February 5, 2025 • 31 mins
Ever wondered if the pressures of modern medicine are taking a toll on our doctors? Dr. Tom Pohlman, a committed nephrologist and key figure in the physician burnout committee, joins us to shed light on this critical issue. Together, we navigate the historical landscape of physician burnout, revealing its rise in prominence and the pivotal role played by Dr. Maslach in bringing this to the forefront. From loss of control and overwork to the weight of patient expectations, learn about the multifaceted challenges faced by healthcare professionals today. The intricate dance between technological advancements and increased workload is no secret, making the quest for a balanced work-life equation more crucial than ever.
Beyond the confines of the hospital walls, we explore lifestyle factors impacting health and wellness. As we tackle issues like poor sleep, diet, and the omnipresent specter of obesity, Tom shares practical wisdom on small, incremental steps that can transform your energy levels and resilience. Simple actions, such as staying hydrated and integrating art and music into your daily routine, are highlighted as powerful tools to enhance mental health and productivity. By focusing on self-care, we aim to inspire listeners to cultivate a lifestyle that cherishes both professional responsibilities and personal well-being.
Finally, we invite you to a journey through the world of mindfulness and meditation. Discover the various practices that can help you manage stress and boost concentration, whether it's through Buddhist practices, mindfulness, or Transcendental Meditation. Tom also reveals his personal strategies for improving sleep quality and incorporating more movement into everyday life. As we discuss the subtle signs of burnout and its far-reaching impact, we underscore the importance of early recognition and proactive measures. Tune in to gain valuable insights that will not only serve healthcare professionals but anyone striving to lead a balanced and fulfilling life.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hi, my name is Jason Edwards and I'm here with my
friend, tom Pullman.
Tom's another fellow physicianand he's involved with our
residency program in multipleareas of the hospital, and Tom's
a nephrologist by trade.
Is that right, tom?
That's correct.
Tom also deals with ourphysician burnout committee, and
(00:22):
so I thought that it would beinteresting to talk about
burnout in general, and so oneof the things I read was that
the term was initially coined bya physician who worked with
drug addicts, and he noticedthat they would sit there and
watch their cigarettes justslowly burn out.
I don't even know if that'strue, but that's what I read.
But I did some PubMed searcheson burnout and one of the nice
(00:45):
things they have on PubMed,which is a repository of
scientific articles that you cansearch on the Internet there
were 27 papers in 1980 publishedregarding the subject of
burnout, and in 2022, there were3,700.
So certainly this has become amore popular topic.
What are your thoughts onburnout in?
Speaker 2 (01:15):
general.
So I think Dr Maslach came upwith a survey on burnout.
She's a psychologist I believeshe's at Stanford and developed
the burnout concept and lookedthrough a number of different
quality of life issues that sheidentified, and she identified
it in not just physicians, butit's been applicable to
(01:37):
physicians, so that's a littlebit of background.
When we started the PhysiciansResilience and Wellness Task
Force, we wanted to be there forburnout, but we wanted to
emphasize more wellness thanburnout.
Speaker 1 (01:50):
What do you mean by wellness?
Speaker 2 (01:52):
So the fact that the person, whether it's a physician
or non-physician is enjoyingtheir job, enjoying their family
, enjoying their life and reallytrying to get the most out of
it that they can.
Burnout is pretty much theopposite of that where you're
dissatisfied, and there's somecontroversy about whether we
separate this from depressionversus burnout.
(02:17):
They dovetail and sometimes it'sa matter of semantics, but
there's a number of things thatgo into burnout Life stresses
overwork, but when they'velooked at it, often it's loss of
(02:40):
control, excuse me, which iskind of a new concept, where
physicians are asked to dothings that they don't really
believe are the best interest ofthe patient, but the
institutions or the insurancecompanies or somebody else are
asking them to do a procedure ora test that they know has been
guidelines, not appropriate.
(03:02):
But turning down the provideror turning down the institution
to do the x-ray, they getdisqualified, punished for.
So there, and there's a lot ofexamples of that.
Speaker 1 (03:23):
Yeah, it actually happens a lot with patients
being educated these days.
You know you can, you canGoogle what tests do what and
what scans do what, and so youcan actually have, you know, the
patient really pressuring youto get a PET scan.
You know a ten thousand dollarscan when it's not indicated and
they feel very passionatelyabout it and you can explain
(03:43):
logically why that's not a goodidea and like, while the
insurance company will almostcertainly deny it.
But it puts you in a kind of aweird position and I mean that's
life right.
I mean especially as aphysician.
But in anything you do you willbe put in weird positions and
you have to figure out how todeal with it.
Speaker 2 (04:03):
Right, but when you're reduced to an RVU
generator, when you're hit withmindless task of clicks and
you're not seeing your family,that leads to burnout.
And in fact we did a survey ofSt Luke's staff last February
(04:25):
and one of the recurringcomments back was the loss of
control, the loss of work-lifebalance, the EMR, and those are
recurrent complaints that leadto burnout.
Speaker 1 (04:39):
Yeah, for sure, and it's a tough time too.
With the computers gettingbetter and the Internet access
and patients being able tomessage you, that's a good thing
for the patient.
But if you're answeringmessages till 8 o'clock at night
and you're not seeing yourchildren, that's tough.
So you know a lot ofoccupations, work, long hours
(05:01):
and difficult jobs.
Sometimes I think that thepublic perception is that
physicians have like a cush life.
If I show up 15 minutes latefor a consult, I mean I realize
the patient's been waiting inthere 15 minutes and they don't
like it, but it's not like I washitting balls at the driving
range.
I'm probably doing some sort ofimplant in the operating room
(05:23):
or something like that.
Speaker 2 (05:24):
My comment, I would bet, is that the second time you
see them they don't do that,Because one of the things that's
been found is making patientwait is not right.
But if the physician spendstime with the patient and
acknowledges that they were late, the patients are fine.
Speaker 1 (05:40):
Yeah, yeah, yeah, and so, yeah, you do your best.
In a lot of jobs, includingbeing a physician, there's
there's a lot of stress, and youcan be put in compromising
situations and you're aroundpeople who are in high stress
situations, and and your job isto try to keep things calm, and
(06:03):
usually we kind of figure thatout during our career and do an
okay job at that.
But I, I, I, um, I worked witha uh, uh a physician who was a
young mother, and I I saw her atin the hospital at eight
o'clock at night you know toomany nights and you realize, you
know, if you've got athree-year-old at home, this
isn't going to work, it's nottenable, and soon enough changes
(06:31):
were made, as they should be.
You can't keep going like that,and so increased workload is
one of the main drivers probablyin every job, main drivers
probably in every job.
