By Carl Zebrowski

Editor of Hakol

If you work in healthcare, there’s a better chance than not that you’re experiencing burnout. That was the framing message of the March 19 presentation by Drs. Chelsea Busch, Kristine Schultz and Lynn Wilson to the Jewish Federation’s Maimonides Society with the theme “Burning the Candle at Both Ends: Addressing Burnout in Healthcare.”

More than 50% of healthcare workers have experienced these problems, said Dr. Zach Goldsmith as he introduced the speakers for the Sunday morning event. In 2021, 63% of physicians reported feeling burned out — almost twice the percentage of previous years.

That number falls in line with the fact that COVID-19 pandemic fueled burnout among healthcare professionals. But the alarming trend had already begun before COVID.

The three presenters know the problem well. “We represent the three biggest specialties that have been affected by burnout,” said Schultz: emergency medicine (Schultz), geriatrics (Wilson) and psychology (Busch). All three of their spouses work in healthcare too, which Schultz points out is itself a factor that increases the risk of burnout.

What is burnout?
Before the presenters could delve into how to fix the problem, they had to define it. Most important, they emphasized, was that burnout is a systemic, organization problem, not a personal one. The individual is not to blame.
Burnout is a long-term work-related syndrome characterized by depersonalization (considering other people, such as patients, a burden), emotional exhaustion (“You don’t have any empathy left to give to patients,” Schultz said), a feeling of decreased personal achievement (“personal exhaustion,” she said).
Symptoms include irritability, anxiety, insomnia and lack of focus. Among the behavioral can be procrastination, illness, lateness. Depression, drug abuse and possibly suicidal thoughts can occur.

At the heart of the problem is a work-life mismatch. Most people experiencing burnout complain about workload. Other potential factors are control over the work itself, adequate rewards, agreement between a worker’s values and the organization’s values.
People with the least power in the system are most at risk, such as residents. “They’re the people who are working 80 hours a week at very low pay,” Wilson said. Others are women, minorities, LGBTQ+ and those in specific specialties.

What can you do for yourself?
“If you’re able to identify burnout early, you can manage it,” Wilson said. “Those who have managed it have increased empathy for patients. They have improved physical and mental health.” Providers also see improved patient outcomes when burnout is managed better.
If you’re experiencing what seems to be an inordinate amount work-related stress, you need to figure out what’s causing it. Several standardized tests are available that lead a test taker through questions whose answers can determine whether the underlying problem is burnout.

If it is, the first step of the cure is focusing on yourself. “You have to have your own back?” said Wilson. “No one else is going to do that for you.” You need to figure out how you spend your work time versus how you want to spend your work time. Decide what tasks to defer, to delegate or to delete.

Wilson explained that deleting certain tasks was a proactive rather than negative action that keeps time open for what matters most. “When we say no to something we don’t want to do,” she said, “we’re saying yes to something else.”

Not all stress is bad, Busch pointed out. Though too much is destructive, some is good. “If we don’t have enough stress,” she said, “we get depressed and bored.” But learn the limit. “We don’t want ‘stress leading into stress leading into stress.”
If you reach your limit, there are things you can do for relief. Physical activity is beneficial, Busch said, not necessarily cardio workouts, but “just moving your body in a way that feels good.” Getting support from your social network and expressing yourself creatively and emotionally help too.

“Having a good, effective cry or going into a room and screaming are very effective,” she said. “Progressive muscle relaxation and deep breathing is probably the biggest bang for your buck.” Also consider professional counseling.

Make sure to assess your goals and values to make sure they line up with what you’re doing at work. “We kind of forget, ‘What was my long-term goal?’” Schultz said. How does what you do at work match what your passion is for practicing medicine? Are you getting the financial security you’re comfortable with, opportunities to satisfy your intellectual curiosity? Write your answers down.

How can you get your organization to change?
“There’s only so much you can do as an individual,” said Busch. The organization also has to address the problem. It needs to fulfill some basic responsibilities: set up a well-being task force, cultivate a culture of fairness, sincerely embody the stated organizational values, and give employees choices, autonomy and flexibility to adjust their work-life balance.

A wellness task force is essential, a group that can help assess worker burnout and address it as necessary. Also essential is the “leadership champion,” Busch said, leaders who can make sure polices are being carried out throughout the organization and push for necessary adjustments.

Hearing others’ success stories can help motivate efforts against burnout. The American Medical Association’s Steps Forward website at edhub.ama-assn.org/steps-forward posts testimonials form healthcare professionals who beat burnout. People describe what they did to improve their situations, including low-cost initiatives of the sort that organizations appreciate.

The overall situation in the healthcare professions needs to change soon. “We have a lot of people leaving the field,” said Busch. Some are retiring early. Some are staying in the field and getting large sign-on bonuses to move to new employers. But then the situation just repeats. The bonuses may bring people in, she said, “but those are not the things that are going to keep people. And bonuses to newcomers can exacerbate inequalities.”

Busch ended the presentation with a turn outside organizations. She called for advocacy at the legislative level to pass laws, for example, that curtail the excessive influence of insurance companies. “Go out and vote,” she said.

Next up for Maimonides
The next Maimonides Brunch and Learn will be a summit on women in healthcare on May 7. “This is a summit to celebrate the women healthcare professionals in the community,” said Dr. Zach Goldsmith, president of the society.

In July, the Jewish Federation will host its annual thank-you gathering of healthcare workers. Aaron Gorodzinsky, who coordinates society activities for the Federation, said the event will probably be at the Shelby in Lower Macungie, but stay tuned for details.