A few of my favorite burnout RESOURCES
As I started to dig into physician burnout further, one of my biggest frustrations was the sheer difficulty in accessing validated tools for assessment of the problem. How could I find out my own score?
The quickest/easiest tool I’ve seen yet to check your burnout “pulse”. Created for the tech industry, but great for anyone (Just click “no” to “Do you work in the tech industry?” and proceed).
I was delighted to come across this terrific list from the National Academy of Medicine.
Important Definitions
One of the most critical things when trying to understand burnout is to get the language right. Here are some definitions that can help:
Burnout - syndrome involving emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment that occurs among various professionals who work with other people in challenging situations (Christina Maslach, PhD)
Moral Injury - the damage done to one’s conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical codes of conduct (http://moralinjuryproject.syr.edu/about-moral-injury/).
NOTE: The definition of Moral Injury can be contentious depending on who you talk to. For example, according to Wendy Dean, MD our problem in medicine is better described as Moral Injury than burnout (https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/). Not everyone agrees. Torie Sepah, MD, and others take issue with this definition; saying the language of Moral Injury creates problems of it’s own (https://www.kevinmd.com/blog/2019/06/the-problem-with-calling-physician-burnout-a-human-rights-violation-or-a-moral-injury.html). Psychologists who study Moral Injury acknowledge that we are facing major moral issues in medicine. Yet, they generally prefer “moral trauma” or “moral distress” as more accurate terms to describe the situation.
Depression - a mood disorder that causes a persistent feeling of sadness and loss of interest (https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007).
PTSD - a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event (https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967).
WHEEL OF FULFILLMENT
According to Maslach, “professional fulfillment” is the antidote to burnout. I was inspired to create this after reading “Designing Your Life” by Burnett & Evans. A book that helped me tremendously. The wheel combines Maslach’s work identifying the six major underlying causes of burnout with a tool taken from the playbook of life coaching.
The “Wheel of Life” meets Maslach’s 6 Drivers of Burnout
The idea is to rate how things are going for you on a scale of 1-10. Then, plot your numbers on the diagram and connect the dots. This gives a visual representation of what is most important to you, and which areas need the most work. Useful for a quick assessment whenever you need it, or tracking over time. I keep a collection of these with dates as well as what was going on at the time I did the exercise.
Here are the evidence-based dimensions of what’s required for professional fulfillment to happen:
Reasonable Workload
Alignment of Values
Sufficient Rewards
Sense of Fairness
Sense of Control
Strength of Community
The higher your scores in each of the above, the more you are on your way to less burnout.
Note: Even though these items are measured at the individual level, it’s often systemic changes that are required to make the most difference.