I feel like, though you know youcan divide it into there are
(06:55):
external factors for burnout andthere are internal factors for
burnout, and sometimes it is notan option to say you know what
I've kind of taken on theseresponsibilities, whether it's
my family or my job or whateverit may be, or taking care of a
loved one or a parent orsomething like that.
But this isn't working for meand I'm not doing that anymore.
Sometimes that's not an option,and so then I think you've got
(07:17):
to turn and say what they callself-care.
Initially, I thought self-carewas sitting on a beach drinking
margaritas, and it turns outthat's not it.
But you've got to find someinternal factors to improve your
capacity to deal with stress.
Speaker 2 (07:31):
That's resilience.
Speaker 1 (07:32):
Yeah and grit, and you know me and you have seen a
lot of people, a lot of patients, and so you see a wide range of
how much resilience some humanbeings have and some people
don't have a lot, and somepeople have an incredible amount
(07:53):
of resilience, a shockingamount of resilience, to deal
with psychological, physical,stress and keep going.
And, and you know, I have someidea of what makes up that, but
what's your take on that?
The difference between people'sinternal resilience?
Speaker 2 (08:08):
Well, that's an ongoing issue, Dr Bayless, and
the teaching program is actuallytrying to find out if you can
teach resilience or not.
I think some people areintrinsically resilient.
You look at them and they canjust handle things.
But I think other people can betaught to a degree not
(08:29):
completely, I think just whatyou mentioned.
I think every day you need to,even if it's a long day, you
need to have something you lookforward to, one, even if it's
just a few minutes, taking adeep breath, listening to some
favorite music, closing youreyes and relaxing.
I think all those are important.
I think other things that areimportant are life maintenance,
(08:51):
getting a good night's sleep.
Now, you can't do that everynight as a physician if you're
on call, but you have to try andcatch up with it.
Make sure you don't losecontext with the important
people in your life, whetherit's your spouse, your family,
your colleagues but keep thoseconnections.
Those are really important.
And then try and have somethingthat in your off time that you
(09:16):
enjoy.
I like to run, I like to garden, I like to read.
Those are all things I like toread.
Those are all things.
And one of the things I mentionoften is also take a step back.
This is a profession wherealmost every day you do
(09:36):
something good for somebody.
Two almost every day, unlessyou're oblivious, you learn
something.
And sure, some of ourclassmates who weren't at the
same level as our academicperformance are making more
money than we are.
But the babies have shoes, wehave food on the table, we live
in a nice, so we have aprofession where we do good, we
(09:59):
learn and we make a living.
Yeah, there's not very manyopportunities when you look
around that you have thoseoptions and and you know, at the
end of the day, when you'rethere at eight o'clock at night
and everything's going wrong,sometimes you have to take a
deep breath and say yep it'sstill an honor to do this job.
Speaker 1 (10:17):
You should still be grateful it could.
You know the alternative wouldbe worse.
And you know you can be a bankpresident, for you know 25 years
.
And uh, you know thealternative would be worse.
And you know you can be a bankpresident, for you know 25 years
.
And uh, you know grandma stilldon't bring you pies and come
kiss you on the cheek, andthat's worth something you know.
Speaker 2 (10:33):
Right, um, and that's the other thing you made the
comment about, uh, beinggrateful.
Um, sometimes you have tolisten for the thank yous, but
they're often there.
Speaker 1 (10:42):
Yeah.
Speaker 2 (10:43):
And it's also worthwhile saying thank you.
Listen for the thank yous, butthey're often there.
Speaker 1 (10:48):
Yeah, and it's also worthwhile saying thank you.
Those will make the day betterand you can lose sight of it too
.
You know, the hug from thepatient amidst the hugs can kind
of drown out and just becomenormal.
And it's important to kind oftake a step back and take stock
of the situation and say, no,this is special, we just had a
good, honest conversation, maybea very difficult conversation,
(11:14):
but you know, I did it the rightway.
I actually think this I dealwith cancer patients, you deal
with patients with kidneydisease, but we both have very
tough conversations withpatients and I actually think
that where you really have topat yourself on the back is the
conversation where you go in andyou tell somebody bad news, but
(11:37):
you're very honest with themand you do it with compassion.
And nobody walks out of theoffice feeling good and it's
very difficult to do, but anyamateur can come give good news.
Any amateur can walk in theroom and say, oh, your cancer is
cured and high five and walkout.
I mean, it's hard to screw thatup, but where you're really
(11:58):
going to differentiate yourselfis by doing the heavy lifting
and being honest and doing itthe right way, with compassion,
and so you know otherwise thepatient's better off seeing the
guy down the street than you.
And you know you don't want tobe below average, you know you
want to be better.
But it's important when youwalk out of that room to pat
(12:19):
yourself and say you did good,because you don't feel good but
you know you did the right thing.
Speaker 2 (12:25):
And I think you learn with experience that it's
always nice to cure the patientor make them medically better,
but sometimes the greatest thingyou can do is make them
comfortable and show compassion,and sometimes that's all you
can do and in reality, sometimesthat's what the patient really
needs.
Speaker 1 (12:46):
Yeah, there was a New York Times article and the
article's old and the guy he wasa physician and his dad was a
physician and this was back.
I think it was in the 20s or30s and they had like digitalis
leaf morphine and epinephrineand that was it and he said my
dad never gave the epinephrineto anybody and the morphine only
(13:08):
lasted two hours.
And so he was like, what was mydad even doing?
But he was talking to patients,he was explaining their disease
to them, he was treating themwith compassion and that's all
he was doing.
But that was a lot, and it'simportant to remember that with
all our fancy tests and all ourfancy drugs, don't forget, you
know to to do those things righttoo.
Speaker 2 (13:30):
That's exactly right.
The other thing I think isimportant it's always important
that we focus, when we'retalking about burnout and
wellness, on the individual, butwe also need to keep in mind
that a lot of the problems thatlead to the burnout are
institutional.
Yeah, and I think that's alittle bit where some of the
emphasis is starting to gonowadays is that don't lose
(13:52):
sight, we're still taking careof a human being, but it's not
the human being's fault.
It's often institutional issuesthat we need to address.
Yeah, yeah, it's ofteninstitutional issues that we
need to address.
Speaker 1 (14:04):
Yeah, yeah, In my life, or in my view, it seems
like it's.
They're both issues, and Iwould say as a society, I mean
like physically.
My guess is, you know, oursleep isn't as good as it used
to be and our diet isn't as goodas it used to be.
And so there is fertile ground,whatever you do, to really tune
(14:27):
your instrument and become abetter, stronger person with a
greater capacity to deal withstress and just straight-up
strength and stamina, and soeating a healthier diet is.
I mean, our obesity rates are.
I think it's something like 40%of adults are obese.
(14:50):
It's up there, Okay, higherthan that.
And so we have fertile groundto make some improvement.
And I think the way you makechanges in your life are slow,
incremental changes.
