How doctors can avoid a burnout? Leading Boston doctor on resilience
Dr. Sanjiv Chopra, renowned Boston-based liver expert and leadership scholar – on how physicians can avoid burnout in a high-pressure modern clinical practice:
I want to mention one other thing, and you actually asked about it: What do we do with physicians’ burnout and resilience? That’s something that I think a lot about, because the statistics are mind-boggling. That the rate of suicide in male doctors in America is 1.2 times higher than the national average. For women doctors 2.2 times [higher], dentists – 5 times [higher] the national average. What are we doing? I think people are feeling that they’re working harder and harder and harder, there’s a lot of paperwork they have to do. That people are not recognizing and validating them And there actually simple things that we can do to validate human beings, to bring back the joy in medicine, for people to feel valued and not experience burnout. And they include having people have access to water and to coffee and to some nuts or fruit. That’s not expensive for a hospital to do, compared to burnout. Burnout will lead to people just being replaced. It costs many many tens of thousands of dollars to replace one individual physician or nurse. And if you burn out, you make mistakes. You’re now subject to litigation, malpractice. So we need to create an environment in the hospital where people can do that. Number 2, you need to have a quiet room where they can go meditate, pray, just sit silently, listen to some music. Number 3, we need to allow much more flexibility. So if a woman is working in a hospital and she has to now pick up her child from daycare twice a week, the other three days maybe the husband is picking up, and she has to be there at five o’clock, we cannot have her last appointment at four o’clock or at 4:15. And now she’s running late, now she’s in traffic, and now the daycare people are unhappy… Let he leave two days in the week at 3:30 and then one Saturday in the month she can make up and see a few patients or she can take a slight cut in her salary. You can help employee peers, you can employ part-time two people instead of one full-time person. Hydration, silence, meditation, mindfulness, exercise, flexibility in the hours – and then validating it. Google did something very interesting years ago. Instead of giving their top people a bonus of a $100,000 or $200,000, which is not unusual for them, they said: “All of you are coming and bring a significant other and we’re going to take you to Costa Rica for eight days, all paid expenses.” They had a great time in Costa Rica, they networked, they met colleagues they’d only seen and met by email, they had their significant others, and then they were asked “Which was more valuable for you? This trip to Costa Rica or previous year when you got a check with the bonus?” And they all said, “trip to Costa Rica”. Social fabric, social connectedness is so important in our lives. But Google validated this by doing this little experiment. It costs Google $18,000 per couple, much less than $100,000. Not that Google needs to save money, right? But it shows a value of recognizing people, giving them an award, giving them a certificate saying “you’re a good person”, sending an email to the whole group saying, “So and so, our social worker today in the transplant service, did an amazing job! My god she was so good and the patient’s family is so grateful…” Just do that – it’s simple things that we can do. There’s a recent study, I think, by my colleague at the Brigham. 60% of third-year medical students in our country – 3rd year medical students – are expressing elements of burn out. They haven’t even started their profession! What are we doing to them? So we have to bring back the joy by celebrating medicine, by telling stories about the baby that was born twice, or this guy, my God, stem cell research or this guy did a live donor transplant – look what happened! Or this medical student made this amazing diagnosis that the rest of us were struggling with… – And trying to rush a little bit less… – Yes, and slow down! I’ll finish with five things people say, and these are the five things: “I should have traveled more, I should have spent more time with my friends, I should have been the bigger person and said I’m sorry, I should have had the courage to pursue my dreams and aspirations, I should have said I love you more often!” Who says these five things? People in hospice when they are asked, “What are your greatest regrets in life?” These are the 5 things. Nobody says, “I should have worked harder. I should have made more money. I should have lived in a big mansion. I should have driven a new Tesla every six months.” Right? So these are the greatest regrets. The point of this is we should be doing it now. Let’s not have these regrets on our death bed. Professor Chopra, thank you very much for this very fascinating conversation! It will be of great interest to people around the world, and we hope to come back to you in the future! Thank you very much! – Thank you so much, great to be with you!