Storytelling by physicians can play a role in limiting the growth of physician burnout, say speakers at Planetree’s International Conference on Patient-centered Care.
Physician burnout leads to more errors, less patient satisfaction and lower patient adherence to recommended treatment, said Dael Waxman, M.D., medical director for patient-centered programming at Carolinas Medical Center–Mercy in Charlotte, N.C., and a board member for the Derby, Conn.-based nonprofit that advocates for patient-centered care.
More than 54 percent of physicians surveyed in 2014 exhibited some symptoms of burnout, up from 45.5 percent in 2011, according to research cited by Waxman. Waxman described how burnout manifests itself in physicians — causing them to be emotionally drained from work, which makes them fatigued at the start of the day and causes irritation to be their typical response to routine work demands. Other signs include talking down to peers, treating patients like objects, a loss of motivation or passion for work and feeling uncertain about their own competence.
Some of the specialties with the most burned-out doctors include emergency medicine, general internal medicine and family medicine. “For the vast majority of people accessing health care, this is the front line,” Waxman noted.
As a countermeasure to burnout, Waxman advocated for physicians to write stories in which they recalled moments they showed or witnessed compassion in health care.
To demonstrate this strategy’s effectiveness, he had attendees split into small groups to tell and discuss stories they wrote on the spot. Dorothea Wild, M.D., of Bonn, Germany, spoke of an older patient with multiple chronic conditions whose physical and mental health were declining rapidly and decided on her own to enter a nursing home.
“Most patients go to the nursing home kicking and screaming and complaining,” Wild said, adding that she told the woman how brave she thought she was. This spurred other memories for Wild of being with patients and their families while they visited with clergy. “Some may feel this is unprofessional, especially if you get emotional,” Wild said. “But you have to retain your humanity.”
Bas Kors, an internist and intensivist physician at Spaarne Gasthuis Hoofddorp, a hospital in the Netherlands, recalled a patient who spent more than two weeks in the intensive care unit before dying from sepsis. His family — sons, daughters and grandchildren — came to the hospital every day, singing to him and keeping him company. Kors said he got goose bumps from just thinking about the love and compassion that flowed freely from the family toward the man.
Waxman asked the others how it felt to write their stories. One man told him how life goes by so fast in health care that he appreciated being able to take the time to reflect and think about one particular moment, while one woman told how the process made her remember details she thought she had forgotten.
Christopher Atkins, a field consultant with the Department of Veterans Affairs in Chattanooga, Tenn., said he could see VA clinicians using the strategies Waxman described to “restore their energy reserves.” “We need this kind of training,” said Atkins, part of the VA’s Veterans Experience team. “In morning team huddles, if they could share something that happened to them yesterday where they used compassion to help a patient heal, it will trickle over to today.”
D’Anna Holmes, a patient engagement program manager at Northwestern Memorial Hospital in Chicago, said issues such as physician burnout were previously considered “soft stuff” and not taken as seriously as they should have. “Physicians, traditionally, have never been surveyed about what their stressors are,” Holmes said. “We’ve started doing provider engagement screening, and we’re hoping to see a difference.”
Holmes said she believes Northwestern physicians and nurses would be open to sharing stories of compassion and that it could be a worthwhile intervention in fighting burnout.
“They need it and we’re getting to a point where physicians realize they need it,” Holmes said. “It’s past time for something like this.”