But you could do it fast too.
You know you could start offfasting for 24 hours if you want
, but I think to developpositive habits it takes time.
(15:13):
And so exercise.
So this is tough, becauseyou're saying I'm overwhelmed,
I'm burnt out, and then you'resaying what's the solution?
The solution is to do more workand hard stuff that you don't
want to do.
It's exercise, eat right,develop these habits.
That aren't fun, but it's abargain with the future that I
will suffer more today so thatin the future I will suffer less
(15:37):
.
Speaker 2 (15:37):
But some of those are also right now.
Investments yeah, the thingthey tell you when you get on a
plane is if the air, if thepressure, the cabin
depressurizes, you put theoxygen on the person next to you
first I mean on you first andthen them.
Yeah, why is that?
Because you have to take careof the person who's taking care
of everybody else first, andthere's plenty of data that
(16:00):
shows if you can improve, makeyour improve resilience,
decrease your burnout, thosethat your efficiency improves
and that your care improves,because compassion fatigue, you
don't.
You know the person's a number,they're not a human being
anymore, and that's a big, a bigissue.
Speaker 1 (16:23):
One of the easiest things that you can do is drink
more water.
As a kidney doctor, you can dois drink more water that that.
That, as as a kidney doctor,you can.
You betcha, but but.
But I'm second that one.
I've.
I've seen that in my own lifebecause I would get home from
work and by the time I was homeI was so tired that I couldn't
play with my kids and I said Ican't.
I've got to do somethingdifferently.
I've got to make some changesin my life because I don't have
enough horsepower to get throughthe day.
(16:43):
Easiest simple change drinkmore water.
You don't notice it in themorning, but in the afternoon,
when you typically fade, younotice you got a little bit more
horsepower to get through andit's good for your skin and it's
good for your bowels and it'sgood for your brain, it's good
for your kidneys.
I can tell if somebody drinks alot of water.
I can tell by looking at theirface, because they have good
skin, and so I'll look at apatient and I go I bet you drink
(17:07):
a lot of water.
You can tell, and so that'scheaper than Botox.
Speaker 2 (17:08):
Those are the self-care issues that we have,
right.
Speaker 1 (17:10):
Yeah, and so that's a good start, and then sometimes
you start something like thatand then you kind of start to
view yourself as a little bithealthier person, and so maybe
you parlay that into a walk andyou start walking a little bit
and then you know, then you getthe salad instead of the steak
(17:31):
and you get some positivemomentum in life and so.
But I do think, with obesity,lack of sleep, you know all this
stuff, there's this energycrisis, where people don't have
enough energy to get through theday and so, and so the good
news is is these are fixablethings, these are things that we
can make better, and I do thinkthat if we fine tune the body,
that the mind would follow andthe mental health would be
(17:53):
better and our work capacitywould get better.
Now we don't want to just, youknow, turn ourselves into
working.
You know widgets that just, youknow, go, go, go.
I think it's important to seethe art and beauty in life, and
I think I think music or art, um, can be, um, well, it's really
the most valuable thing in theworld, really.
(18:13):
You know the, the uh, I meanliterally the.
You know the paintings, uh, youknow, some of them are
priceless, but it's, it's, it's.
It's good to step back and seethe beauty of this world Cause
it's there.
Speaker 2 (18:23):
Step back and the whole line about taking a deep
breath.
Yeah, it really makes adifference.
Speaker 1 (18:28):
Do you meditate or have you ever meditated before?
Speaker 2 (18:30):
I actually have, and so I have a series of about 15.
So there's different ways tomeditate.
I found out one is the Buddhistway to clear your mind.
I can't clear my mind, it'sjust not possible.
So I put things that I thinkwould make me better in there
(18:50):
and I try to do that pretty muchevery night when I wake up in
the middle of the night and I dothose kind of a series of
things that these are things Ishould make myself better.
So are you thinking aboutcertain things?
(19:19):
Is that what you're saying?
Just a list of things that Ikind of go through and I have
them and I go through them andkind of take inventory of where
I am?
Speaker 1 (19:33):
Yeah, yeah.
Meditation is thinking aboutwhat you're thinking about, or
that's mindfulness, mindfulnessmeditation is a type of
meditation that's very popular,and there's all sorts of stuff
Transcendental meditation, whichis TMorg, and then they have
the call app, or there's anotherone I can't remember the name
of it, but there's manyresources.
Speaker 2 (19:54):
So, actually, if you go to the St Luke's website and
wellness.
They have a list of littlemeditation videos that can help
you do those things and theyhave different kinds of
meditation videos.
They have the clear your mindor they have think of something
beautiful or think of somethingthat you enjoy.
(20:14):
And you know I've got into thehabit of doing it at night or
early in the morning, but in themiddle of a really rotten day,
taking three minutes or fiveminutes and just taking
inventory will help.
Speaker 1 (20:29):
Yeah, it helps immediately.
But it also you.
You start to carry with you theability to kind of stop for a
second and within one second,say I'm tense.
I'm tense right now.
I can feel it right between myshoulder blades, I'm tense, and
you take a breath and you let itout and you say you know you're
(20:49):
going to be okay, but just calmdown, don't, don't, don't hold
all your energy so tight, right,and it helps you be more
present and be able to talk andlook at the person in front of
you and not be thinking aboutall these things, and you have
better control about what'scoming in and out of your mind.
But it's like practice, it'slike you know if you're like
golf, like it's going to takesome time to get better.
Speaker 2 (21:09):
But it gets easier.
Yeah, bad habits are hard tobreak.
Good habits are hard to breaktoo.
Yeah, so if you can make it ahabit, you don't have to think
about it as much.
You don't have to put the timeaside because the time's aside
to decide.
Speaker 1 (21:23):
Yeah, yeah, I was talking I was having dinner with
one of the board members,actually and I was saying you
know, everybody knows about dietand exercise.
I think the two next big thingsthat people will start talking
about are sleep and mobility.
I think, like you know, I don'tknow if you can, you know, buy
stock and sleep and mobility,but I think you'd do well if you
did, because it's I think thoseare two really important things
(21:46):
that'll that'll make a bigdifference.
And I've started taking, youknow, sleeps very seriously, um,
over the past couple of yearstoo, and that's something that
there's no magic bullet.
You, you, you develop a routineand you slowly get better at it
and, um, and so do you sleeppretty well.
Speaker 2 (22:02):
Yeah, I have.
I do have semi magic bulletsicbullets.
I love to read, yeah, and Ilike to read medicine, and
medicine will put me to sleep ina minute at night.
Now, during the day I can readlonger, but at night, and so if
I'm having trouble fallingasleep, I just pull out the New
England Journal or pull up anarticle.
I try and stay off, try andcompletely stay off of screens
(22:23):
before bedtime and I try to, butyou know it's probably my age,
but I like to have a piece ofpaper or a magazine or a book in
my hand.
