Finding worklife balance Avoiding burnout Worklife balance supports

Finding work-life balance Avoiding burnout

Work-life balance supports individuals to split their time and energy between work and the other important aspects of their lives.

Work-life balance Balance is a continuum. It is something we strive to achieve.

Life in balance What does a life in balance look like?

Life in balance • • Able to feel achievement at work and at home Sleep well Healthy/Exercise Hobbies Spiritual Spend time with friends and family Relaxed, peaceful, content

What does a life out of balance look like?

Life out of balance Spend way too much time on one thing while neglecting other areas of our lives. Leads to being: • Stressed • Unhappy • Unproductive • Disjointed • Not doing things as well as we would like • This is not a permanent state. We believe this to be a temporary state.

What causes us to get “out of balance”? • Job Creep • Personal Life Creep • Transition

Consequences of being out of balance? When people are “out of balance” over a prolonged period of time burnout occurs which can cause permanent damage to their body and loss of important professional and personal relationships.

Causes of burnout • Being under significant stress/in transition for an extended amount of time • Loss of hope that there is an end to the stress • Belief things will always stay this way

Identifying Burnout Emotional Exhaustion: Feeling emotionally spent Depersonalization: Cynical, negative and detached Decreased Personal Accomplishment

Is burnout real? Is it getting better or worse?

Burnout on the Rise Medscape's Physician Lifestyle Report 39. 8% responded that they were burned out in 2013 46% reported burnout in 2015 Highest burnout rates found in critical care (53%) and emergency medicine (52%), and with half of all family physicians, internists, and general surgeons reporting burnout

“Physician burnout is actually turning into a silent epidemic. Doctors are more disenchanted with their profession then ever before in the history of medicine. Most feel significantly burdened by the increasing regulations, oversight, demands, paired with decreased reimbursements with increased liability. Physicians in general feel there is no strong political force representing them and their needs, and many are retiring or getting out of the business at a record pace. ”

“It’s worth, my observation is that physician burnout is alive and well in Virginia. I am afraid it may even get worse as we deal with ICD 10 and continue payment reform in the transition to a value based care system. ”

“I think burnout is on the rise. The patients are more acute, higher volumes of patients and more regulatory requirements. ”

“Burnout is an issue that I think it is often rooted in a disconnect between the mission of the individual and the mission of the team or organization in which she is working. ”

Burnout Pulse Check

Identifying our emotions Confused Frustrated Ripped off Exploited Cornered Angry Scared Sad Conflicted Overwhelmed Okay Hopeful Happy Numb Powerless

Life Loss Timeline

Feel Stuck Loss of practice Medicaid Expansion Not providing care want Paperwork Loss of autonomy Rules/Regulations Technology Income loss EHR Fear of being sued Divorce Parent Dies Grandparent dies TODAY Got Remarried Child Graduates High School Had Baby Opened Practice Got Married Grad/Med School

Decide to leave New boss/owners don’t know how to run Practice Sold EMR/Learning Technology Quit job; Not working Moved TODAY Serving patients better Love new job Learn new technology Supportive Spouse Changed Job Kids Graduated Juggling parenting/working Got new job Had Children Got Job Married Began Practicing Medicine

Lots of Loss Bombs • • Loss of Identity Loss of Autonomy Loss of Income Loss of Medical Profession as you knew it Loss of Happiness Loss of Control of Patient Interactions Loss of Passion

“If I could just practice medicine the way I was trained, and doing what I know is right, I would be happy. ”

Consider Grief

What Stinks?

What helps?

What helps Knowing what you DO have control over: • • Where you work Who you work for Attitude Taking care of self Relationships with others Implement balance in your life Adapt or not

What helps? Finding what fills you. Tapping into your passion. • Family • Volunteer • Spiritual • Hobby

“I think doctors that can release from the past and accept new paradigms, and still feel connected to their professional mission, have much less burnout”

What helps? Advice from your peers! • Creating a daily devotional that I share with close friends and refer to several times a day • Workout 5 days a week • Maintaining an attitude of gratitude for my life, my profession and my patients

What helps? I set times in my schedule to do things for myself: • No emails after 7: 00 p. m. (I do get behind but I’m still employed) • Don’t work on Saturdays • Do paperwork every Sunday from 6: 00 -9: 00 p. m. • Being okay with never being caught up

What helps? • • • One meal as a family that’s not rushed Hobbies Take walks Read fiction Have lunch with someone Interacting with others

What helps? Having the tools you need to do your job: good IT, good team and a good boss. I am taking better care of patients now than I was 5 years ago thanks to the resources and team around me.

What helps? “One thing that has made a big difference in burnout is strengthening and broadening our clinical team. In the past 3 years we have added a social worker and NP to our staff, strengthened our counseling team and added administrative support. There is a greater understanding that pts' health does not fall solely on the physician, but that there are myriad resources available to help share the burden that a physician/provider can so easily assume. ”

What helps? General Practices: A lot of practices are offering more variability in scheduling of the work day than were recently available. You can work evening hours, regular M-F 8 -5 schedules, M-T 8 -7 etc etc. They also provide incentives and time away from primary work that is paid so that providers can take part in other activities they may enjoy; i. e. lobbying, research, travel medicine.

What helps? What helps is knowing myself. My old job didn’t “feel good”. The organization I worked for got bought by a big corporation. It took two years of trying to make it work before I listened to the internal voice growing stronger telling me that it was not a good fit. I tried it. I didn’t like it. I did not have the skill set to stay in the middle of the mayhem. I am now working where it feels like a small town again and we are doing the right thing with patients and saving lives.

What helps? There is a way to have a life if you are a member of a team with a shared vision, a shared joy in achieving goals and a good boss. It can give your brain a rest, allow you to take a lunch break and leave at a reasonable time.

What helps? Practicing Mindfulness

What helps? “Unplugging”/changing phone settings so when I am with my family so I can be present and stay in the moment

What helps? I’ve hired a scribe! It’s one of the best things I have done.

What helps “Knowing the signs/personal triggers when I am getting out of balance. For me these are a testy cranky feeling, a realization that I am not keeping track of my phone as carefully (so what if I miss a call) as opposed to diligently taking it even into the bathroom, feeling overwhelmed. ”

What helps? Most important: staying connected with and intentionally seeking out those who feed my soul, make me laugh, share my tears and frustrations.

What helps? The quality of the relationships with patients—it’s not the payment for service or dollar amount for a service that carries you…it’s the kind words from a patient that carries you.

Daily/Short-Term Coping Activities • • Step outside/walk the parking lot Call a loved one Chat with a colleague Turn it into a game—depowers it! Favorite Quotes/Mantras visible Focus on a funny or happy memory Focus on future activity THEME SONG!

Plan for “out of balance” Understand plan for the times in our life when we knowingly will be out of balance—and take care of ourselves: • Year-end school activities • Holidays • Major Life Transitions • Vacations • Professional Conferences & Meetings (MSV, VHHA, VNA, VAPA)

Staying Balanced • • Take time off Seek help from a life coach or therapist Consider a job change Set boundaries—Learn to say NO Be aware of your triggers Prioritize what’s important and schedule it Humor Balance is a continuum

Better learn balance. Balance is key. —Mr. Miyagi

“It has become more acceptable to talk about fatigue and have back up available in these cases. I think overall, physicians are being more mindful of burnout due to all the education and lectures we receive about it. ”

“I do not have a great work life balance at the present time but I am not a physician so I cannot speak for them. I typically work 12 hours minimum each day and usually work at least 8 to 10 hours on the weekend. ”