inPractice - Fall 2019 - 3

SECOND
OPINION

Q
A

What steps can health care providers
take to avoid burnout?

Our experts weigh in.

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Jen Brady, MA, RD, LDN

Nicholas Dower, LAc

George Cattell Jr., MS, PES, COS

Lead Acupuncturist
Penn Medicine Lancaster General Health

Exercise Physiologist
Penn Medicine Lancaster General Health

I view wellness as a spectrum of resilient
behaviors. "Burnout" is when we move beyond
the boundaries of our physical and emotional
tolerance. By increasing our capacity or
threshold, we can decrease the likelihood of
burnout. The framework that often guides me
toward healthy life choices is that of Chinese
medicine. One of its foundational philosophies,
the Wu Xing, provides a model that characterizes
health into five "pillars of wellness."
1. Appropriate Rest/Sleep: Consider hours of
sleep, quality, naps and feelings of vitality.
2. Appropriate Movement: Includes exercise,
ergonomics, meditation and general body
awareness, as well as goal setting, a clear vision
of your future self and confidence building.
3. Appropriate Social Interactions: Consider
family, friends and work. Do these
interactions support and bolster you
to allow for creative thinking?
4. Appropriate Nutrition: Includes type and
quality of food, speed of consumption, and
relationship with food and eating patterns.
5. Appropriate Connection with Something
Bigger than Yourself: Examples may be
religion, volunteer work, science and
environmental work. Are these activities
done mindfully and on a regular basis?

In the health care field, we all work with patients
who may not be at their best. It can be stressful,
exhausting and frustrating. Leaving these feelings
undealt with can lead us to feeling burned out.
Here are some tips I like to share to help prevent
health care providers from getting to that point.

Associate Director of Benefits and Wellness
Penn Medicine
Burnout among health care providers is
complex, caused by many contributing factors.
Changes to the electronic health record,
charting, time pressure, increases in workload,
stresses to improve patient care and outcomes,
and ever-changing insurance requirements are
all factors.
The impact on provider burnout is evident:
Research shows that burnout can cause
depression, substance abuse, decreased quality
and satisfaction in life, emotional and physical
exhaustion, and detachment from patient care.
This has a snowball effect for health care
organizations, leading to high costs from
poorer patient care, medical errors and increased
turnover. The American Medical Association
estimates that one burned-out provider can cost
between $500,000 to $1 million.
Before addressing and improving burnout, it's
important to know where you are. There is a
stigma tied to reporting poor well-being, so
many people suffer in silence. It's important for
health care organizations to invest in resources to
support burnout prevention and well-being, but
it's also imperative to talk about what is going on
and how you are feeling, and utilize the resources
at hand. If I could give five short points of advice,
they would be:
1. Recognize your symptoms.
2. Know your resources-and use them.
3. Speak up.
4. Take breaks away from work.
5. Find joy at work, remembering why you chose
to be a provider and focusing on the positive
impacts you make every day.

If the pillars are imbalanced and not appropriate
for your age, lifestyle or genetics, then
physiological inefficiencies accumulate, and the
threshold of your resilience lowers. If these pillars
are balanced, then resilience and physiological
efficacy are optimized, the range of dynamic
equilibrium widens, and you may find more ease
in all aspects of life-including the daily stressors
of working in health care!

1. Not every day is great, but there is greatness in
every day. At night, write down three positive
things that happened in that day. It will reframe
your mind from dwelling on the negative to
recognizing the good before you go to bed.
2. When you are leaving work, listen to an
audiobook or your favorite podcast. Use the
commute to unplug from work so you are
not taking the stresses home with you.
3. Everyone knows you are not perfect, so be
willing to ask for help and to help when one
of your co-workers is feeling overwhelmed.
4. Talk to your co-workers about your difficulties,
and listen when they talk about theirs. Listening
openly and respectfully could be the thing that
changes their day.
5. Get a workout in! As little as 30 minutes
of intentional exercise can change your
mood completely. n

PA College / Fall 2019

3
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