Dr. Maiysha Clairborne says she experienced burnout twice in her career as a physician. “Burnout is a buzzword now, but before there was a name for it there was definitely burnout, and that’s what I experienced. It took me to the edge of life, and I was one of the lucky ones who reached out for help.” Clairborne was in her residency program the first time she reached that point. “I didn’t even reach out to the counselor because I was afraid of the implications of saying that I was feeling a certain kind of way,” she adds.
To help doctors such as Clairborne, the Western Carolina Medical Society developed the Healthy Healer program, which provides advocacy services, resources, retreats, workshops, counseling and coaching to physicians and physician assistants in Western North Carolina.
Claiborne, now a Healthy Healer coach and owner of The Stress Free Mom MD, a coaching practice that specializes in helping physicians who are mothers, explains that burnout is not always easy to spot before a physician is on the precipice of it. “The thing about burnout is that it can be insidious, and most doctors don’t realize they have it or they are burning out until they are actually hitting the wall and it’s advanced,” she says.
The Healthy Healer Program was developed after WCMS made physician and physician assistant burnout a priority in their strategic plan in 2015. “We started by doing burnout retreats,” says Miriam Schwarz, CEO at WCMS. “We’re a small nonprofit. We don’t have a large budget, so we had to kind of piece this together from what we had.”
The retreats were a success, she says. The WCMS had expected to see 20-30 people attending the Burnout-Proof Physician Retreat in 2015, but it drew over 100 attendees.
Retreats are still offered as a part of the program, and attendees earn continuing medical education credits. With the positive reception to the retreats, WCMS expanded the program. “We spent most of 2016 vetting coaches and vetting psychologists and making sure that they were going to operate within the philosophy and the tenets that we had developed,” says Schwarz. She explains that all services must be flexible to accommodate physicians’ work schedules.
“One of our goals is to normalize taking care of yourself and admitting when you need help and getting help,” Schwarz says. “Another goal of ours is to engage families and colleagues in helping their loved ones identify burnout and mental health issues and encourage them to get help.” Schwarz explains that all counseling and coaching is completely confidential. “The whole stigma issue is a problem. There’s a stigma in the general community about mental health, depression, anxiety and burnout. But, in the medical profession it’s almost seen as a sign of weakness, and so it takes a lot of bravery to step forward and say, ‘I need help,’” says Schwarz.
According to a 2017 paper, “Burnout Among Health Care Professionals,” published by the National Academy of Medicine, “More than half of U.S. physicians are experiencing substantial symptoms of burnout.”
Healthy Healer coach Dr. Mark Jaben explains that there are three “cardinal symptoms” of burnout: exhaustion (either physical or mental), depersonalization or cynicism (increased sarcasm, or starting to see others, including patients, as obstacles) and lack of effectiveness (feeling one’s work does not matter or is not making a difference). “If you are experiencing any one of those three, you really have to pause before you spiral down too far,” says Jaben.
Clairborne explains what physicians and physician assistants can expect when reaching out for support with coaching. “What we do with the Western Carolina Medical Society is we are a resource for physicians that are experiencing overwhelm; who are exhausted; who feel like they don’t have the skills to cope; who think they want to leave medicine; and who think they want to leave their job,” says Clairborne. “We look at and examine what is going on and look to see, ‘How can we create structures that will have them be satisfied or increase their satisfaction and fulfillment in their current positions?’ We do this by teaching them the skills of self-care but also the skills of effective boundaries and communication so that they can get what they want even in the workplace.”
However, Clairborne continues, teaching skills on the physician side of things addresses only part of the problem. Change is also needed within medical facilities and corporations, she says. “From the training side, the conditioning that goes on in medical schools needs to be broken,” says Clairborne. “This mindset of ‘Never show weakness’ and ‘Never ask for help and suck it up and put yourself last and put the patients first, and eat when you can, sleep when you can, pee when you can’ — these are the types of things that get said when you’re in residency and when you’re in medical school. That’s covert conditioning to ignore our own bodily needs: physical needs for sleep, for food and to eliminate.”
Jaben notes that “as more and more physicians are becoming employed, organizations look at success as productivity and the bottom line financially, and we’ve not recognized that we pay an unintended consequence for that. To create that, we’re driving people down into their spiral, and when you drive people into their spiral, they become less productive, not more productive.
“At the end of the day, if your workforce is burned out, what you’re delivering to your customers, clients and patients is not going to be as good as if people are enthused, engaged, energetic and motivated. I think we’re in the midst of learning those lessons in our organizations.”
WCMS Healthy Healer Program