Identify and act on the drivers of burnout that are crucial for the well-being of cardiologists

Disclosures: Poppas reports that she has a financial interest in GE. The other authors do not report any relevant financial information.

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Clinician burnout is a multifactorial problem, found in a large portion of cardiologists, that requires a multi-pronged approach to eliminate in health care practitioners, according to a statement on clinician wellness.

The American College of Cardiology, the American Heart Association, the European Society of Cardiology, and the World Heart Federation released a joint opinion statement highlighting the many manifestations of clinician burnout, its main drivers and causes. ways in which institutions can act to reduce its prevalence among health workers. , especially cardiologists. It was published in the Journal of the American College of Cardiology, Circulation, the European Heart Journal and Global heart.

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“As clinicians, we strive to improve the health of our patients; yet it is increasingly clear that our own well-being is an essential component of the quadruple goal: to improve the health of the population, to improve the patient experience, to reduce costs and to improve the working lives of healthcare workers. “, Cardiology today Member of the Editorial Board Laxmi S. Mehta, MD, FACC, FAHA, a non-invasive cardiologist and professor of medicine in the Division of Cardiovascular Medicine at Ohio State University, and colleagues wrote. “The well-being of the clinician is described as the experience of satisfaction and commitment in the work, while also having a sense of professional growth and a sense of meaning at work. “

Burnout is defined as emotional burnout, depersonalization, and a sense of low self-accomplishment in a stressful work environment, Mehta and colleagues wrote.

According to the Constitution of the World Health Organization, “Health is a state of complete physical, mental and social well-being and not just the absence of disease or infirmity. “

Therefore, the authors of the joint opinion statement argued that the absence of burnout does not necessarily represent a state of well-being among physicians. They said burnout is an extreme component of the well-being spectrum for clinicians and can be concomitant with other common mental health issues.

Prevalence and characteristics of burnout

Athena Poppas

“Over the past few decades, there have been significant changes in healthcare with the expansion of technology, regulatory burden and administrative burdens. These developments have had a cost for the well-being and the work-life integration of clinicians ”, Athena Poppas, MD, MACC, past president of the ACC, director of the Lifespan Cardiovascular Institute in Providence, Rhode Island, and chief of cardiology and professor of medicine at the Warren Alpert School of Medicine at Brown University, said in a press release. “The COVID-19 pandemic has put additional pressure on clinicians due to increased patient mortality, concerns about personal and family safety, fear of the unknown and increased professional demands. Now is the time to join our global healthcare professionals in calling for rapid action to improve the well-being of clinicians around the world.

As Healio previously reported, 35.4% of US cardiologists reported feelings of burnout; 43.9% said they felt stressed; and a quarter of physicians who reported burnout reported experiencing symptoms such as physical and / or emotional exhaustion, a personal sense of lack of accomplishment, cynicism and detachment.

At the 2017 AHA Science Sessions, researchers reported that burnout was also 29% more likely among cardiologists who are female compared to men.

Doctors who said they were exhausted were also:

  • spend more time in direct clinical practice;
  • less satisfied with achieving their professional goals or the desired financial compensation;
  • less likely to recommend cardiology as a career; and
  • less likely to report feeling valued or treated fairly at work.

Exhausted doctors also reported a lack of workload control, a hectic work environment, misalignment of values ​​and insufficient documentation time, the statement said.

Strategies to prevent burnout

Laxmi S. Mehta

“Healthcare organizations have primarily focused on the concept of ‘repairing the employee’ with individual-focused programs (self-resilience and stress management training) as a solution to improving well-being; However, much more effort needs to be geared to the systemic issues that affect the work environment, ”Mehta and colleagues wrote. “The intentional refinement of practice environments with highly functional teams in which clinicians can optimally care for patients enables all team members to find value and purpose in their work and can lead to better outcomes.” for healthcare organization and patients. “

To support the psychosocial health of clinicians, the authors recommended that institutions adopt the Stanford Well® professional growth model. This approach incorporates a culture of well-being, practice effectiveness, and areas of personal resilience while taking into account modifiable intrinsic factors such as recognition, trust and sense of work, and extrinsic factors such as call schedules, compensation and technology.

The authors of the joint statement also recommend the use of an adapted model of Maslow’s hierarchy of needs by Shapiro and colleagues. This model provides a hierarchical step to respond to the professional growth of clinicians. The hierarchy reads as follows:

  1. basic physiological and mental needs;
  2. Safety and security;
  3. respect for administrators, colleagues and patients;
  4. appreciation and interpersonal connection; and
  5. resources and time to treat patients and fully practice medicine.

According to the statement, hospital credentials committees should improve investigations of mental health issues so as not to perpetuate their underreporting or undertreating due to clinicians’ fear of losing their hospital privileges.

“Even before the COVID-19 pandemic, clinicians often struggled with existing health systems that did not fully support them,” Fausto Pinto, MD, PhD, president of the World Heart Federation, dean of the Faculty of Medicine at the University of Lisbon and head of the cardiology department at Santa Maria / CHLN University Hospital, Lisbon, Portugal, said in the statement. “Clinician burnout prevention strategies must target the root causes of the problem. Medical societies, as well as foundations of civil society, have an important role to play in creating support networks for their members and in pushing governments to adopt meaningful changes in health policies. “

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