Burnout, Drop Out, Suicide: Physician Loss in Emergency Medicine, Part I

Abstract

Each year more than 400 physicians take their lives, likely related to increasing depression and burnout. Burnout-a psychological syndrome featuring emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment-is a disturbingly and increasingly prevalent phenomenon in healthcare, and emergency medicine (EM) in particular. As self-care based solutions have proven unsuccessful, more system-based causes, beyond the control of the individual physicians, have been identified. Such system-based causes include limitations of the electronic health record, long work hours and substantial educational debt, all in a culture of "no mistakes allowed." Blame and isolation in the face of medical errors and poor outcomes may lead to physician emotional injury, the so-called "second victim" syndrome, which is both a contributor to and consequence of burnout. In addition, emergency physicians (EP) are also particularly affected by the intensity of clinical practice, the higher risk of litigation, and the chronic fatigue of circadian rhythm disruption. Burnout has widespread consequences, including poor quality of care, increased medical errors, patient and provider dissatisfaction, and attrition from medical practice, exacerbating the shortage and maldistribution of EPs. Burned-out physicians are unlikely to seek professional treatment and may attempt to deal with substance abuse, depression and suicidal thoughts alone. This paper reviews the scope of burnout, contributors, and consequences both for medicine in general and for EM in particular. [

Combating pharmacist burnout: A model for critical care clinical pharmacy faculty

“…Also, factors such as critical decision‐making and demanding workload may be amplified in the critical care setting, given the higher patient acuity and unremitting nature of providing care for patients in critical care units. Additionally, higher patient acuity can lead to detrimental patient outcomes and cause psychological trauma for health care workers, which has been termed Second Victim Syndrome, and thought to contribute to burnout . These factors likely affect all providers within critical care, including pharmacists.…”

Wellness Review 2019, Part 1

“…A thoughtful article on burnout, drop out, and suicide in emergency medicine physicians appeared in Western Journal of Emergency Medicine [27]. Part I (of II) looks at causes of burnout, consequences of burnout, and lastly at unique aspects of emergency medicine (a good resource for everyone in healthcare).…”

Самоубийства Среди Врачей И Медицинских Работников: Обзор Литературы

“…Обвинения и изоляция перед лицом медицинских ошибок, неутешительные результаты лечения приводят к эмоциональной травме врача и так называемому синдрому «второй жертвы», что является как причиной, так и следствием выгорания. Кроме того, врачи страдают от интенсивной клинической нагрузки, высокого риска судебных разбирательств, хронической усталости и от нарушения циркадного ритма [32].…”

“…Accusations and isolation in the face of medical errors, disappointing treatment results lead to emotional trauma of a doctor and the so-called "second victim" syndrome, which is both the cause and consequence of burnout. In addition, physicians suffer from intense clinical stress, high risk of litigation, chronic fatigue, and circadian rhythm disorders [32].…”

“…СЭВ вызывает такие последствия, как -снижение качества медицинской помощи, рост врачебных ошибок, неудовлетворённость пациентов и поставщиков услуг, истощение медицинской практики, усугубление нехватки и неправильного распределения врачебного персонала. «Сгоревшие» врачи не обращаются за профессиональной помощью, а пытаются справиться с депрессией и суицидальными мыслями самостоятельно [32].…”