To Fight Burnout, Organize

Eisenstein, Leo

doi:10.1056/nejmp1803771

Cited by 56 publications

(46 citation statements)

References 5 publications

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“…Clinicians who experience burnout rely more heavily on implicit and explicit biases during periods of stress and increased cognitive workload, as their capacity to regulate biases may be reduced during these times [68,69]. In addition to the stress of working in demanding clinical environments, a sense of powerlessness in treating patients who are subjected to adverse social situations and inadequate resources can also contribute to burnout [70,71]. This can be particularly true for those working with patients affected by severe mental health conditions [72].…”

Section: Education On Burnout and Biasmentioning

confidence: 99%

Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth

et al. 2019

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Section: Education On Burnout and Biasmentioning

confidence: 99%

Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth

et al. 2019

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“…48 Primary care residents are deterred from continuing primary care practice by frustration with navigating the boundary between social and medical needs, 49 and trainees increasingly seek additional avenues for intervention. 50 Clinicians change care plans and report improved patient interactions when they are aware of social needs. 51 Equipping clinicians with social needs resources through teambased care may therefore improve the sustainability and effectiveness of primary care work.…”

Section: Discussionmentioning

confidence: 99%

Capacity to Address Social Needs Affects Primary Care Clinician Burnout

et al. 2019

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PURPOSE Primary care clinicians disproportionately report symptoms of burnout, threatening workforce sustainability and quality of care. Recent surveys report that these symptoms are greater when clinicians perceive fewer clinic resources to address patients' social needs. We undertook this study to better understand the relationship between burnout and clinic capacity to address social needs. METHODS We completed semistructured, in-person interviews and brief surveys with 29 primary care clinicians serving low-income populations. Interview and survey topics included burnout and clinic capacity to address social needs. We analyzed interviews using a modified grounded theory approach to qualitative research and used survey responses to contextualize our qualitative findings. RESULTS Four key themes emerged from the interview analyses: (1) burnout can affect how clinicians evaluate their clinic's resources to address social needs, with clinicians reporting high emotional exhaustion perceiving low efficacy even in when such resources are available; (2) unmet social needs affect practice by influencing clinic flow, treatment planning, and clinician emotional wellness; (3) social services embedded in primary care clinics buffer against burnout by increasing efficiency, restoring clinicians' medical roles, and improving morale; and (4) clinicians view clinic-level interventions to address patients' social needs as a necessary but insufficient strategy to address burnout. CONCLUSIONS Primary care clinicians described multiple pathways whereby increased clinic capacity to address patients' social needs mitigates burnout symptoms. These findings may inform burnout prevention strategies that strengthen the capacity to address patients' social needs in primary care clinical settings.

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“…Medical students widely fear loss of empathy in a depersonalizing healthcare system (Eisenstein, 2018), and indeed this may be one reason why travel to distant sites to interact with patients in indigenous settings remains cathartically appealing. Perhaps GHEs can be offered to enhance resilience among medical trainees and clinicians who seek to regain meaning in their practice through empathic communication with patients as they express a common sense of shared humanity (Center et al, 2003;Gordon, Baranov, & Fleisher, 2018;Kline, Harford, & Culp, 2018).…”

Section: Discussionmentioning

confidence: 99%

The Potential Impact of Morality on Medical Student Global Health Participation

Rowe¹,

Post²

2019

GJHS

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Interest in global health experiences (GHEs) has surged in the last decade throughout undergraduate medical education. Positive clinical and cultural learning impacts are well described; however, the moral and motivational typology of the globally minded medical student are yet to be elucidated. We surveyed 85 US medical students, 41 who participated in a GHE during medical school and 44 who did not, to examine their sense of moral association with local community, Americans, and all of humanity. Measures of empathy and spirituality were also administered, as well as a qualitative prompt to elicit reasons for participating, or not, in a GHE. The results of logic regression analysis suggest that the strongest predictors of GHE participation are strong, geographically non-specific identification with ‘all humanity’ [OR=1.31, P<0.01, 95% CI, 1.07–1.59], as well as participation in an abroad experience prior to medical school [OR 141, P<0.01, 95% CI, 10.1–1960]. While respondent groups did not differ significantly in their association with local community, incremental increase in identification with ‘Americans’ decreased likelihood of IME participation by 20% [P=0.02, 95% CI, 0.67–0.96]. No significant effect was found between participant groups in response to empathy or spirituality scales. This pilot study demonstrates that a global regard for ‘all humanity’ may motivate GHE participation while a strong national association diminishes its likelihood.

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To Fight Burnout, Organize

Cited by 56 publications

References 5 publications

Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth

Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth

Capacity to Address Social Needs Affects Primary Care Clinician Burnout

The Potential Impact of Morality on Medical Student Global Health Participation

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