Physician burnout: Solutions from someone who's been there, done that

With more Canadian doctors reporting burnout over the past year—at a rate that’s almost double from pre-pandemic times—the need for solutions continues to burn urgently. Dr. Lorraine Sharp, a family physician in Sault Ste. Marie, Ont., said during a session at the Family Medicine Forum—hosted in Toronto in early November by the College of Family Physicians of Canada—that the most effective solutions combine personal and organizational strategies. People facing a bad situation can either “leave it, change it or accept it,” she explained. She’s been there, done that. During the session, Dr. Sharp shared her own experience with burnout, which ultimately led to the decision to close down her family practice. “My patients now have no family doctor,” said Dr. Sharp, who works as a hospitalist and as an on-call doctor for palliative care, and also teaches at the Northern Ontario School of Medicine. “I had to reconcile my feelings of guilt with doing what works for me.” During the forum, she shared some personal strategies for coping with burnout. Self-awareness and being more mindful are key, she said. “If we are not focused on the present moment, we can’t pause and evaluate where we are and if we’re starting to creep into unhealthy patterns,” she said. To increase self awareness and mindfulness, she suggested doing a “mindful minute” and a 20-second “body scan”—a form of meditation that brings attention to the breath. She also encouraged setting alarms as reminders to reset or to switch from work mode to, say, family mode. Read: Video: 4 ways to take time off as a physician Keeping a journal can also be a good way to increase self-awareness. To make it easier to get into the habit of journaling, Dr. Sharp suggested putting pen and notebook where they can become integrated into a daily routine. “Put the journal on your pillow, with a pen ready to go so you can write down your thoughts before going to sleep,” she said. Another important step towards better self-awareness? “Let go of perfectionism,” said Dr. Sharp. “Skip the comparison to other doctors.” Setting boundaries is critical in any personal strategy for burnout. Doctors need to define where “we end and where our patients begin,” she said. “Do we jump into their story or do we sit there and recognize the feeling but stay separate?” she asked. “I choose to be empathetic but my empathy has boundaries.” Doctors also need to set boundaries with their time and with other aspects in their lives. These include time spent on their phone, even how much alcohol they consume. There are no hard and fast rules on how to set boundaries, it’s a matter of determining what is most supportive and healthy, said Dr. Sharp. Better communication can also make a significant difference in mental health and burnout. Simply refocusing a conversation can lead to better results and more pleasant interactions, she said. For example, if a patient starts an appointment by complaining about how long she needed to wait, a good approach might be to offer a brief apology and then say something to the effect of “since I know your time is valuable and I want to make sure we can address your concerns, why don’t we discuss what you came in for today?” Having a ready list of responses and statements that can smooth over rough moments can come in handy, especially when you’re too tired or busy to think of something appropriate to say, said Dr. Sharp. Read: The art of the chart: 10 tips that help me never chart at home She stressed the importance of effective time management. Doctors who haven’t “mastered” their EMR should make the time and effort to do so—it will be worth it in the long run, said Dr. Sharp. Delegation and redirecting tasks that aren’t core to a doctor’s practice is also a must. “I used to fill out the patient’s section on a form if the patient didn’t fill it out,” said Dr. Sharp. “But then I thought, ‘why am I doing this’ and started to send the forms back for patients to fill out.” Efforts to address burnout also need to be made at the organizational level. Training doctors to work as part of a team is a step in the right direction. Cross-training staff is also a good idea because it helps ensure that when one doctor can’t take on a task, another team member has the knowledge and skills to take over. Decreasing the EMR burden on doctors is also crucial, said Dr. Sharp. “For every hour spent with a patient, a doctor spends 1.4 hours of EMR time,” she said. “Data entry, updating patient profiles—all of that is now on the physician.” Giving doctors more control over their time through flexible scheduling can also go a long way towards reducing burnout, said Dr. Sharp. She also pointed to the importance of creating safe zones—physical spaces where physicians can come together to socialize, share their concerns and build relationships. “Making those connections and being with like-minded people–these things matter,” said Dr. Sharp. Read: How healthcare leaders can foster psychologically safer workplaces

Physician burnout: Solutions from someone who's been there, done that

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