Cardiologists are always concerned with their patients’ health but how do we make sure they don’t burn out themselves? Burnout is rising in all physicians, and cardiologists are not an exemption. Cardiology is a very popular specialty among medical students as it is associated with outstanding training standards, high prestige, and increased income.
In a US-based survey of 15,000 physicians across 29 specialties, some 42% reported evidence of burnout. When the results were split by specialty, cardiology was somewhere in the middle with 43% of physicians affected. One of the more alarming findings was the age group of physicians experiencing the greatest incidence of burnout—50% of physicians reported were those in the age group of 45 to 54 years old.
Burnout in cardiologists has serious negative personal and professional consequences and is associated with suboptimal healthcare outcomes for patients. It is primarily driven by professional and healthcare system demands and inefficiencies such as excessive workload, role complexity, training and certification demands, inefficient compensation models, lack of resources, computerization, and loss of autonomy. Moreover, loss of connectedness with patients, difficulties in balancing work and personal life, and perfectionism in medical practice further increase the risk for burnout. Burnout among cardiologists may be best mitigated by organizational strategies complemented by individual stress reduction and reflection techniques under the resilience-based approach. Large-scale strategies are needed to mitigate burnout and promote physician wellness as a shared responsibility of healthcare systems and individuals. All must be committed to creating a new culture in medicine.
The consequences of physician burnout can be both personal and practice related. At the practice level, physicians who report feeling burned out are more likely to reduce their clinical work hours and to reduce the number of patients in their clinical practice. Some physicians are more likely to quit medicine altogether or to retire from their home institution and to find places of work that are more conducive to a work-life balance.
Burnout occurs as a result of a complex interplay between institutional and personal factors. According to some studies, female physicians are at 30-60% higher risk of experiencing burnout compared to male physicians. Age is another significant personal factor. Contrary to what is established for non-physician populations, several studies have demonstrated that younger physicians experience higher levels of burnout compared to older physicians. Perhaps physicians with more clinical experience have a more thorough understanding of the work dynamics, safeguarding them against burnout. In addition, physician personality traits, including introversion, predispose physicians to burnout. Conversely, grit and perseverance have been identified as protective factors against burnout. Other factors associated with burnout include having a younger child, having a partner in a non-medical profession, and lack of a social support system.
Dr. Beth Frates suggests a three-fold approach to preventing burnout and achieving three dimensions to well-being. These are the healthy body, the peaceful mind, and the joyful heart. For a healthy body, a person must focus on exercise, nutrition, and sleep. For a peaceful mind, a person needs a strong stress-reduction technique that they can use in the moment, vacation opportunities, and a growth mindset. For a joyful heart, it is recommended to find natural sources of energy like nuts (instead of an extra cup of coffee) or a walk-and-talk with a friend.
On a broader level, there is agreement that systems-level change will be necessary to reduce burnout among cardiologists and their teams by rethinking workflows and improving work environments.This can be done by creating a second task force charged with helping reduce the administrative burden on cardiology teams, including physician’s assistants and nurse practitioners.
One way some cardiovascular practices are starting to reduce administrative burden is by hiring scribes who enter patients’ information into electronic medical records, thus freeing clinicians to focus on clinical care. There is also data suggesting that using scribes increases productivity, practice revenue, and patient and physician satisfaction.
Dr. Madhav Swaminathan from Duke University is working to support physicians to prevent, and to also help treat, physician burnout. She suggests an approach to deal with burnout called the three R method. First is to Recognize the symptoms of burnout. The second is to Reverse burnout by seeking professional help to reduce the damage that has been caused by burnout, and third is to develop Resilience to burnout by improving one’s own personal wellness.