CDEM Voice – Topic 360

 

The Burning Question

A snapshot from the Emergency Medicine Physicians Wellness and Resilience Summit

What is it that separates Emergency Physicians with 30-year-long careers from those who burn out after less than a decade? Why is the rate of burnout higher in our field than in any other medical specialty? What can we do to help stem the epidemic of burnout amongst Emergency Medicine physicians, residents, and students? These questions and many others were tackled at the Emergency Medicine Physicians Wellness and Resilience Summit, held in Dallas in February.

 

Shanafelt’s eye-opening study in 2015 demonstrated a steadily-rising rate of burnout amongst physicians. This study showed that, between 2011 and 2015, the rate of physicians endorsing at least one symptom of burnout increased from 45% to 54%. The same study revealed that, though Emergency Physicians (EPs) report a higher level of satisfaction with their work-life balance than most specialties, the rate of burnout amongst EPs is the highest of any specialty (Shanafelt 2015). This high level of burnout amongst EPs has been echoed in subsequent studies. The Medscape Lifestyle Study in 2017 re-demonstrated the steadily-increasing rates of burnout amongst all physicians and showed that nearly 60% of Emergency Physicians experience symptoms of burnout, the highest of any specialty.

 

Even medical students have demonstrated higher levels of burnout than their peers. Brazeau et al demonstrated that matriculating medical students have a lower rate of burnout and depressive symptoms than their age-similar college-graduate peers, but somewhere in medical school that relationship flips, and medical students develop higher levels of burnout and depression than their peers (Brazeau 2014).

 

There are many reasons why the stressors of medicine, and Emergency Medicine in particular, can cause high rates of burnout and stress. These stressors can vary in importance throughout one’s career. Medical students may find the lack of control and lack of autonomy most frustrating while seasoned providers may be most challenged by the demands of electronic documentation, irregular hours, and lack of administrative support.

 

The Wellness and Resilience Summit brought together representatives from all of the major Emergency Medicine Groups, including ACEP, AAEM, AACEM, CORD, SAEM, EMRA, RSA, ACGME, and CDEM, to discuss potential solutions to the burnout epidemic. Many ideas were considered as potential areas for intervention or further investigation. All of the findings are currently being written up and will be published to help open a dialogue in our field.

 

The discussion that focused on our medical students touched on potential initiatives to help teach resilience. More resilient individuals are less susceptible to the stressors of our job and experience less burnout. Emergency Medicine is a stressful field, and we want to give our students and residents the tools they need to have long, rewarding careers. The next step for CDEM is to start investigating the role we can play in mitigating burnout. Through the cooperation of multiple professional organizations, we can help reverse the tide of ever-increasing burnout in our field.

 

Emily Fisher MD

on behalf of the Emergency Medicine Physicians Wellness and Resilience Summit

 

Brazeau C, Shanafelt T, Durning S, Massie SF, Eacker A, Moutier C, Satele DV, Sloan JA, Dyrbye LN. Distress Among Matriculating Medical Students Relative to the General Population. Academic Medicine. Nov 2014; 89(11): 1520-1525. doi: 10.1097/ACM.0000000000000482

Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, West CP. Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc. Dec 2015;90(12):1600-13. doi: 10.1016/j.mayocp.2015.08.023.

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