Continuing the conversation on physician burnout

While efforts to address the issue at UNC continue, a national leader on the subject visited to discuss his research and was welcomed with a full auditorium.

Continuing the conversation on physician burnout click to enlarge Tait Shanafelt, MD

As national conversations about physician burnout continue to grow louder, Samantha Meltzer-Brody, MD, MPH, knows there’s not a simple solution to the problem.

“Addressing physician burnout requires a dialogue that is both bottom-up and top-down,” said Meltzer-Brody, associate professor of psychiatry. “This takes an all-hands-on-deck effort.”

With support from the Dean’s office, a new effort is underway to organize an institution-wide wellness committee in the UNC School of Medicine. And Meltzer-Brody continues to focus on leading Taking Care of Our Own, a program designed to address burnout and other mental health concerns of residents and physicians at UNC Medical Center. She said conversations are ongoing about the best ways to track physicians’ levels of distress and hopefully identify problems before they balloon. The Taking Care of Our Own Program was initially funded in 2012 through the Sanders Clinician Scholars Program.  The program has experienced substantial growth over the past four years and has been utilized by all clinical departments across the SOM.  Recently, the program received new funding from UNC Faculty Physicians for the next three years.

Meltzer-Brody helped to spearhead the effort to bring Tait Shanafelt, MD, to UNC for a March 4th lecture titled “Finding Meaning, Balance and Personal Satisfaction in the Practice of Medicine.” Terry Noah, MD, and Sue Tolleson-Rinehart, PhD, of the Department of Pediatrics and Joanne Jordan, MD, MPH, executive associate dean of Faculty Affairs and Leadership Development supported this effort.  Shanafelt is a hematologist/oncologist at the Mayo Clinic and also directs the Mayo Clinic’s Program on Physician Well-Being.   Shanafelt’s visit was co-sponsored by the Departments of Psychiatry and Pediatrics, the UNC SOM Dean’s office, and the Academy of Educators.

“Dr. Shanafelt is a thought leader on this issue,” Meltzer-Brody said. “We wanted to bring him to UNC so that he could help to put this problem in national context, discuss the successful initiatives that have been put in place at the Mayo Clinic, and offer new ideas and tools that could potentially be applied in Chapel Hill.

Shanafelt’s presentation was drawn from the results of a multiple studies of physician well-being, which found that more than half of doctors in the United States are now experiencing at least one syptom of professional burnout and that rates have significantly increased since 2011.

He highlighted the ways that burnout can manifest across the spectrum of medical training and into practice. Shanafelt found that upon entering medical school, future physicians reported better mental health profiles than those of their peers who chose other fields. After two years of medical school, however, this was reversed, with medical students reporting elevated levels of depression and anxiety. Shanafelt and his team found that while physicians reported high satisfaction with the decision to go into medicine, that satisfaction was coupled with professional burnout and dissatisfaction with how their work lives integrate with their personal lives.

Meltzer-Brody emphasized that burnout is not a specific diagnosis, but the cumulative effect of multiple issues. Shanafelt defined burnout as “a syndrome of emotional exhaustion, loss of meaning in work, feelings of ineffectiveness, and the tendency to view people as objects.”

All of this can lead to an erosion of personal and professional relationships, decreased empathy for patients and, in some cases, medical error and decreased productivity.

Meltzer-Brody said that as attention to this issue continues to increase, UNC is positioned to implement innovative solutions, citing the fact that Taking Care of Our Own was one of the first comprehensive physician mental health programs in the country.

“This is a national issue that no hospital or health system is immune from,” Meltzer-Brody said. “I’m glad UNC Health Care and the School of Medicine are making this a priority.”

If you missed the lecture, it is available at UNC Lecture Capture.


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