And you know I said this isn'tworking and the next thing I
know I'm asleep.
I literally I'm falling.
So I guess it is working.
Speaker 1 (22:38):
Yeah, the blue light on the screen tells your pineal
gland to wake up and that.
So that's not good and so, yeah, so we got drink water, stretch
, sleep, I think, for exercise,the best way to go about it if
you don't exercise is to setsome goal that's shamefully low,
like walk to the end of thedriveway and back, and do that
(22:59):
every day at two o'clock untilyou've developed the habit, and
then add volume to it after that, and so there's many ways you
know to do it, but I thinkthat's a good way is just get
the habit down first.
Speaker 2 (23:12):
There's a number of physicians that I notice, since
I get here early, who park faraway from the doors.
They can Totally empty parkinglot.
Yeah, good for them.
Speaker 1 (23:22):
Yeah, yeah, it gets your mind right too.
That's not a bad thing to do inthe wintertime either, because
it's uh and uh I don't know whatbook it was, but uh, they
called it.
Um, uh, practice poverty iswhat the book called it.
But so so I've done that a fewtimes just to remind myself that
, like everybody doesn't, youknow, have a warm spot, and it
kind of Right.
Speaker 2 (23:42):
But then the thing that's also nice about it is
when you add those up, it addsup steps.
Yeah, and you're right, youdon't.
I think exercise, dedicatedexercise, is important, but if
you can't do that on a busy day,taking the steps walking to
things, making a reason to getup and walk, even if it's just
walking around the office to getsome exercise.
Speaker 1 (24:04):
Yeah, the, the blue zones, people work with
communities and designingcommunities to make them so,
where people, the easy choice isthe choice that's good for your
health.
So, like the grocery stores,like you wouldn't, it's close
enough that you wouldn't get inyour car and go to it, but it's
far enough where it's a littlebit of a walk but it's just
(24:25):
easier to just walk thereinstead of back.
Or you know the way they woulddesign cities and communities
and so, and so I think a lot ofthese cities, where you know the
percent of people making it toa hundred was is way above the
norm, um, they're kind of set upin a way, um, and then you know
as.
So, aside from exercise,friendships, I think as people
(24:48):
get older and their children areout of the house, friendships
just become so, so important toyour health and your mental
health, and they just becomemore and more important as we
get older.
That's my opinion.
Have you found?
Speaker 2 (25:03):
that true.
I think friendships throughoutlife are important.
I think the friendships andwhat you're leading to is the
friendships change, how youobtain them and how you maintain
them change, and you know Ihave more time to try and do
those now, but you know, one ofthe things that used to be nice
(25:23):
in medicine is that we all gottogether periodically you went
down to x-ray, you went to this.
Now we're siloed with thecomputer and that's the real
problem and we're trying tobreak down some of those silos.
Some of the silos in medicineper se are not going to be break
it downable, but if we can putback that camaraderie, the
(25:43):
personal part of medicine, bothbetween patients and providers
and between providers.
Speaker 1 (25:51):
That's one of the things I love about St Luke's so
much and I've said this beforeis that it's a small enough
hospital.
I mean, we have manyspecialties almost every
specialty is here but it's asmall enough hospital that we
all know each other, and so mostof my good friends are people I
work with.
That we all know each other andso, you know, most of my good
friends are people I work with,and that's a nice thing.
(26:12):
You know to go into thelunchroom and see a friendly
face and have a goodconversation or ask somebody
advice.
You know, if something's goingon with my kid and I can say,
tom, you've had kids, what am Idoing here?
Speaker 2 (26:18):
You know help me out and that's really a good piece
of advice is that keep in mind,all of our problems are ours,
but there's somebody else outthere with a similar problem and
a similar experience and askingand peers and colleagues.
Many have gone through it orare going through it and you
(26:39):
don't know it.
Speaker 1 (26:39):
Yeah.
Speaker 2 (26:40):
And that's really important.
Speaker 1 (26:42):
Yeah yeah, just mathematically it works out.
If it's an old problem, you canlook in old places and find it,
and just if you consider old,50 years before now and back,
that's a lot of years and a lotof writing, and odds are, the
answer is going to be there.
(27:02):
If it's a new problem, you gotto look at new places.
But you know, you can find somenice texts that tell you a lot
of truth about life, whetherit's the Tao Te Ching or
whatever it may be, and so Ithink reading can be huge too.
Speaker 2 (27:19):
I think those are very helpful, and then I don't
think they need to be separate.
Yeah, human interactions andthe reading.
I don't think they need to beseparate.
Yeah, human interactions andthe reading.
Speaker 1 (27:28):
The first step in any problem is kind of defining the
problem and saying that, hey, Ihave burnout or I'm starting to
move towards burnout, and so doyou think there's value in that
?
Speaker 2 (27:41):
Absolutely, and I think identifying that is really
important.
It's now fairly widely acceptedbut for an individual it's
sometimes hard.
There are actually very nicemetrics on how to do that.
So the Maslach survey is thekind of gold standard.
But there's shorter surveys andwe've put some of them in the
(28:05):
wellness tab and we've actuallyoffered in one of our surveys we
didn't get a really a bigresponse but I think identifying
we'd like to identify peoplebefore they're burned out, when
they're starting to show thosemanifestations, and intervene
because burnout can really bedestructive to the person
(28:26):
individually.
Intervene because burnout canreally be destructive to the
person individually, to theirfamily and to their patients.
And so, yes, it's reallyimportant to identify it, to
admit it and to seek help for it.
Speaker 1 (28:43):
And my guess is that if you take the time out of your
day to go online and fill outthe burnout survey, I mean
there's some reason that you'redoing that, and it doesn't mean
that we have to do some maximalintervention, but it could just
be time to kind of take some,you know, take a step back and
reanalyze your life and say whatare the external things I can
change and that may be a lot orit may not be and then what are
(29:03):
the internal things I can changeto to develop more resilience
and and to to kind of increasemy physical and mental capacity
to deal with the stress.
Speaker 2 (29:15):
And you can change.
Speaker 1 (29:16):
That I mean for sure.
You can make a big difference.
Speaker 2 (29:20):
When you're significantly burned out, you
don't have the energy to do evenmuch of that.
That's right, and so we'veactually.
If, if you have the energy todo even much of that, that's
right, and so we've actually.
If you have the energy to go tothe wellness tab, those
resources are face up.
Okay, they're right there, sowe try to do make that available
.
Speaker 1 (29:36):
Yeah, and so the idea is you know, catch yourself at
the you know burnout one out of10 stage, because it's going to
be harder to deal with this thecloser you get to 10.
Speaker 2 (29:49):
You're just going to pass it, and we all have bad
days.
Burnout is not a bad day.
