Preventing physician burnout – is there a secret recipe? Part 1
The recently published Medscape’s Physician Lifestyle Report: 2012 starts to tell the story of what it is to be a physician in the US today, beginning with an overall “happiness” rating.
Approximately 1 in 3 physicians — both men and women — rated themselves a 5 and 40% rated themselves a 4 (suggesting “pretty happy”). The average happiness score for physicians who responded was 3.96, which is on the cheerful side but not overwhelmingly happy. When looking at happiness ratings by specialist, the 5 happiest were rheumatologists (4.09), dermatologists (4.05), urologists (4.04), ophthalmologists (4.03), and emergency medicine physicians (4.01). The 3 least happy professionals were tied at 3.88: neurologists, gastroenterologists, and internists. The next unhappiest were oncologists, general surgeons, and plastic surgeons, all tied at 3.89.(This is a link to the actual Physician Lifestyle Report by specialty in case you are interested!)
Nearly 60% of physicians ages 40 and younger don’t hold out much hope for American healthcare.Among the 500 respondents, nearly a third (31%) said they were “highly pessimistic” about the future of the U.S. healthcare system. Another 26% characterized themselves as “somewhat” pessimistic. Four percent (4%) said they were “highly optimistic,” and 18% claimed to be “somewhat” optimistic.About a third of those who were pessimistic (34%) specifically cited the “new healthcare law/regulations” as the reason. But that proportion would come closer to half if those who provided responses such as “system is a mess,” “distrust of government,” “government intervention,” and “Medicare is a mess and will only get worse” are added in. When asked specifically how the Affordable Care Act will impact their practice, 49% of all respondents — those optimistic about the future of healthcare as well as the pessimists — said the ACA will have a negative impact.(Here too is this report).
There are specific and reproducible patterns of changing neural activity and brain structures associated with stress. In the high-stress state, subject’s scans reveal less activity in the higher brain and more activity in the lower brain that directs involuntary behaviors and emotional responses. Prolonged stress correlates with structural increases in the density and speed of the neuron-to-neuron connections in the emotion-driven reactive networks of the lower brain, and corresponding decreased connections in prefrontal cortex conscious control centers.The explanation of these changes is generally attributed to the brain’s neuroplasticity of “neurons that fire together, wire together.” The brain literally rewires to be more efficient in conducting information through the circuits that are most frequently activated.As you internalize your thwarted efforts to achieve your goals and interpret them as personal failure, your self-doubt and stress activate and strengthen your brain’s involuntary, reactive neural networks. As these circuits become the automatic go-to networks, the brain is less successful in problem-solving and emotional control. When problems arise that previously would have been evaluated by the higher brain’s reasoning, the dominant networks in the lower brain usurp control.