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STRESSED OUT

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for the patients with this disease that I care about.”
“The question is,” he said, “how many soccer

games is it OK to miss to still have the relationship
with my kids that I want and the impact profession-
ally that I aspire to? It’s this integration of these two
spheres that’s really where the rubber meets the road.”

Addressing isolation of colleagues every two weeks to go out to a restaurant in town with
Due to some of the changes to the medical profes- their colleagues. Dr. Shanafelt said about 1,000 physicians have
signed up.
sion over the past few decades that have resulted in
busier schedules, higher productivity expectations One physician in the audience who teaches in a residency pro-
and more time spent documenting, physicians have gram noted, “One of the questions that I got once — that I still
less time to interact with each other. don’t know how to answer —is: ‘Aren’t you just teaching us how to
trick ourselves into being happier when we really are in this horrible
“That interaction has always been part of the fabric situation?’”
of the profession,” Dr. Shanafelt said. “We have
amazing colleagues, and getting to work with those “I look at it just like clinical skills,” Dr. Shanafelt answered. “You
people is what makes this profession great. But we as an individual want to do your [continuing medical education]
have less of that interaction now than we did in the and keep yourself current and refine your art as best you can. And
past.” the system in which you plug into is also going to make you a better
or less effective physician.”
In a study at the Mayo Clinic, Dr. Shanafelt and
colleagues randomized 75 physicians and “bought” “The answer is: ‘Yeah, I get it, this isn’t all yours and the organi-
an hour of their time. One-half of them used the zation has to do its part,’” he said. “But you want to be as good as
hour every other week however they wanted for nine months — for you can at navigating the choppy water and knowing it’s going to
instance, to catch up on administrative tasks or get home early. The come. And we’re trying to give you that skill set.”
other one-half used it to meet with a group of colleagues to engage
a curriculum largely around sharing their experience of the chal- More resources to help combat burnout
lenges and virtues of being a physician. The AMA’s STEPS Forward™ collection of practice improve-

“We measured a variety of personal and professional characteris- ment strategies helps physicians make transformative changes to
tics,” he said. Both groups saw a reduction in physician-reported their practices. It offers modules on preventing physician burnout
burnout symptoms, but the group who met with their colleagues in practice, preventing resident and fellow burnout and improving
also had an improvement in meaning of work, “and we came back physician resiliency.
a year after the intervention ended.”

“The group who had that hour to catch up on admin went im-
mediately back to baseline with respect to burnout as soon as they
stopped getting an hour,” he said, “but those who had met with
their colleagues every other week for nine months, the burnout and
meaning in work remained improved a year after the intervention
ended.”

As a result, Mayo conducted a second study during which physi-
cians met for happy hour, breakfast, lunch or dinner. Mayo would
buy the meal and send five questions the physicians could choose
from to talk about as a group. The study saw the same outcomes as
the previous study in improvement in burnout and meaning in work
just from that interaction.

The Mayo Clinic’s board approved the program, which they now
offer to all physicians. As a standard practice, Mayo pays for groups

20 San Antonio Medicine • April 2017