Yeah, burnout is a persistentdeterioration in how you look at
life, how you get enjoyment outof life and how you perform
your major task, and this iswe're physicians.
But this has been looked at,and in the entire healthcare
(30:10):
industry, from the top to thebottom, this is an issue, and so
we need to address all of us.
Speaker 1 (30:18):
Yeah, yeah for sure.
It's like what's the health ofhealthcare?
And actually this became anissue in COVID too, with, like,
our physical health is you know,the the the healthier we are,
the better we can serveourselves and our families and
our community.
Well, tom, thanks so much forjoining me.
It was a it was an interestingconversation.
(30:39):
I like talking about this stuffbecause you have to read about
it and you always learnsomething new, and so I very
much appreciate you andeverything you do.
Speaker 2 (30:46):
Yep, thank you very much, I enjoyed it as well.
Hi, my name is Jason Edwards and I'm here with my
friend, tom Pullman.
Tom's another fellow physicianand he's involved with our
residency program in multipleareas of the hospital, and Tom's
a nephrologist by trade.
Is that right, tom?
That's correct.
Tom also deals with ourphysician burnout committee, and
(00:22):
so I thought that it would beinteresting to talk about
burnout in general, and so oneof the things I read was that
the term was initially coined bya physician who worked with
drug addicts, and he noticedthat they would sit there and
watch their cigarettes justslowly burn out.
I don't even know if that'strue, but that's what I read.
But I did some PubMed searcheson burnout and one of the nice
(00:45):
things they have on PubMed,which is a repository of
scientific articles that you cansearch on the Internet there
were 27 papers in 1980 publishedregarding the subject of
burnout, and in 2022, there were3,700.
So certainly this has become amore popular topic.
What are your thoughts onburnout in?
Speaker 2 (01:15):
general.
So I think Dr Maslach came upwith a survey on burnout.
She's a psychologist I believeshe's at Stanford and developed
the burnout concept and lookedthrough a number of different
quality of life issues that sheidentified, and she identified
it in not just physicians, butit's been applicable to
(01:37):
physicians, so that's a littlebit of background.
When we started the PhysiciansResilience and Wellness Task
Force, we wanted to be there forburnout, but we wanted to
emphasize more wellness thanburnout.
Speaker 1 (01:50):
What do you mean by wellness?
Speaker 2 (01:52):
So the fact that the person, whether it's a physician
or non-physician is enjoyingtheir job, enjoying their family
, enjoying their life and reallytrying to get the most out of
it that they can.
Burnout is pretty much theopposite of that where you're
dissatisfied, and there's somecontroversy about whether we
separate this from depressionversus burnout.
(02:17):
They dovetail and sometimes it'sa matter of semantics, but
there's a number of things thatgo into burnout Life stresses
overwork, but when they'velooked at it, often it's loss of
(02:40):
control, excuse me, which iskind of a new concept, where
physicians are asked to dothings that they don't really
believe are the best interest ofthe patient, but the
institutions or the insurancecompanies or somebody else are
asking them to do a procedure ora test that they know has been
guidelines, not appropriate.
(03:02):
But turning down the provideror turning down the institution
to do the x-ray, they getdisqualified, punished for.
So there, and there's a lot ofexamples of that.
Speaker 1 (03:23):
Yeah, it actually happens a lot with patients
being educated these days.
You know you can, you canGoogle what tests do what and
what scans do what, and so youcan actually have, you know, the
patient really pressuring youto get a PET scan.
You know a ten thousand dollarscan when it's not indicated and
they feel very passionatelyabout it and you can explain
(03:43):
logically why that's not a goodidea and like, while the
insurance company will almostcertainly deny it.
But it puts you in a kind of aweird position and I mean that's
life right.
I mean especially as aphysician.
But in anything you do you willbe put in weird positions and
you have to figure out how todeal with it.
Speaker 2 (04:03):
Right, but when you're reduced to an RVU
generator, when you're hit withmindless task of clicks and
you're not seeing your family,that leads to burnout.
And in fact we did a survey ofSt Luke's staff last February
(04:25):
and one of the recurringcomments back was the loss of
control, the loss of work-lifebalance, the EMR, and those are
recurrent complaints that leadto burnout.
Speaker 1 (04:39):
Yeah, for sure, and it's a tough time too.
With the computers gettingbetter and the Internet access
and patients being able tomessage you, that's a good thing
for the patient.
But if you're answeringmessages till 8 o'clock at night
and you're not seeing yourchildren, that's tough.
So you know a lot ofoccupations, work, long hours
(05:01):
and difficult jobs.
Sometimes I think that thepublic perception is that
physicians have like a cush life.
If I show up 15 minutes latefor a consult, I mean I realize
the patient's been waiting inthere 15 minutes and they don't
like it, but it's not like I washitting balls at the driving
range.
I'm probably doing some sort ofimplant in the operating room
(05:23):
or something like that.
Speaker 2 (05:24):
My comment, I would bet, is that the second time you
see them they don't do that,Because one of the things that's
been found is making patientwait is not right.
But if the physician spendstime with the patient and
acknowledges that they were late, the patients are fine.
Speaker 1 (05:40):
Yeah, yeah, yeah, and so, yeah, you do your best.
In a lot of jobs, includingbeing a physician, there's
there's a lot of stress, and youcan be put in compromising
situations and you're aroundpeople who are in high stress
situations, and and your job isto try to keep things calm, and
(06:03):
usually we kind of figure thatout during our career and do an
okay job at that.
But I, I, I, um, I worked witha uh, uh a physician who was a
young mother, and I I saw her atin the hospital at eight
o'clock at night you know toomany nights and you realize, you
know, if you've got athree-year-old at home, this
isn't going to work, it's nottenable, and soon enough changes
(06:31):
were made, as they should be.
You can't keep going like that,and so increased workload is
one of the main drivers probablyin every job, main drivers
probably in every job.
I feel like, though you know youcan divide it into there are
(06:55):
external factors for burnout andthere are internal factors for
burnout, and sometimes it is notan option to say you know what
I've kind of taken on theseresponsibilities, whether it's
my family or my job or whateverit may be, or taking care of a
loved one or a parent orsomething like that.
But this isn't working for meand I'm not doing that anymore.
Sometimes that's not an option,and so then I think you've got
(07:17):
to turn and say what they callself-care.
Initially, I thought self-carewas sitting on a beach drinking
margaritas, and it turns outthat's not it.
But you've got to find someinternal factors to improve your
capacity to deal with stress.
Speaker 2 (07:31):
That's resilience.
Speaker 1 (07:32):
Yeah and grit, and you know me and you have seen a
lot of people, a lot of patients, and so you see a wide range of
how much resilience some humanbeings have and some people
don't have a lot, and somepeople have an incredible amount
(07:53):
of resilience, a shockingamount of resilience, to deal
with psychological, physical,stress and keep going.
