The Etherist Podcast, Season 4: Physician Well-Being

In the wake of the COVID-19 pandemic, anesthesiologists are being asked to do more than ever with less. Staffing shortages, supply chain issues, administrative burdens, regulatory compliance and unpredictable work hours continue to plague the field and contribute to burnout. This is a universal problem, and these are symptoms of a work environment that’s not conducive to sustainability.

Although “burnout” has historically been defined in several different ways, the term is generally characterized by three distinct components: emotional exhaustion (feelings of being overextended and depleted), depersonalization (having cynical and detached attitudes toward one’s work), and reduced feelings of personal accomplishment (involving a negative self-evaluation of one’s own effectiveness and worth).

So, what are the main causes of burnout and how can physicians foster a greater sense of well-being? Unfortunately, like any complex problem, there is no single solution. It’s a multifactorial condition that’s rooted in everything from schedules to culture. Anesthesiologists are often treated more like cogs in a wheel than professionals on which the system depends. And that’s what it’s mostly about, right? Simply wanting to feel valued, to be acknowledged as essential rather than expendable.

Nevertheless, there’s no scarcity of areas that require change. Do you curse the existence of the electronic health record? If you do, you are not alone. What is basically a billing system (one not designed by physicians) was forced on physicians, with virtually no input from physicians. It changed the way anesthesiologists worked; it changed how they thought; and it changed how they interacted with patients.

Additionally, in the push for volume-based care over value-based care, anesthesiologists are often asked to manage not one, not two, but three and even four ORs simultaneously. The expectation to simply get everything done, and as fast as possible, further cultivates this sense of depersonalization. It’s no longer Mr. Pizzi undergoing a total knee replacement; it's just another knee replacement. There’s an undeniable yet indefinable loss of personal achievement without that vital patient connection. Deprived of actually getting to know your patients, a profession that you once loved and maybe even felt a calling to, can slowly erode to feeling like a series of tedious tasks.

And without any say in what time a surgery begins or how long it goes on, the inability to dependably plan one’s personal time and achieve a sustainable work‒life balance only further highlights two recurring stresses: lack of control and a feeling of being marginalized.

From institutional to legislative reform, there are countless opinions on how to stabilize the specialty’s turmoil. Yet the one prevailing sentiment is that if there isn’t significant change in healthcare, as well as the way anesthesiologists are viewed and treated, then the mass exodus will not only continue but even accelerate.

So, what can you personally do? Is the touted yoga and meditation combo the true salvation? For those listening to this right now, from medical school onward, did anyone actually teach you how to take care of yourself—walk you through the key elements for self-care and self-preservation? The focus is solely on taking care of patients, which obviously is critical, but as a former AMA president once said, "The most important patient we really have to take care of is the one in the mirror."

Join us as we speak with leaders in the physician well-being movement, and learn from their unique perspectives on achieving work‒life balance and personal fulfillment. In this first episode, we feature a true rock star: Amy Vinson, who among many other things is the chair of the American Society of Anesthesiologists Committee on Physician Well-Being.

This is episode 1 of season 4 of “Anesthesiology News presents The Etherist.” Episode 2 will be available on November 3, 2022. It will delve deeper into defining just what burnout is, how quickly it can creep up, the unexpected toll it can leave behind, and why being mindful of it and your well-being are paramount.

Sponsored by Masimo.