1. Finding work-life balance Avoiding burnout

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

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

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

5. 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

6. What does a life out of balance look like?

7. 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.

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

9. 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.

10. 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

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

12. Is burnout real? Is it getting better or worse?

13. 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

14. “Physician burnout is actually turning into a silent epidemic
“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.”

15. “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.”

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

17. “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.” 

18. Burnout Pulse Check

19. Identifying our emotions
Confused Angry Okay Frustrated Scared Hopeful Ripped off Sad Happy Exploited Conflicted Numb Cornered Overwhelmed Powerless
Red flag words

20. Life Loss Timeline

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

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

23. 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

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

25. Consider Grief

26. What Stinks?

27. What helps?
Group activity

28. 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
MOVING THE HAND

29. What helps? Finding what fills you. Tapping into your passion. Family
Volunteer
Spiritual
Hobby
Where can you add value outside of work?

30. “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”

31. 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

32. What helps? I set times in my schedule to do things for myself:
No s 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

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

34. 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.

35. 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.”

36. 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 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.

37. 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.

38. 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.

39. What helps?
Practicing Mindfulness

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

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

42. 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.”

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

44. 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.

45. 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!

46. Plan for “out of balance”
Understand and 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)

47. 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

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

49. “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.”

50. “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.”