Sharing feelings and responsibilities can be an important ingredient to overcoming burnout. Support can be found in personal relationships with friends, family, spouses, and in group settings (eg, church groups or clubs). Professional organizations may provide much-needed support, whether for general professional collegiality or, for example, help with alcohol(Drug information on alcohol) and drug problems (as with Caduceus Club meetings for physicians). Most states have health programs that offer support for physicians who struggle with substance abuse or with emotional problems. This support can include professional intervention and advocacy.
Attitude/meaning. Recapturing empathy with patients and regaining a sense of meaning from medicine is another important strategy for overcoming burnout. A recently published study describes an effort to combat the loss of meaning that often occurs in those who experience burnout in medicine.18 In this study, a continuing medical education course focused on enhancing mindfulness, communication, and self-awareness among primary care physicians.
Mindfulness refers to the quality of being fully present and attentive in the moment during everyday activities. A study of internists that indicated the capacity of “being present” with their patients correlated more strongly with finding meaning in their work than with diagnostic and therapeutic victories.19 In that study, doctors were asked to write and discuss meaningful experiences in medicine. The participants described the process of writing these narratives and talking about them as both profound and helpful.
Age and experience. A recent study done in Australia surveyed 158 physicians with both the Maslach Burnout Inventory and the Kessler Psychological Distress Scale and included a semistructured interview about issues related to burnout for a subsample.15 Older and more experienced doctors had lower burnout scores; this group qualitatively described themselves as experiencing less psychological distress than they did when they were younger. They attributed this change to the development of protective defenses in their relationships with patients as well as to accumulated experience and changed work conditions. These doctors were encouraged to pass on such lessons to their younger colleagues.
Conclusion
Although external stressors themselves cannot always be changed, healthy approaches to lessen the stresses of medicine and avoid burnout can be learned at any age (Table). The protective defenses that may be helpful include such strategies as learning to compartmentalize so that work can be left behind when there is time to relax. Use of such healthy defenses may help doctors avoid lapsing into depersonalization and distancing behaviors that are characteristic of burnout.
