Ep 103 Preventing Burnout and Promoting Wellness in Emergency Medicine

This is EM Cases Episode 103 Preventing Burnout and Promoting Wellness in Emergency Medicine. Burnout – it’s the elephant in the room that we all know about but prefer not to discuss. Yet according to a 2013 Medscape survey, 40% of physicians reported burnout in U.S. In this episode, Sara Gray and Chris Trevelyan present an honest approach to preventing burnout and promoting wellness, outlining strategies both at the individual and systems levels. They explain why wellness matters, how you can strive to achieve it and how to recognize when you or a colleague are unwell so that you can get the help you need... Podcast production, sound design by Anton Helman, edited by Sucheta Sinha & Anton Helman Written Summary and blog post by Alexander Hart & Shaun Mehta, edited by Anton Helman November, 2017 Cite this podcast as: Helman, A, Gray, S, Trevelyan, C. Preventing Burnout and Promoting Wellness in Emergency Medicine. Emergency Medicine Cases. November, 2017. https://emergencymedicinecases.com/preventing-burnout-promoting-wellness-emergency-medicine/. Accessed [date]. Why does preventing burnout and promoting wellness matter in emergency medicine? Compared to the general population, physicians have higher burnout and suicide rates, and Emergency Medicine has the highest rates of burnout of all the medical specialties. Burnout can predispose to coronary artery disease, hypertension, mental health issues, substance use, social conflict, alienation, isolation, and a sense of futility in one's career. Burnout is also associated with increased medical error, professionalism issues and diminished ability to empathize - all leading to worse quality of care. Traditionally, we have kept silent in the face of these stressors, wearing our fatigue as a badge of honour. That paradigm has thankfully started to shift. By promoting wellness in ourselves and our medical systems, we will have more satisfying careers, live healthier lives, take better care of our patients and possibly even improve patient outcomes. How can we recognize burnout in ourselves and our colleagues? Burnout is occupationally focused and occurs when demands people face on the job outstrip the resources they have to meet them. It is important to recognize the signs of burnout in our colleagues and ourselves before the ill-effects of burnout take hold. Burnout is defined as a triad of: * Emotional exhaustion * Depersonalization (negative, callous, cynical and detached responses towards others as well as alienation from others) * Reduced personal accomplishment (feelings of incompetence and poor achievement at work) Individual contributors to burnout in emergency medicine There are several individual contributors to burnout, including responsibility burden, time pressures, difficult work interactions with patients, their families and consultants, financial concerns, medical errors, medical-legal law suits and strained work-life balance. Self-perceived medical errors are one of the most important contributors to burnout. Fifty percent of physicians report that medical errors lead to increased anxiety for future errors, decreased job confidence, decreased job satisfaction as well as potential mental health issues. Why are we so hard on ourselves when we screw up? We were all taught from a young age to believe in the all-knowing infallible doctor, we feel very uncomfortable admitting to error, and this is a natural path for high achievers like us who strive for perfection, (despite the fact that perfection is a myth). Some of us may perceive error to indicate weakness in ourselves. This often results in staying silent after errors, which leads to embarrassment, shame,