And, and you know, I have someidea of what makes up that, but
what's your take on that?
The difference between people'sinternal resilience?
Speaker 2 (08:08):
Well, that's an ongoing issue, Dr Bayless, and
the teaching program is actuallytrying to find out if you can
teach resilience or not.
I think some people areintrinsically resilient.
You look at them and they canjust handle things.
But I think other people can betaught to a degree not
(08:29):
completely, I think just whatyou mentioned.
I think every day you need to,even if it's a long day, you
need to have something you lookforward to, one, even if it's
just a few minutes, taking adeep breath, listening to some
favorite music, closing youreyes and relaxing.
I think all those are important.
I think other things that areimportant are life maintenance,
(08:51):
getting a good night's sleep.
Now, you can't do that everynight as a physician if you're
on call, but you have to try andcatch up with it.
Make sure you don't losecontext with the important
people in your life, whetherit's your spouse, your family,
your colleagues but keep thoseconnections.
Those are really important.
And then try and have somethingthat in your off time that you
(09:16):
enjoy.
I like to run, I like to garden, I like to read.
Those are all things I like toread.
Those are all things.
And one of the things I mentionoften is also take a step back.
This is a profession wherealmost every day you do
(09:36):
something good for somebody.
Two almost every day, unlessyou're oblivious, you learn
something.
And sure, some of ourclassmates who weren't at the
same level as our academicperformance are making more
money than we are.
But the babies have shoes, wehave food on the table, we live
in a nice, so we have aprofession where we do good, we
(09:59):
learn and we make a living.
Yeah, there's not very manyopportunities when you look
around that you have thoseoptions and and you know, at the
end of the day, when you'rethere at eight o'clock at night
and everything's going wrong,sometimes you have to take a
deep breath and say yep it'sstill an honor to do this job.
Speaker 1 (10:17):
You should still be grateful it could.
You know the alternative wouldbe worse.
And you know you can be a bankpresident, for you know 25 years
.
And uh, you know thealternative would be worse.
And you know you can be a bankpresident, for you know 25 years
.
And uh, you know grandma stilldon't bring you pies and come
kiss you on the cheek, andthat's worth something you know.
Speaker 2 (10:33):
Right, um, and that's the other thing you made the
comment about, uh, beinggrateful.
Um, sometimes you have tolisten for the thank yous, but
they're often there.
Speaker 1 (10:42):
Yeah.
Speaker 2 (10:43):
And it's also worthwhile saying thank you.
Listen for the thank yous, butthey're often there.
Speaker 1 (10:48):
Yeah, and it's also worthwhile saying thank you.
Those will make the day betterand you can lose sight of it too
.
You know, the hug from thepatient amidst the hugs can kind
of drown out and just becomenormal.
And it's important to kind oftake a step back and take stock
of the situation and say, no,this is special, we just had a
good, honest conversation, maybea very difficult conversation,
(11:14):
but you know, I did it the rightway.
I actually think this I dealwith cancer patients, you deal
with patients with kidneydisease, but we both have very
tough conversations withpatients and I actually think
that where you really have topat yourself on the back is the
conversation where you go in andyou tell somebody bad news, but
(11:37):
you're very honest with themand you do it with compassion.
And nobody walks out of theoffice feeling good and it's
very difficult to do, but anyamateur can come give good news.
Any amateur can walk in theroom and say, oh, your cancer is
cured and high five and walkout.
I mean, it's hard to screw thatup, but where you're really
(11:58):
going to differentiate yourselfis by doing the heavy lifting
and being honest and doing itthe right way, with compassion,
and so you know otherwise thepatient's better off seeing the
guy down the street than you.
And you know you don't want tobe below average, you know you
want to be better.
But it's important when youwalk out of that room to pat
(12:19):
yourself and say you did good,because you don't feel good but
you know you did the right thing.
Speaker 2 (12:25):
And I think you learn with experience that it's
always nice to cure the patientor make them medically better,
but sometimes the greatest thingyou can do is make them
comfortable and show compassion,and sometimes that's all you
can do and in reality, sometimesthat's what the patient really
needs.
Speaker 1 (12:46):
Yeah, there was a New York Times article and the
article's old and the guy he wasa physician and his dad was a
physician and this was back.
I think it was in the 20s or30s and they had like digitalis
leaf morphine and epinephrineand that was it and he said my
dad never gave the epinephrineto anybody and the morphine only
(13:08):
lasted two hours.
And so he was like, what was mydad even doing?
But he was talking to patients,he was explaining their disease
to them, he was treating themwith compassion and that's all
he was doing.
But that was a lot, and it'simportant to remember that with
all our fancy tests and all ourfancy drugs, don't forget, you
know to to do those things righttoo.
Speaker 2 (13:30):
That's exactly right.
The other thing I think isimportant it's always important
that we focus, when we'retalking about burnout and
wellness, on the individual, butwe also need to keep in mind
that a lot of the problems thatlead to the burnout are
institutional.
Yeah, and I think that's alittle bit where some of the
emphasis is starting to gonowadays is that don't lose
(13:52):
sight, we're still taking careof a human being, but it's not
the human being's fault.
It's often institutional issuesthat we need to address.
Yeah, yeah, it's ofteninstitutional issues that we
need to address.
Speaker 1 (14:04):
Yeah, yeah, In my life, or in my view, it seems
like it's.
They're both issues, and Iwould say as a society, I mean
like physically.
My guess is, you know, oursleep isn't as good as it used
to be and our diet isn't as goodas it used to be.
And so there is fertile ground,whatever you do, to really tune
(14:27):
your instrument and become abetter, stronger person with a
greater capacity to deal withstress and just straight-up
strength and stamina, and soeating a healthier diet is.
I mean, our obesity rates are.
I think it's something like 40%of adults are obese.
(14:50):
It's up there, Okay, higherthan that.
And so we have fertile groundto make some improvement.
And I think the way you makechanges in your life are slow,
incremental changes.
But you could do it fast too.
You know you could start offfasting for 24 hours if you want
, but I think to developpositive habits it takes time.
(15:13):
And so exercise.
So this is tough, becauseyou're saying I'm overwhelmed,
I'm burnt out, and then you'resaying what's the solution?
The solution is to do more workand hard stuff that you don't
want to do.
It's exercise, eat right,develop these habits.
That aren't fun, but it's abargain with the future that I
will suffer more today so thatin the future I will suffer less
(15:37):
.
Speaker 2 (15:37):
But some of those are also right now.
Investments yeah, the thingthey tell you when you get on a
plane is if the air, if thepressure, the cabin
depressurizes, you put theoxygen on the person next to you
first I mean on you first andthen them.
Yeah, why is that?
