Urologists discuss the spectrum of burnout


"I think that at any point, everyone is somewhere on that spectrum," says Anne M. Suskind, MD, MS, FACS, FPMRS.

In this installment of “Begin Your Journey,” host Scott A. MacDiarmid, MD, FRCPSC, and Anne M. Suskind, MD, MS, FACS, FPMRS, discuss the spectrum of burnout. MacDiarmid is a urologist with Alliance Urology Specialists in Greensboro, North Carolina. Suskind is an associate professor of urology; obstetrics, gynecology, and reproductive services, associate chair of faculty affairs and diversity, equity, and inclusion, and chief of neurourology and female pelvic medicine and reconstructive surgery at the University of California, San Francisco.


MacDiarmid: When you think of how common burnout is, or at least how it's defined, I think some of the statistics, it's half a million doctors, 60,000 residents, 40,000 medical students, a third of the 3 or 4 million nurses. It's over 50% prevalent, so you look to your left, you look to your right, you've probably seen somebody struggling a little bit to be joyful with their job. And then, of course, the effects that I mentioned, it's almost a public health crisis. What's been your experience? How does it impact your world and your thoughts? You've got residents, you've got faculty, you're in a university system. What do you think? What's your experience in this?

Suskind: I think it's a spectrum. That's my experience. And I think that at any point, everyone is somewhere on that spectrum. People feel more or less or no burnout, hopefully. But I think that it's something I'm very aware of, and I think that I probably over think about it, in terms of trying to build programs and interactions that support people. It's also something that I think about within myself quite a bit, and I try to consciously check in with myself, where am I on that scale? What do I need to continue to fuel myself so that I can continue to show up in the way that I want to show up in my job with my patients, with my colleagues, with my mentees, etc. There are various tools for doing that, but I think it's important for us to check in with ourselves regularly, to kind of understand what do I need at this time, so that I can continue to do what I want to do, or course correct, or change in the ways that we see fit. And I think that just building that self awareness, I think it starts with each one of us.

MacDiarmid: Why do you think it is so common?

Suskind: I think, certainly, it's an epidemic. And I think that, you know, we're seeing and experiencing burnout today in rates that I believe have never been experienced before, or were experienced differently. I think there's no one answer to that. But in general, I think a lot of us enter into medicine with this idealism and this feeling that we want to help people, and we want to serve, and we have the best of intentions, and there's all this enthusiasm and passion. And as we go through the ranks in various ways, there's all these repeated stressors that we experience, and they are vast. It runs the full gamut from new pressures under the pandemic, new ways of doing work, having to change how we function, working with the EMRs, working with our colleagues, limited resources, and being asked to do more personal interactions. I give a talk on this, and I have a very expansive list. It goes on and on. And what happens is it usually isn't any one thing. I believe it's this kind of repetitive insult that happens over time, and people just get to a point where they reach this feeling like they don't want to come to work or they feel overwhelmed, or there's this hopelessness or there's, of course, the cardinal symptoms that we measure in the Maslow burnout - this reduced efficacy, so we're not as efficient at our job; this increased cynicism; and just this kind of exhaustion. And then we start to identify with it, and we start to think that that's who we are, and that's how all things have to be, and I think we can very easily get lost in that.

This transcription was edited for clarity.

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