1. What factors do you believe contribute most significantly to rehab physician burnout in today's healthcare environment?
It's a complicated question and has variability between individuals. The healthcare system and its regulatory burden has trickled down to every physician in America. The multitude of administrative tasks that are required in patient care are often at odds with taking good care of patients. Physiatrists chose this field to take care of patients and healthcare's evolution toward prior authorization, local coverage determinations and automatic denials detract from our ability to practice sound medicine. These barriers hit our patients and practices especially hard given the populations we serve. Some estimates suggest that physicians spend nearly 15.5 hours per week on paperwork. This balance of administration to patient care is at the heart of our burnout. Additionally, rehab doctors care for patients with complex, chronic problems that may not have definitive treatment options. This can be a significant emotional load for us. It also limits the feelings of fulfillment and completion that come with curing a disease, setting a fracture or performing a successful surgery.
2. What strategies do you currently use to maintain a healthy work-life balance and prevent burnout?
I've always loved to exercise and have meditated since I was a teenager, so I've had some long-term habits that have supported me well in my life. I have twin daughters who love the arts, rock-climbing, skiing and tennis, so I throw myself into what they're doing as much as I can. Beyond that, I spend time reading as much fiction as I can to keep my brain from constantly focusing on work. I'm a mediocre artist and guitar player, so I still have a few creative outlets that I still enjoy.
3. How do you prioritize self-care and mental well-being in your professional life?
This is such a great question. It really is about setting priorities that are meaningful to you. I'd love to spend more time on personal interests and self-care but that isn't always a reality with young kids and my other responsibilities. I accept that that is the season of life that I'm in. I prioritize the things I really need to be mentally and physically healthy. For me, that's waking up earlier than the twins, so I can exercise, read and get some contemplative time before things get up and running with my work and their school.
4. What can residents do to avoid burnout early in their career?
This is a tough question. I haven't always done well avoiding burnout in my own career. It's something I've struggled with and have become more aware of as I've advanced in my life and career. Reflecting on it, I'm not sure physicians can fully avoid burnout in this current environment, but I really do believe we can find a great deal of joy in the practice of medicine, despite all the challenges.
I believe that the healthcare system isn't set up to take good care of physicians right now. We've spoken about that in the other questions today. Early on, the pressure to build a successful practice, make a name for yourself and find your career path is incredibly demanding, and doesn't come with a road map like we have in med school and residency. These early work challenges happen at a point in life where you're just starting out, may have loads of debt, may not be sure that you're in the right practice. In my situation, I was just starting my life with my wife and trying to start a family. Money stress, job stress and family stress are prime ingredients for a tough time in your life, and I'm not sure these feelings of burnout and overwhelm can be avoided.
My best advice is to consciously develop the habits that you'll need to master your craft and love your career. Read about things in the field that interest you, attend meetings that inspire you, reach out to mentors who you admire, create fun ways to engage with your patients and develop teaching skills that can impact residents and fellows. Cultivate the things in your life and career that give you meaning and fulfillment. It takes time, grace and perseverance to navigate your early career. From my experience, my mentors and colleagues in PM&R were instrumental in helping me navigate this time in my life. We're all in this together and I hope that you find ways to take good care of yourselves in your future.
Physician burnout and wellness are critical priorities for AAPM&R. The Academy is actively addressing these challenges and advocating for meaningful solutions. Learn more about AAPM&R's efforts to support physicians and combat burnout by viewing our resources online.