Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy
■ Clinical Practice Management
■ Training & Education ■ Leadership

Are You Burned Out?

Acknowledging burnout among radiology professionals and calling for a community-based solution

What does the word "burnout" mean to you? If you had asked me 35 years ago, I would have said a pejorative appropriately describing some of the teenagers in my neighborhood. When I think about burnout now, I think about medical professionals I work with. And, unlike the 1980s teens that I steered very clear of, I've deep sympathy for the talented and caring individuals I am honored to call colleagues who are exhibiting a burgeoning phenomenon of modernity. From the nurse practitioner who quit her once-beloved job to go back to school for a master's degree in education to several physicians all in one specialty who've individually confided in me over the last few weeks that they are thinking about leaving our institution, burnout has become a disturbingly pervasive part of the health care workplace vernacular.

Although you can find various definitions of burnout, perhaps the original definition remains the clearest. Describing the consequences of severe stress and high expectations experienced by people working in helping professions, Herbert J. Freudenberger and Geraldine Richelson coined the term in 1974 and defined it as "the extinction of motivation or incentive, especially where one's devotion to a cause or relationship fails to produce the desired results" in the book "Burnout: The High Cost of High Achievement." I cannot improve upon the evocative portrait they paint:

If you have ever seen a building that has been burned out, you know it's a devastating sight. What had once been a throbbing, vital structure is now deserted. Where there had once been activity, there are now only crumbling reminders of energy and life. Some bricks or concrete may be left; some outline of windows. Indeed, the outer shell may seem almost intact. Only if you venture inside will you be struck by the full force of the desolation.

​When you read this about burnout, does it describe you? Do you think you could recognize it in someone else, especially when it's disguised as disruptive behavior that might be incorrectly attributed to a personality trait (such as a bad temper) or treated as a moral failing? Looking at a JACR article on this subject, I was drawn to a list of personality traits associated with higher risk for psychological morbidity.

I went down the list, checking off each that could apply to me at least some of the time. I stopped before I reached the end. I had been checking all of them. Even some of the characteristics that would individually be admirable, such as empathy, might, in aggregate with the others, predispose someone to burnout. 

The causes of burnout are multifactorial, as explained by the authors of the same article:

People do not have a limitless capacity to deal with workplace stressors. We have different thresholds and triggers, but none of us is immune to burnout if the circumstances are right. However, burnout need not be inevitable. The good news is, the condition can often be prevented and treated. After mentioning some barriers to dealing with mental health issues, the JACR authors describe a few existing approaches of indeterminate efficacy. 

A letter to the editor published in JACR describes one individual's personal experience in physician coaching, including the idea that positive coping tools like exercise and hobbies don't automatically confer protection from burnout. Preventing burnout can require a diverse array of approaches, from stress-reduction techniques to adjustments to workplace culture. The Mayo Clinic established a small but successful pilot program (called "Stress Management and Resiliency Training") for radiology faculty. 

How do you as an individual and your institution or organization manage and prevent burnout? Should the ACR be doing more, such as establishing a task force or facilitating the creation of programs like the Imaging 3.0 Toolkit? Should the pages of JACR contain more articles on this topic? Can we leverage social media to effect change? In other words, how can we as a community of radiology professionals best support each other? 

What about quitting? Throwing in the towel is not a great option or even a good option and, for the majority of us, it's not the option we really want. It's an option of last resort. Let's do what we can to keep it that way.

​Looking for more inspiration on how to beat burnout? Check out the January ACR Bulletin.

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Wednesday, 26 June 2019

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