Medical Wellness Flashcards
Burnout:
a state of being that includes emotional exhaustion, depersonalization, and lack of feeing any personal accomplishment despite efforts.
Stress
physical and psychological reaction to ever increasing demands of life;
some stress is normal and can be productive
Some find stress arouses fear, uselessness, guilt, anger and incompetence
Physician Suicide
Suicide rates: approximately 300-400 per year;
that’s over 2 RVU graduating classes, per year
Suicide rates are higher among physicians than their non-physician counterparts, by
40% for men
130% for women
Of note, depression is not necessarily higher, completed suicide attempts are higher
Burn out, quality of life and depressive symptoms predict suicidal ideation
epidemiology of depression
Physicians:
up to 60% report experiencing burn out
up to 30% report being depressed
Medical Residents
Depression/depressive symptoms: 30-40%
75% of first year IM residents went from burnout free to some level of burnout
Burn out rates range: 30%-80%
RVU Epidemiology
Medical Students:
Depression/Anxiety Rates: 40%
Burn out rates: between 45% - 71%
Suicidal ideation: approximately 11% - of those reporting
RVU Students*
Feeling hopeless sometimes, often or always: 23%
Feeling depressed sometimes, always or often: 47%
Feeling emotionally exhausted often or always: 45%
statistics about stress and burnout among physicians
In another survey, only 54% of physicians would choose medicine as a career again
An average of 56% of surveyed physicians report being unsatisfied with their work-life balance
55% of surveyed physicians felt their personal life and family had suffered because they had chosen medicine as a profession.
alcohol abuse
One recent study reported about 13% or males and 21% of females met diagnostic criteria for alcohol abuse or dependence
Variables such as choice of specialty, suicidal ideation and burnout as associate with alcohol abuse or dependence
The same study suggested independent variables such as younger age, being male, unmarried, impulsive, depressed, smoking tobacco, and having a low perception of risk were stronger indicators for at-risk drinking behavior.
contributing factors to wellness
Medical culture
Work place elements
Personal character traits
School variables
medical culture
Rewards unhealthy behavior
Statistics go under reported due to embarrassment, of student, physician, schools and other health care systems
Maintains mental health stigma
Medical student report believing that if they admit being depressed that
faculty would perceive them as “unable to handle their responsibilities”
fellow students would ‘respect (my) professional opinion less.’
Seeking help would make student feel “less intelligent.”
Potential Contributing Factors: Physician Characteristics
Conscientious, hard working, high achievers, self-sacrificing, and self critical (good for being a physician, not so good for well being).
Role bound: Wrap up one’s identity into being a physician; I’m good or bad relative to how I am as a doctor;
Physicians tend to avoid formal healthcare; only a minority have their own primary care physician.
work place variables
Long often unscheduled hours; professional time eats into personal time;
Isolation; decreasing opportunities to connect
Keeping up with an ever-growing body of information (reading)
Finances; business and personal; student debt
Managed care limiting professional freedom
Stress in Medical School
Much research suggests high levels of stress during medical school
Statistics for medical students generally reflect those of physicians
One study showed that mental health worsens throughout medical school
Potential causes of student distress
Adjustment to medical school environment Year 1 & 2: Relocating (away from supports) Increased scholastic workload Concern for academic performance Attempts to master large volumes of information Necessity to join a new peer group Human cadaver experience High stakes exams (boards)
Adjustment to medical school environment Year 3 & 4: Separation from peer group New work environment/different hospital New rotation each month (different knowledge) Unstructured learning environment Lack of free time Long work hours Financial concerns Student abuse
Signs of Burnout:
Feeling overwhelmed in general Critical of self and others Negativity, cynicism Emotional/physical exhaustion It doesn’t feel like fun anymore; lack of personal accomplishment; unmotivated Home feels like a burden due to feeling overwhelmed with commitments outside the home Marital or other relationship problems Feelings of hopelessness or helplessness Tearfulness; crying easily Suicidal ideation Anxiety, depression, sleep difficulties Workaholic; increasing work efforts; ‘it helps patients if I work more, so it should help me’ Concentration difficulty Socially isolated Chronically late for appointments Psychologically absent; difficult deciding what to do, ambivalence Excessive guilt Feelings of worthlessness Family and/or friends notice and comment
Common Signs of Burnout in Medical School
Tearfulness Sense of feeling overwhelmed Feeling paralyzed; don’t know what to do Very tired; poor sleep habits Decreased focus, concentration, retention Chaotic study habits; constant study-school-sleep, repeat Increased isolation Little to no outside activities
