Since 2004, Adventist Health System has placed a high priority on identifying and treating physician burnout, making it one of the nation’s leading authorities on the issue.
Under the direction of Senior Vice President for Mission and Ministry Ted Hamilton, M.D., Adventist, based in Altamonte Springs, Fla., has created a physician support services department — PSS. “I don’t know how many marriages have been saved and careers have been salvaged, I don’t know how many doctors may have averted a more difficult future because of this program, but there are many of them,” Hamilton says of PSS, which has aided roughly 1,000 Adventist physicians over the years.
Prior to PSS, Hamilton had been a family medicine doctor who eventually found himself overseeing physician activities at Adventist’s flagship facility, 2,741-bed Florida Hospital, an acute care facility located in Orlando. “Our medical staff leaders developed at Florida Hospital the first of what is now referred to as a code of conduct. We called it a citizenship policy back then, and it was designed to help us deal with incidents of unprofessional behavior, language, not doing medical records in a timely manner,” he says, noting, “This was before anyone was thinking about burnout.”
Hamilton directed Adventist, which has 44 hospitals in 10 states, to enable staff doctors to see a clinical psychologist confidentially. Over time, Hamilton began noting similarities between what he was doing and research that University of California, Berkeley, psychology professor Christina Maslach had conducted on the topic of occupational burnout. Hamilton started applying the Maslach Burnout Inventory, a 22-item survey that gauges whether a respondent is dealing with depersonalization, exhaustion and an inability to derive satisfaction from work to Adventist doctors.
“Burnout is most frequently recognized in primary care, emergency medicine, OB/GYN, internal medicine, but it is in every specialty,” Hamilton says. “And it’s not just about the doctors — think about the influence a well, healthy, whole doctor exerts on an institution and his patients, versus a doctor who is exhausted, burned out and being difficult to deal with because life is difficult.”
The factors that contribute to physician burnout are “complex and multifactorial,” Hamilton acknowledges. However, certain issues are particularly burdensome today, he says, pointing to “increasing regulation, increasing bureaucracy, increasing demands for documentation and increasing time devoted to activities that are not directly related to patient care.”
A 2014 study conducted by the Mayo Clinic and the American Medical Association indicated 54 percent of physicians felt they were dealing with career burnout. An Adventist Health System doctor experiencing those pressures gets six free visits to Adventist’s PSS program. Afterward, a physician can pay for counseling through her health plan or on an out-of-pocket basis.
Hamilton says that doctors “need to have the courage and wisdom and tact to tell one another. ‘You don’t seem to be yourself — tell me what is going on.’ Especially when it comes to long-term colleagues, or someone you look up to.
Recognizing that burnout exists and providing help are critical. “It’s something that is very important to me, to Adventist Health System and to the medical profession,” Hamilton says.