MSMS Michigan Medicine November December 2022

14 michigan MEDICINE® | Nov / Dec 2022 The answer is multi-pronged, and almost certainly beyond the scope of any one article. Undoubtedly, there is an institutional component to burnout. Physician satisfaction levels have been waning for years now—a trend that has moved in lockstep with increased bureaucratic and corporate burdens being placed on providers. Things like tending to cumbersome patient EMRs and working for organizations increasingly driven by volume and “quality” metrics continue to chip away at the amount of time physicians can spend listening to—and ultimately caring for—their patients, which is the exact kind of work they always intended to do and what likely drew them to medicine in the first place. That erosion of meaningful work has undoubtedly contributed to the rise of physician burnout, and the COVID-19 pandemic has only served to exacerbate those particular pressures. All that helps to explain the rise in burnout, but it does little to explain the enormous gulf between those needing help and those who actually seek it. That is because there is also a personal component to the development of burnout and the management of it, or rather, the lack thereof. In the world of medicine, burnout is easy to dismiss. Many physicians think it is just something that comes with the territory. The long hours, the rapid pace, the sheer intensity and consequence that come along with it—of course there is an inherent level of stress in all of that. But stress and burnout are not necessarily the same thing, and too often the last person most physicians think to treat and diagnose is themselves. And that failure to recognize and address a serious problem at its onset can come with serious consequences. In short, there is an awareness problem at play in all of this: a lack of awareness for how stress and burnout differ—what is healthy and normal and what is not. A lack of the necessary self-awareness to recognize and address mental and behavioral health concerns amongst providers—for all the tools and training physicians are given to treat others, they are ill- equipped to diagnose and care for themselves. And finally, a lack of awareness about the tools and resources available to help physicians cope should they be able to clear those first two hurdles. With any luck, this article will help to fill in those gaps. What Is Stress? What Is Burnout? What Is the Difference? Medicine is stressful. There is no escaping that fact. And, importantly, there is also nothing inherently wrong with it. In fact, properly managed, stress can promote growth, development, and resiliency, just as the stress of a deadline or a situation can help one to focus and perform. The easiest, and perhaps most relevant, analogy is one related to the human body. Every elite athlete trains their body to perform. That training is a form of stress, and growth and performance only come through strain. Properly implemented and managed, stressing one’s body in such a way can produce incredible results. However, there is an important and often overlooked component that goes along with effective training and that is the rest and recovery that must accompany it. Athletes who do not invest adequate time into that side of the equation eventually suffer. At some point, the body breaks down without the rest and recovery it needs—that is when injuries happen; that is when performance suffers. Managing the everyday stress that comes with being a physician is no different. “There’s a common misconception among providers that stress and burnout are one and the same, and that’s something we need to work to address,” says V. Simon Mittal, MD, MMM, Physician Consultant at VITAL WorkLife. “Because work-related stress can and does happen, and some degree of it is fine so long as physicians have