Until recently, physician burnout was something of a taboo topic in medical circles, but the problem has become so severe that it is now at the center of a national conversation, and Elizabeth Lawrence, MD, thinks UNM should have a voice in it.

 Burnout is a multifaceted syndrome characterized by a high degree of emotional exhaustion, depersonalization (cynicism), and a low sense of personal accomplishment at work. It now affects more than half of all practicing physicians.

The consequences are serious for everyone, says Lawrence, affecting the quality and cost of health care and the nation’s ability to treat an increasingly sick population. Lawrence, who was chief resident in Internal Medicine at UNM in the 1990s, returned to the faculty in 2015 after a decade in private practice specifically to focus on physician wellness and preventing provider burnout.

“In my private practice I cared for a large number of health care providers, and was very struck by the impact that our work has on individual health,” she says. “Also, I myself burned out, having found that it was very difficult to run a private practice, handling everything from clogged toilets to employee hiring, while raising kids and taking care of dying parents.”

She took time off and dove into the research, coming across a growing body of literature in a growing field. When an opportunity arose in the area of undergraduate medical education at UNM, Lawrence became the director of the Office of Physician and Student Wellness.

“I always felt you couldn’t send medical students into an environment with burned-out residents or faculty and expect them to learn good self-care,” she says. Accordingly, the program includes initiatives at all levels. At its heart is a four-year curriculum that teaches skills ranging from time management to health coaching and self-care (yoga, mindfulness, narrative reflection) to the de-stigmatization of seeking help.

“There is a national call to pay attention to this issue,” Lawrence notes, because burnout raises the cost of care and increases the likelihood of physician error and the ordering of unnecessary tests. Patients are also impacted by disruptive or rude interactions with burned-out physicians.

The toll on health care workers themselves is especially alarming: Nearly a quarter of ICU nurses tested positive for post-traumatic stress in one study, while physician experience high rates of depression (39 percent) and suicide rates are double that of the general population.

One major reason that burnout is rising among physicians – up from 44 percent in 2011 to 54 percent today – comes down to recent changes in the nation’s health care system, Lawrence says.

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