Like you, I’ve seen all the articles on physician burnout. And I’ve nodded my head at the disconnect in even the term “burnout.” Some have argued that the word “burnout” implies that it’s somehow the physicians’ fault. That we are not strong enough. Not “resilient” enough. Simply, not enough.
Sure, there’s myriad reasons we are all maxed out: electronic medical records, burgeoning government mandates, patient satisfaction surveys that lack wisdom, insurance restrictions. But there’s one reason that we don’t often talk about: loneliness.
The Harvard Business Review recently published a survey on over 1500 full-time employees, assessing their loneliness and sense of support. It turns out, the more education you have, the more lonely you are. As you and I would suspect, doctors were at the top of the heap (surprisingly, neck and neck with lawyers!), reporting 25% higher loneliness scores than those with bachelor’s degrees.
We have all experienced the loneliness that comes with medical education — it starts when we are labeled “gunners” in our pre-med years, and magnifies when we turn down vacations at spring break, or during the summer because of our educational commitments.
The differences grow stronger as we see our friends in accounting, marketing, and sales finish their four years of college and start living. Our delayed gratification plays out ever-so-slowly, as we trudge through internship, residency, even fellowship. By the time we get out and start our “real lives,” some of our old college buddies are a decade ahead of us!
We never really catch up. When we start our first real jobs, and our non-medical colleagues want to meet for lunch, we realize just how large the gap is. We all know doctors don’t do lunch. As our parents, neighbors, colleagues wonder why we are missing the ballet recitals, the soccer tournaments, the cookie sale, we try to explain, but … it’s like we have our own language.
It would be OK if all physicians were banded together in solidarity, and we could meet once in a while to share notes and build each other up. But these days, when doctors’ lounges are being closed down, when we’re staying late at the office to finish our charting, when we barely can find time for our families, let alone ourselves — the time for physician-to-physician camaraderie is cut short.
Yeah. We’re lonely. So what? Well, here’s the rub. There is research, including a 2015 meta-analysis of studies on loneliness, that tells us loneliness is not just a problem — it’s a life-threatening problem. Lack of social interaction is worse for our health than smoking, obesity, and high blood pressure. And, as mentioned in my TEDx talk, social isolation increases our risk of death from 35 to 45%, depending on which study you read.
Isolation as a physician can increase our daily frustration, increase our risk of medical error, and increase our risk of suicide. Undoubtedly, this contributes to the fact that physicians have the highest suicide rate among all professions.
Now that you’re totally in a funk, what can you do to improve this situation? In our hospital, the women physicians got together and formed a book club, called “Wine, Women, and Zen.” We meet once a month, rotating to different members’ homes for a potluck, book discussion, and fellowship. It has grown from 8 members to almost 80. Some of my physician coaching clients have recharged their batteries by forming a Journal Club. Journal Clubs are not just for academic settings. Many folks in private practice settings or hospitalists have found that a Journal Club allows for social interaction, sharing of patient cases, and bridge building among colleagues.
In the glory days of medicine, many physicians had Wednesday afternoons off to play golf. Sadly, this was before my time. But in retrospect, it was a perfect opportunity for physicians to bond together, have a breather, and enjoy a bit of physical activity.
Interestingly, a recent article in The Washington Post by David Cordani, president and CEO of Cigna, discussed the need for corporations to develop a “culture of connectivity” to combat loneliness. Suggestions such as offering a caregiver leave program, establishing employee resource groups, improving networking through mentorships, and coaching were all included. Even more interesting? The article did not mention physicians.
Some hospitals have begun to focus on the issues of physician isolation by working to change the culture.
One of the main ways we can work toward improvement is by identifying the problem and owning it. So this week, reach out to a fellow physician. Offer a kind word. Meet for coffee. Or your favorite adult beverage. It starts with one.
Starla Fitch is an ophthalmologist, speaker, and personal coach. She blogs at Love Medicine Again and is the author of Remedy for Burnout: 7 Prescriptions Doctors Use to Find Meaning in Medicine. She can also be reached on Twitter @StarlaFitchMD.