Dealing with burnout, stress and depression
Mark S. McIntosh, M.D.
Allison B. Ventura, Ph.D.
Support is available for UF COMJ physicians in distress
Patient caseloads and other clinical demands, academic responsibilities, meetings and paperwork consume much of a physician’s time. Then mix in personal commitments and obligations, and the chances for burnout are high.
Physicians face unique challenges. The stress is all too real and, unfortunately, can lead to depression and even suicidal thoughts. But the University of Florida College of Medicine – Jacksonville wants to remind its faculty physicians, residents and fellows that there is a host of resources available if they ever need help.
The department of psychiatry has a special page that lists wellness services within and outside the UF Health network — all available to UF COMJ faculty and trainees at no cost:
- ComPsysch Guidance Resources is the new employee assistance program, providing 24/7 support and access to counselors who offer confidential, short-term support for personal issues. The service provides emotional support, work-life solutions, legal guidance and financial advice for faculty, staff and residents, as well as their family members. If necessary, referrals can be made.
- Members of the Duval County Medical Society have access to its free and confidential wellness program, which is specifically designed to address physician burnout. In-person appointments with a counselor are available within 24 hours of request, including before and after normal business hours. Member physicians can receive up to six counseling sessions per year. No insurance is billed and no electronic records are created.
- Links to information and modules from the American Medical Association are also available. Topics include avoiding physician burnout and preventing distress and suicide.
Strengthening support, shedding the stigma
Mark McIntosh, MD, an associate professor of emergency medicine at UF COMJ and medical director of employee wellness at UF Health Jacksonville, heads a committee that meets twice a month to discuss ways to improve support for physicians on campus.
“We want to help doctors take care of themselves,” McIntosh said. “As providers, we’re always giving. But too often, we don’t focus on our own needs. If you’re going to be involved in a career in medicine, you must understand the risks of burnout.”
In addition to reminding faculty of the available services, the well-being committee wants to help shed the stigma on mental illness and create an environment in which people feel more comfortable seeking help for their problems.
“We’re really trying to change the culture and destigmatize mental health problems,” said Allison Ventura, PhD, a psychologist and an assistant professor in the department of psychiatry who serves on the committee. She has presented at several on-campus workshops and seminars focused on physician wellness.
“Let’s help each other, provide more mentoring and have more conversations about this,” Ventura said. “In the medical world, there’s this ‘forget about your problems and just suck it up’ mentality. That mindset has to change.”
Suicide statistics illustrate the seriousness.
Each year in the United States, between 300 and 400 physicians take their own lives, according to data cited by the American Medical Association. Studies also suggest the suicide rate among female physicians is 130 percent higher than women in general. Among male physicians, it’s 40 percent higher.
Data regarding medical students and residents are alarming, too. A group of researchers had a study published in the Journal of Graduate Medical Education that examined burnout among medical trainees.
The group found that by the third year of medical school and into residency, up to one-third of trainees may be clinically depressed — with 50 to 70 percent experiencing burnout symptoms and 6 to 12 percent reporting suicidal ideation.
“The rates of depression and suicide are high, and it’s something we need to talk about and address,” Ventura said.
Feedback from UF COMJ residents
A handful of UF COMJ residents provided feedback about workload and burnout during a recent Clinical Learning Environment Review site visit by the Accreditation Council for Graduate Medical Education.
Of the 29 residents questioned about a hypothetical scenario, 48 percent said they would “power through” their work shift if they were maximally fatigued with two hours remaining. Twenty-one percent would ask their supervisor to be taken off duty and 14 percent would notify their supervisor and expect to stay, while 7 percent would approach another resident about taking over their shift.
The ACGME gave 26 UF COMJ faculty members, including residency program directors, the same scenario. Four percent of faculty members and 14 percent of program directors believed the resident would power through, while 62 percent of faculty members and 68 percent of program directors believed the resident would notify a supervisor and ask to be taken off duty immediately.
Also, 38 percent of the residents and fellows interviewed said they see signs of burnout among faculty “sometimes,” while 34 percent said they see those signs “often.”
Linda Edwards, MD, senior associate dean for educational affairs at UF COMJ, said the ACGME is requiring institutions to address well-being as part of the accreditation process. They must provide education on symptoms of burnout and depression, tools for self-screening and access to confidential, affordable mental health services.
“You cannot pick up a medical journal or go to a medical association’s website without reading an article or op-ed on physician burnout and the need to address the well-being of our physicians,” Edwards said. “It’s an important issue and we are taking it seriously. Assisting our residents, fellows and faculty to achieve the appropriate work-life balance will lead to safer patient care, greater job satisfaction and healthier physicians.”
McIntosh says the committee’s goals are to strengthen existing services to create a comprehensive wellness program, develop and implement a crisis-response plan and establish a second victims’ program. A “second victim” is a health care provider who experiences emotional trauma following an adverse patient outcome.
Leon L. Haley Jr., MD, MHSA, dean of UF COMJ and CEO of UF Health Jacksonville, champions those aims, adding that physician wellness became a priority soon after he arrived on campus more than a year ago.
“We need to truly examine the support we have in place for faculty, residents and staff,” Haley said. “Having engaged employees is critical to any organization. And what becomes clear is that there’s a whole wellness component to it. We are looking to provide more resources, and ensure those resources are easy to access.”
Mark S. McIntosh, M.D.
Allison B. Ventura, Ph.D.