Saturday, March 10, 2012

Fifty Ways To Prevent Burning Out

Job burnout. That's a problem almost all of us have experienced. Whether it is medical students cramming for their umpteenth exam or an anesthesiologist getting called in the early morning hours for another D+C, we've all thought about saying "I've had it." and walk out the door and on towards the greener pasture on the other side of the hospital front door.  In the February issue of General Surgery News, Moshe Schein, MD, a surgeon with a self-described work experience of over three decades, lists fifty things we can do to prevent capitulating into career sullenness and despondency.

While some of the advice are specific to surgeons, the majority are applicable to everyone, including anesthesiologists. Listed are the usual platitudes about treasuring your family life and maintaining an exercise program to stay healthy. But there some nuggets of wisdom sprinkled in there that are worth considering. For instance, there is this little tidbit at #27, "In the lecture hall he preaches what he heard at the last association meeting, but in practice he continues to do what he did since his residency." So don't just do something just because you've done it the same way for twenty years. Medicine is constantly evolving and our practice should too. 

There is also this astute quote at #49, "The young man knows the rules, but the old man knows the exceptions. … The young man feels uneasy if he is not continually doing something to stir up his patient’s internal arrangements. The old man takes things more quietly, and is much more willing to let well enough alone." As I gain more experience with anesthesia, I find that I tend to jump less often at the slightest change in heart rate, less likely to intervene at the merest shift in blood pressure. Through painful experience, I've learned that doing something, anything, over the smallest fluctuation in vital signs usually leads to overcompensation as the body will naturally attempt to get back into equilibrium. It can take nerves of steel, and faith in your own personal observations, to understand that. Now I patiently watch the patient carefully and only treat when it is clearer that the patient needs some assistance from me to get back into balance.

Even in this age of constant economic turmoil and medical uncertainty, medicine can still be a wonderfully fulfilling career. But expectations have to be changed, not necessarily lowered, to get the most job satisfaction. No longer is working 80 hour weeks and missing family milestones indications of a successful physician. And it never should have been.

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