Hello everyone!
My name is Jamie and I’m a first year emergency medicine resident.
Welcome to episode 2 of “Ask Doctor Jamie!”
It’s a series on my channel where I answer a question sent in by you guys!
Today’s question is from Danica.
Danica asks: Hi Jamie!
“I'm sure you've heard that EM has one of the highest burnout rates - how did you navigate
around this idea?
What is your advice for prospective EM doctors who fear the burnout?”
So let’s me address a 3 things before answering the question.
First, EM-is emergency medicine and it’s the specialty that I’m in.
It is the medical specialty concerned with the acute-care scenarios or injuries requiring
immediate medical attention.
Second, what is burnout?
Burnout has been defined as a long-term, unresolvable job stress that leads to exhaustion and feeling
overworked, cynical, detached from the job and lacking a sense of personal accomplishment.
While burnout is prevalent in people working in healthcare, it can affect anyone from students,
people in other professions and even YouTubers.
And third thing I want to address is, Danica is probably referring to the one of the many
reports which show that EM specialty has one of the highest burnout rates.
In 2017 almost 60 percent of the emergency medicine physicians that were surveyed reported
feeling burnt out.
In 2018 and 2019 that number was 48 percent!
That’s basically one in two!
Here’s why burning out is an issue: Doctors who are burnt out are more likely
to make medical errors.
They tend to work less efficiently AND being burnt out can lead to depression, substance
abuse, and other serious consequences for not only themselves but for the patients they
care for.
So I’m about halfway done with my intern year and I’ll be completely honest and say
that there are times (a lot of times) where I do feel really burnt out.
I would say the biggest cause for me is time.
Everyone knows residency schedule is hard.
I work 5-6 12 hour shifts per week and often my one day off ends up being either a transition
day going from nights to days or a day when I need to get a bunch of errands done like
laundry, doctor’s appointments, making food, et cetera.
Another big thing is what happens during the actual shift.
This is especially true in emergency medicine where things are constantly happening 24/7.
I remember when I shared my first month experience in a vlog and one of the challenges I faced
during work was working straight through my 12 hour shift without taking a proper lunch
break or even a bathroom break.
My motivation then was there are a lot of patients that need to be seen in the emergency
room and I didn’t want to keep them waiting.
I felt guilty for taking a break during work.
Obviously, this isn’t something I can maintain long term.
I’ve been told that the habits you build up as an intern and later as a senior resident
are the habits that you live with as an attending.
For that reason, I’ve been trying really hard to advocate for myself and go take a
break even if it’s only for 15-20 minutes.
Emergency rooms, especially in a busy city like New York will never slow down.
So unless there is something major going on, I try to find a good time to rest my mind
for few minutes and it really makes a big difference.
So that’s what I can do from my end.
Hospitals and administration have some responsibility as well.
According to a survey by MedScape, some of the reasons for physicians feeling burnt out
include: too many bureaucratic tasks like charting and paperwork, too many hours at
work, lack of respect from coworkers and administration, and generally feeling like a cog in a wheel.
Let’s talk about the workload of a physician.
According to AAMC, 25% of doctors are expected to retire within the next 10 years while the
population of people who need healthcare will double.
So that means there will be less physicians for more patients.
We can expect the workload for physicians to continue to increase and so will the rate
of burnout
Despite this, up until 2010, the number of doctors entering the workforce has stayed
consistent (15,000 for MD and about 3000 for DOs).
But it’s not all bad news- there are efforts being made to target the increasing need for
healthcare providers.
Recent legislations, specifically Resident Physician Shortage Reduction Act plans to
add more than 15,000 residency spots between 2019 to 2023.
So with all that said, I think we can safely say we probably won’t be seeing any major
administrative changes for awhile.
For the foreseeable future, workload will still be very heavy, there will always be
more patients.
So how do we personally deal with feeling burnt out?
Here is my advice on dealing with burnout hopefully even before it starts to happen.
First and foremost, make sure you’re going into the specialty that you really enjoy!
This may take some soul searching and choosing your specialty as a medical student is one
of the most important decisions we all have to make.
So make sure you talk to all your residents and attendings and think about what you like
and don’t like about each of your rotations.
Second, have go-to ways to decompress and process your hard day at work.
This may come in the form of journaling or drawing, talking to your partner or friends,
or getting a good workout in.
I do a combination of all of the above and I really try not to keep anything bottled
in or unprocessed.
Third, explicitly think about what makes your job worth it and why you enjoy what you do.
I once heard this podcast about how emergency medicine physicians sometimes have a hard
time being on the receiving end of a patient’s gratitude.
Maybe it’s because of the constant patient flow or maybe it’s because our patients
are constantly trying to either leave the hospital or be moved to a different part of
the hospital (aka not in the emergency room).
But patients do appreciate the work that we do so if they come up to you to say thank
you, take a moment to receive their thanks feel proud of the work that you’ve done
for the patient.
Last but not least, expect long hours but strive for a better work-life balance.
It’s almost impossible have any kind of control over your schedule as a resident,
much less as an intern.
But there are ways to make your time really count.
One important thing to do is to advocate for yourself on and off your shift.
Make sure you give yourself a break to eat and go to the bathroom.
When you’re home, try to think about what would make you feel the most rested and fulfilled--
whether that’s going to the gym or just watching tv at home or meeting up with friends
for a quick dinner.
With 12 hour shifts, you can probably pick only one of these things, but make a conscious
decision to pick something for yourself and know that you have the power to make the most
of your free time.
So that’s all I have for today’s questions.
I hope you guys found it helpful.
If you want to submit your question for this series, you can email me or DM me on instagram
@thestrivetofit!
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BYE