Because you have to take careof the person who's taking care
of everybody else first, andthere's plenty of data that
(16:00):
shows if you can improve, makeyour improve resilience,
decrease your burnout, thosethat your efficiency improves
and that your care improves,because compassion fatigue, you
don't.
You know the person's a number,they're not a human being
anymore, and that's a big, a bigissue.
Speaker 1 (16:23):
One of the easiest things that you can do is drink
more water.
As a kidney doctor, you can dois drink more water that that.
That, as as a kidney doctor,you can.
You betcha, but but.
But I'm second that one.
I've.
I've seen that in my own lifebecause I would get home from
work and by the time I was homeI was so tired that I couldn't
play with my kids and I said Ican't.
I've got to do somethingdifferently.
I've got to make some changesin my life because I don't have
enough horsepower to get throughthe day.
(16:43):
Easiest simple change drinkmore water.
You don't notice it in themorning, but in the afternoon,
when you typically fade, younotice you got a little bit more
horsepower to get through andit's good for your skin and it's
good for your bowels and it'sgood for your brain, it's good
for your kidneys.
I can tell if somebody drinks alot of water.
I can tell by looking at theirface, because they have good
skin, and so I'll look at apatient and I go I bet you drink
(17:07):
a lot of water.
You can tell, and so that'scheaper than Botox.
Speaker 2 (17:08):
Those are the self-care issues that we have,
right.
Speaker 1 (17:10):
Yeah, and so that's a good start, and then sometimes
you start something like thatand then you kind of start to
view yourself as a little bithealthier person, and so maybe
you parlay that into a walk andyou start walking a little bit
and then you know, then you getthe salad instead of the steak
(17:31):
and you get some positivemomentum in life and so.
But I do think, with obesity,lack of sleep, you know all this
stuff, there's this energycrisis, where people don't have
enough energy to get through theday and so, and so the good
news is is these are fixablethings, these are things that we
can make better, and I do thinkthat if we fine tune the body,
that the mind would follow andthe mental health would be
(17:53):
better and our work capacitywould get better.
Now we don't want to just, youknow, turn ourselves into
working.
You know widgets that just, youknow, go, go, go.
I think it's important to seethe art and beauty in life, and
I think I think music or art, um, can be, um, well, it's really
the most valuable thing in theworld, really.
(18:13):
You know the, the uh, I meanliterally the.
You know the paintings, uh, youknow, some of them are
priceless, but it's, it's, it's.
It's good to step back and seethe beauty of this world Cause
it's there.
Speaker 2 (18:23):
Step back and the whole line about taking a deep
breath.
Yeah, it really makes adifference.
Speaker 1 (18:28):
Do you meditate or have you ever meditated before?
Speaker 2 (18:30):
I actually have, and so I have a series of about 15.
So there's different ways tomeditate.
I found out one is the Buddhistway to clear your mind.
I can't clear my mind, it'sjust not possible.
So I put things that I thinkwould make me better in there
(18:50):
and I try to do that pretty muchevery night when I wake up in
the middle of the night and I dothose kind of a series of
things that these are things Ishould make myself better.
So are you thinking aboutcertain things?
(19:19):
Is that what you're saying?
Just a list of things that Ikind of go through and I have
them and I go through them andkind of take inventory of where
I am?
Speaker 1 (19:33):
Yeah, yeah.
Meditation is thinking aboutwhat you're thinking about, or
that's mindfulness, mindfulnessmeditation is a type of
meditation that's very popular,and there's all sorts of stuff
Transcendental meditation, whichis TMorg, and then they have
the call app, or there's anotherone I can't remember the name
of it, but there's manyresources.
Speaker 2 (19:54):
So, actually, if you go to the St Luke's website and
wellness.
They have a list of littlemeditation videos that can help
you do those things and theyhave different kinds of
meditation videos.
They have the clear your mindor they have think of something
beautiful or think of somethingthat you enjoy.
(20:14):
And you know I've got into thehabit of doing it at night or
early in the morning, but in themiddle of a really rotten day,
taking three minutes or fiveminutes and just taking
inventory will help.
Speaker 1 (20:29):
Yeah, it helps immediately.
But it also you.
You start to carry with you theability to kind of stop for a
second and within one second,say I'm tense.
I'm tense right now.
I can feel it right between myshoulder blades, I'm tense, and
you take a breath and you let itout and you say you know you're
(20:49):
going to be okay, but just calmdown, don't, don't, don't hold
all your energy so tight, right,and it helps you be more
present and be able to talk andlook at the person in front of
you and not be thinking aboutall these things, and you have
better control about what'scoming in and out of your mind.
But it's like practice, it'slike you know if you're like
golf, like it's going to takesome time to get better.
Speaker 2 (21:09):
But it gets easier.
Yeah, bad habits are hard tobreak.
Good habits are hard to breaktoo.
Yeah, so if you can make it ahabit, you don't have to think
about it as much.
You don't have to put the timeaside because the time's aside
to decide.
Speaker 1 (21:23):
Yeah, yeah, I was talking I was having dinner with
one of the board members,actually and I was saying you
know, everybody knows about dietand exercise.
I think the two next big thingsthat people will start talking
about are sleep and mobility.
I think, like you know, I don'tknow if you can, you know, buy
stock and sleep and mobility,but I think you'd do well if you
did, because it's I think thoseare two really important things
(21:46):
that'll that'll make a bigdifference.
And I've started taking, youknow, sleeps very seriously, um,
over the past couple of yearstoo, and that's something that
there's no magic bullet.
You, you, you develop a routineand you slowly get better at it
and, um, and so do you sleeppretty well.
Speaker 2 (22:02):
Yeah, I have.
I do have semi magic bulletsicbullets.
I love to read, yeah, and Ilike to read medicine, and
medicine will put me to sleep ina minute at night.
Now, during the day I can readlonger, but at night, and so if
I'm having trouble fallingasleep, I just pull out the New
England Journal or pull up anarticle.
I try and stay off, try andcompletely stay off of screens
(22:23):
before bedtime and I try to, butyou know it's probably my age,
but I like to have a piece ofpaper or a magazine or a book in
my hand.
And you know I said this isn'tworking and the next thing I
know I'm asleep.
I literally I'm falling.
So I guess it is working.
Speaker 1 (22:38):
Yeah, the blue light on the screen tells your pineal
gland to wake up and that.
So that's not good and so, yeah, so we got drink water, stretch
, sleep, I think, for exercise,the best way to go about it if
you don't exercise is to setsome goal that's shamefully low,
like walk to the end of thedriveway and back, and do that
(22:59):
every day at two o'clock untilyou've developed the habit, and
then add volume to it after that, and so there's many ways you
know to do it, but I thinkthat's a good way is just get
the habit down first.
Speaker 2 (23:12):
There's a number of physicians that I notice, since
I get here early, who park faraway from the doors.
