Dr. Denis Grillo, Ear, Nose & Throat, 09/25/12

In past articles, you have heard me describe the situation of having too few doctors to treat the burgeoning population. In the past articles, I focused on the cost of medical school, aging doctors retiring. This problem that stresses the doctor workforce has to do with doctors becoming burned out.

In our society, doctors are expected to be strong, cope with anything that is thrown at them, and have multiple interpersonal relationships with staff and family, as well as colleagues.

We are taught that we must separate work and home issues, be vigilant and be able to work under almost any circumstances without wavering or endangering patient care.

The reality of medicine is that it has changed over the years for various reasons. Physicians encounter increased stress factors, including not just trying to be a good doctor, but also be a businessman, deal with unhappy patients and handle complications in patient care that sometimes are out of the doctor’s control and related to the patient’s diet and lifestyle.

For years, we have seen medicine change such that doctors are constantly told what they need to do and which rules they need to follow, while attorneys continue to mount the threat of litigation that seems to go unchecked. These types of factors were not so prevalent decades ago, and contribute to the stress and anxiety of a practicing physician, and directly contribute to burnout and loss of physicians.

A balance of work and other pursuits is ideal, but sometimes elusive and difficult to achieve. Simple little things such as technology, and technologic advances, have made it so it is difficult for physicians to balance their professional and personal life. Going home does not mean leaving things behind. We now have cellphones, iPads, computers, Internet, email — all these ways of communicating that ultimately make physicians constantly accessible.

Physician burnout is characterized by many things: emotional exhaustion, depersonalization in the office and the workplace, anxiety and frustration because of perceived low personal accomplishment.

Decades ago, physicians were few, and sometimes one doctor did everything. If it was not able to be done, patients accepted that. Now­adays, there are tremendous strides in improvement of medical care so that not every doctor can do everything by his- or herself. But the mindset is you must do everything you can, thus creating unrealistic situations that bring on stress and anxiety. Physicians are trained early on to be really tough.

This goes back to medical school, when they put you in the lab in the classroom, which is essentially a training camp, and the intention is sometimes to weed out those who can’t “cut it.” So physicians learn early on to suppress their fears and anxiety, and sometimes take on the attitude that they can do and take on anything. This is unrealistic, and leads to a “burnout” situation.

It is true we expect a lot from doctors, but you still have to understand they are human beings and have physical and mental limitations.

Most surveys still put doctors as at the top of the list of one of the most respected professions in our country, and doctors themselves hold themselves up as having strong virtues, and strive to be perfect.

According to one study in the archives of surgery, one in 16 physicians has been reported to have contemplated suicide. Another statistic that holds true is that the physician suicide rate is twice as high as the general public. I can relate to that; I have one classmate who killed himself shortly after his residency training.

Stress management is not taught in medical school, or residency. The medical community is trying to make some efforts to reduce stress on doctors by reducing their call load, and there are now laws limiting the amount of hours residents work per week. This helps physicians from not burning out, and also helps to facilitate patient care and patient safety.

I frequently tell my patients that life is like a road race: you have to balance your pursuits, and you have to pace yourself, otherwise you will not finish the race successfully. I have been in practice for 25 years, and I can tell you that I have changed the way I have practiced to try to have a healthy, and successful, and long career, and I have abandoned my “Bring it on” attitude about being able to take care of and manage any patient situation.

The recent loss of a physician in this community, who was in his 40s, is an example of the result that can occur from burnout and how it can affect your health. The medical community must recognize that, not only do we have to take care of our patients, but we also have to take care of ourselves so that we can be there for our patients.

Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.