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Is Burnout Talk Causing More Burnout?

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Skeptical Scalpel

Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and critical care and has re-certified in both several times. He blogs at SkepticalScalpel.blogspot.com and tweets as @SkepticScalpel.

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Skeptical Scalpel (click to view)

Skeptical Scalpel

Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and critical care and has re-certified in both several times. He blogs at SkepticalScalpel.blogspot.com and tweets as @SkepticScalpel.

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"There is certainly much to be depressed about in medicine...But could it be that the more stories written about burnout and depression, the more burned out and depressed doctors become?"
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Almost every day for the last few years, someone is writing about physician burnout or depression.

The problems begin in medical school. A recent paper featured drawings that medical students had done depicting faculty as monsters. One student felt so intimidated during a teaching session that she drew a picture of her urinating herself.

The paper equated faculty and residents supervising students to “zombies, vampires, ghosts, and other supernatural figures.” In dealing with the state of the world today, the authors cited a comment by the novelist Stephen King saying that to cope with adversity, people make up horror stories. That sounds pretty serious.

Could the problem be declining student resilience? An article about college students in Psychology Today pointed out that they are less able to deal with seemingly minor affronts. And teachers are reluctant to “give low grades for poor performance, because of the subsequent emotional crises they would have to deal with in their offices.”

“If emotional contagion has such an impact on Facebook users, maybe all these stories about burnout and depression have an impact on students and doctors too.”

 

This has forced faculty “do more handholding, lower their academic standards, and not challenge students too much.” The article pointed out that college students exhibit more anxiety and depression and take more prescription drugs for these problems than ever before.

It’s not just students.

A systematic review of 54 studies found that 29% of resident physicians were depressed or had depressive symptoms. The number ranged from 20.9% to 43.2%, depending on the method studies used to assess depression.

Investigators from the Mayo Clinic and the AMA found that more than 50% of practicing physicians surveyed exhibit symptoms of burnout, and the problem has worsened since 2011. Depression and suicidal thoughts are also common.

All of these studies have been covered extensively by media such as the Washington Post, NPR, Time Magazine, Forbes, among many others and were widely discussed on Twitter.

Here’s a thought. What about “emotional contagion,” the subject of a 2014 paper published in PNAS? The authors studied 689,000 Facebook users and found that negative emotions can be transferred from one person to another without direct contact. They concluded, “…emotions expressed by others on Facebook influence our own emotions, constituting experimental evidence for massive-scale contagion via social networks.” If emotional contagion has such an impact on Facebook users, maybe all these stories about burnout and depression have an impact on students and doctors too.

There is certainly much to be depressed about in medicine—stress, declining reimbursements, soul-sucking electronic medical records, long hours, arbitrary rules, and much more.

But could it be that the more stories written about burnout and depression, the more burned out and depressed doctors become?

 

Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and critical care and has re-certified in both several times. He blogs at SkepticalScalpel.blogspot.com and tweets as @SkepticScalpel.

5 Comments

  1. This is in response to the two comments from January 26. I guess there are two ways to look at this issue. Both of them were expressed here.

    Reply
  2. Unless we acknowledge the problem , the process of prevention and management will not start. The US Defence Dept didn’t even _accept the diagnosis of the PTSTD in the returning veterans, seeking help. Medical professionals are just as Human as any one else, and deserve all the help they can get- to survive the non stop onslaught from many segments of media, society , & Trial lawyers

    Reply
  3. bloody hell boo-hoo , life’s a bitch and then you die. are any occupations free of stress? we have a great privilege to be physicians. letting others bring us down is a reflection of our own weakness . how is medical practice in syria or afghanistan these days?
    oh, really, stressful? can’t compare to meaningful use.

    Reply
  4. Can’t answer for students, residents etc, but for those in practice it is real. The Damocles sword of malpractice that hung over our heads has been replaced by a Medusean devil with multiple blades each labeled by some 3 or 4 letter government acronym waiting for us to fail to “perform”.
    Each day the goal post is moved to another level founded on the sands of another committee consisting of 3 piece suits and administrators.
    The current head of CMS announces “meaningful use will end in 2016” and even he finds his suits pull him back into their abyss of regulations and “oh no it’s not”. And you wonder why we are depressed?

    Reply
    • I hope I didn’t give the impression that I thought burnout and depression weren’t real. I simply wonder if it’s become contagious. I had not read that meaningful use was back on the agenda. Do you have a link to an article confirming that please?

      Reply

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