They can Totally empty parkinglot.
Yeah, good for them.
Speaker 1 (23:22):
Yeah, yeah, it gets your mind right too.
That's not a bad thing to do inthe wintertime either, because
it's uh and uh I don't know whatbook it was, but uh, they
called it.
Um, uh, practice poverty iswhat the book called it.
But so so I've done that a fewtimes just to remind myself that
, like everybody doesn't, youknow, have a warm spot, and it
kind of Right.
Speaker 2 (23:42):
But then the thing that's also nice about it is
when you add those up, it addsup steps.
Yeah, and you're right, youdon't.
I think exercise, dedicatedexercise, is important, but if
you can't do that on a busy day,taking the steps walking to
things, making a reason to getup and walk, even if it's just
walking around the office to getsome exercise.
Speaker 1 (24:04):
Yeah, the, the blue zones, people work with
communities and designingcommunities to make them so,
where people, the easy choice isthe choice that's good for your
health.
So, like the grocery stores,like you wouldn't, it's close
enough that you wouldn't get inyour car and go to it, but it's
far enough where it's a littlebit of a walk but it's just
(24:25):
easier to just walk thereinstead of back.
Or you know the way they woulddesign cities and communities
and so, and so I think a lot ofthese cities, where you know the
percent of people making it toa hundred was is way above the
norm, um, they're kind of set upin a way, um, and then you know
as.
So, aside from exercise,friendships, I think as people
(24:48):
get older and their children areout of the house, friendships
just become so, so important toyour health and your mental
health, and they just becomemore and more important as we
get older.
That's my opinion.
Have you found?
Speaker 2 (25:03):
that true.
I think friendships throughoutlife are important.
I think the friendships andwhat you're leading to is the
friendships change, how youobtain them and how you maintain
them change, and you know Ihave more time to try and do
those now, but you know, one ofthe things that used to be nice
(25:23):
in medicine is that we all gottogether periodically you went
down to x-ray, you went to this.
Now we're siloed with thecomputer and that's the real
problem and we're trying tobreak down some of those silos.
Some of the silos in medicineper se are not going to be break
it downable, but if we can putback that camaraderie, the
(25:43):
personal part of medicine, bothbetween patients and providers
and between providers.
Speaker 1 (25:51):
That's one of the things I love about St Luke's so
much and I've said this beforeis that it's a small enough
hospital.
I mean, we have manyspecialties almost every
specialty is here but it's asmall enough hospital that we
all know each other, and so mostof my good friends are people I
work with.
That we all know each other andso, you know, most of my good
friends are people I work with,and that's a nice thing.
(26:12):
You know to go into thelunchroom and see a friendly
face and have a goodconversation or ask somebody
advice.
You know, if something's goingon with my kid and I can say,
tom, you've had kids, what am Idoing here?
Speaker 2 (26:18):
You know help me out and that's really a good piece
of advice is that keep in mind,all of our problems are ours,
but there's somebody else outthere with a similar problem and
a similar experience and askingand peers and colleagues.
Many have gone through it orare going through it and you
(26:39):
don't know it.
Speaker 1 (26:39):
Yeah.
Speaker 2 (26:40):
And that's really important.
Speaker 1 (26:42):
Yeah yeah, just mathematically it works out.
If it's an old problem, you canlook in old places and find it,
and just if you consider old,50 years before now and back,
that's a lot of years and a lotof writing, and odds are, the
answer is going to be there.
(27:02):
If it's a new problem, you gotto look at new places.
But you know, you can find somenice texts that tell you a lot
of truth about life, whetherit's the Tao Te Ching or
whatever it may be, and so Ithink reading can be huge too.
Speaker 2 (27:19):
I think those are very helpful, and then I don't
think they need to be separate.
Yeah, human interactions andthe reading.
I don't think they need to beseparate.
Yeah, human interactions andthe reading.
Speaker 1 (27:28):
The first step in any problem is kind of defining the
problem and saying that, hey, Ihave burnout or I'm starting to
move towards burnout, and so doyou think there's value in that
?
Speaker 2 (27:41):
Absolutely, and I think identifying that is really
important.
It's now fairly widely acceptedbut for an individual it's
sometimes hard.
There are actually very nicemetrics on how to do that.
So the Maslach survey is thekind of gold standard.
But there's shorter surveys andwe've put some of them in the
(28:05):
wellness tab and we've actuallyoffered in one of our surveys we
didn't get a really a bigresponse but I think identifying
we'd like to identify peoplebefore they're burned out, when
they're starting to show thosemanifestations, and intervene
because burnout can really bedestructive to the person
(28:26):
individually.
Intervene because burnout canreally be destructive to the
person individually, to theirfamily and to their patients.
And so, yes, it's reallyimportant to identify it, to
admit it and to seek help for it.
Speaker 1 (28:43):
And my guess is that if you take the time out of your
day to go online and fill outthe burnout survey, I mean
there's some reason that you'redoing that, and it doesn't mean
that we have to do some maximalintervention, but it could just
be time to kind of take some,you know, take a step back and
reanalyze your life and say whatare the external things I can
change and that may be a lot orit may not be and then what are
(29:03):
the internal things I can changeto to develop more resilience
and and to to kind of increasemy physical and mental capacity
to deal with the stress.
Speaker 2 (29:15):
And you can change.
Speaker 1 (29:16):
That I mean for sure.
You can make a big difference.
Speaker 2 (29:20):
When you're significantly burned out, you
don't have the energy to do evenmuch of that.
That's right, and so we'veactually.
If, if you have the energy todo even much of that, that's
right, and so we've actually.
If you have the energy to go tothe wellness tab, those
resources are face up.
Okay, they're right there, sowe try to do make that available
.
Speaker 1 (29:36):
Yeah, and so the idea is you know, catch yourself at
the you know burnout one out of10 stage, because it's going to
be harder to deal with this thecloser you get to 10.
Speaker 2 (29:49):
You're just going to pass it, and we all have bad
days.
Burnout is not a bad day.
Yeah, burnout is a persistentdeterioration in how you look at
life, how you get enjoyment outof life and how you perform
your major task, and this iswe're physicians.
But this has been looked at,and in the entire healthcare
(30:10):
industry, from the top to thebottom, this is an issue, and so
we need to address all of us.
Speaker 1 (30:18):
Yeah, yeah for sure.
It's like what's the health ofhealthcare?
And actually this became anissue in COVID too, with, like,
our physical health is you know,the the the healthier we are,
the better we can serveourselves and our families and
our community.
Well, tom, thanks so much forjoining me.
It was a it was an interestingconversation.
(30:39):
I like talking about this stuffbecause you have to read about
it and you always learnsomething new, and so I very
much appreciate you andeverything you do.
Speaker 2 (30:46):
Yep, thank you very much, I enjoyed it as well.
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