progressive wellness programs tailored to those suffering with burnout symptoms, with accompanying dedicated rooms for exercise or meditation
• Targeted locum tenens services which place highly specialized physicians and advanced practitioners to help support specialties within the facility most at risk for burnout
• Comprehensive telehealth solutions tailored to this type of environment
• Programs to improve employer-clinician alignment so physicians and advanced practitioners can be part of the decision-making process

For physicians like Dr. Roper, it’s about rediscovering the passion for practicing medicine overall and, in her case, for caring for critically ill patients.

With her hospital intervening early with a comprehensive wellness program, focusing on a holistic approach to reducing stress and managing burnout, Dr. Roper has moved beyond being part of the 44%, finding balance in her home life and work life once again.

Miechia A. Esco MD, PhD, RPVI, FACS, is a vascular surgeon who has been working as a locum tenens physician for 5 years and is currently a member of the LocumTenens.com Customer Advisory Board. The piece reflects her views, not necessarily those of the publication.

Clinicians interested in responding to the piece or submitting their own work can contact us here.