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Alleviating health care professional burnout by taking your foot off the accelerator


“It's hard for us as physicians to think about anything other than continuing to put the accelerator into the red zone. But sometimes, a little bit of self-awareness can allow you to sustain a career for many years longer,” says Colin P. West, MD, PhD.

In this installment of “Begin Your Journey,” Colin P. West, MD, PhD, talks with host Scott A. MacDiarmid, MD, FRCPSC, explains how taking care of health care professionals helps those professionals take care of patients. West is a professor of biostatistics, medical education, and medicine at Mayo Clinic in Rochester, Minnesota. MacDiarmid is a urologist with Alliance Urology Specialists in Greensboro, North Carolina.


MacDiarmid: You and I have talked about the health care professionals and health care systems being on the same side and having the same mission. It's a big ship we have to move, but we can do it together. Have you had good success at the Mayo Clinic?

West: I have to say, first of all, that things at Mayo continue to be aspirational. We're in the same boat everyone else is in. On the plus side, we have a lot of strengths at Mayo in terms of a unique core value that everyone who chooses to work at Mayo rallies around. This idea of a common culture, where the primary needs of the patient come first, and an increasing recognition that we elevate the needs of our patients by taking care of our staff, so that they go together, is something that has served Mayo very well over the years. But I don't want to leave listeners with the impression that we're somehow a place that has everything figured out. Our historical data suggest, for example, that burnout levels at Mayo tend to be better than national averages. But we're not immune from this. We've been able to use some of that common culture, that understanding of what connects us with meaning, values, and purpose? The needs of the patient. How do we honor those? We honor those by taking care of our staff, so that they can take care of the patients and deliver the mission of the institution. That is something that leadership at Mayo Clinic tends to buy into. They don't have to be sold on that. And I think, in a way, it makes the business case for other organizations that might be a little hesitant because they wonder about the financial side of things. By saying, "Look, you can focus on those things at a place like Mayo and, although we maintain nonprofit status, do well financially so that you can reinvest in your staff, in your physical facilities, so that you can have things be cutting edge, state of the art. You can have places that patients can come to for healing in every sense of the word.” And so you can both take care of your employees because it's the morally right thing to do and because it's good business.

MacDiarmid: This may be an awkward question. Let's assume the same prevalence of burnout is in surgeons. Are there times you want to say, why don't you folks slow down a little bit?

West: This really ties into something we touched on earlier, which is that self-awareness, that being intentional about where you are on your wellbeing spectrum. If you're working really hard, and you are in a state of flow in the work that you're doing, and you've got a dynamic around you that supports that and that can function well in that, then there's nothing wrong with working super hard. When we look at specialties, for example, neurosurgeons work really long hours; the specialty data support that. Neurosurgeons do not have the highest burnout levels. In fact, they're pretty average. Now, they've got terrible work-life balance, as a rule. And I'm not just saying that to be judgmental; that's what the national data show. But they're not more burned out because of it. And when I've talked with my neurosurgical colleagues, part of it is because the work that they do, while being incredibly demanding and time intensive, is incredibly purpose driven. And so they're able to strike a positive balance, often, across all of these different contributors. And to me, that's the take-home message: If there are parts of your life that are not hitting on all cylinders, it might be that you're putting too much into the work side of things so that you're out of balance. And you need to listen to the people around you. Listen to your own inner voice and step back, take stock of what's around you, and think, maybe I am driving a little bit too hard. And it's that pathological altruism that's keeping me from being my full holistic best as a human being. And almost paradoxically, if you're in that situation, if you take your foot off the gas just a little bit, give yourself a chance to metaphorically smell the roses, you actually find yourself being more productive, more effective, a better physician, a better partner, a better member of your community, a more fulfilled human being. That's the goal that we're looking for. It's hard for us as physicians to think about anything other than continuing to put the accelerator into the red zone. But sometimes, a little bit of self-awareness can allow you to sustain a career for many years longer, more effectively.

MacDiarmid: Very well said. I want to finish off by thanking our viewers. I'm really proud of all the health care providers in our country. I want you to begin your journey to joy and fulfillment. And I want to thank Dr. Colin West. Could you offer some closing remarks?

West: I would just say, to segue off of what you just mentioned, it is a privilege and continues to be a privilege to be a health care professional, specifically to be a physician, not just in the United States, but anywhere in the world. There is no greater profession. And our task in taking care of our colleagues is to help them connect with that. We want it for ourselves, we need to expect it for our colleagues. And I think most importantly, the way we honor that privilege, the trust that our patients put in us, is by providing our patients the best possible care by being in an environment within which we can thrive and deliver that level of care. If we do that, we're actually honoring our commitments to this incredible profession, and we can sustain it. We can continue to recruit people, generation after generation, who are going to maintain the foundations of what we built in a profession that has no other. That's the objective. That's why I do what I do. And it's why I continue to be optimistic about the future because I see these ideals in every new class of medical students that comes in.

This transcript was edited for clarity.

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