Eyeworld

6 Ophthalmology Business • September 2018 by Liz Hillman, Ophthalmology Business Senior Staff Writer A hard look at burnout In addition to finding that about 35% of their physicians would be considered burned out according to the Maslach Burnout Inventory (33% of ophthalmologists at Cleveland Clinic who completed the inventory experienced overall burnout), they found that depersonalization was associated with more ombudsman complaints from patients, emotion- al exhaustion was associated with a greater likelihood of the physi- cian leaving the organization, and physicians with more clinical time were more likely to be emotionally exhausted. "What concerns me is that at the end of the day 35 out of every 100 physicians in our group are going home mentally and physical- ly exhausted, feeling like they have nothing left to give, and yet, they're going home to their families," Dr. Windover said. Thirty-five percent is also signif- icant when you look at some of the outcomes of burnout, Dr. Windover said, noting other research that has shown burnout being associated with more surgical errors, medication errors, hospital-acquired infections, standardized mortality rates, and costs to the health system. Much of the burnout experi- enced at the Cleveland Clinic, ac- cording to Dr. Windover, was related to inefficiencies in practice. "We don't think providers get exhausted working with patients, per se … quite the opposite. There is other data that has come out that has shown that as one's clinical time increases, the amount of time necessary to document a 15-minute visit is exponentially greater. It's the In a letter published in JAMA Internal Medicine, 1 Dr. Windover and coauthors described an assessment of physician burnout across specialties from a single large academic medical center, Cleveland Clinic. Overall, they found 35% of physicians across medical specialties within this in- stitution met the criteria for overall burnout. The study included 1,145 phy- sicians who completed the Maslach Burnout Inventory between Aug. 1, 2013, and May 1, 2014. The Maslach Burnout Inventory was developed by Christina Maslach, PhD, in 1981 as a way to measure the experience of burnout, evaluating emotional exhaustion, depersonalization, and personal accomplishement. 2 "We thought it was important that our organization assess burn- out, not just provider engagement or wellness. Then we were able to make tailored interventions or see if the interventions that were already offered were working or if we needed to contribute more resources," Dr. Windover said. A study at a single large academic medical center revealed 35% of physicians across medical specialties were burned out P hysicians experiencing burnout are often told to focus on wellness. Do yoga. Take deep, calming breaths. Talk with someone. Go for walks. While techniques aimed at improving wellness can be beneficial for stressed physicians, they are not addressing the issues that brought physicians to experience burnout in the first place, said Amy Windover, PhD, clinical psychologist, Office of Patient Experience, Cleveland Clinic, Cleveland. "We are recognizing that burn- out has become a major issue because there are problems with our health- care delivery system and we need to fix that; no amount of personal resil- ience is going to improve burnout if we aren't addressing the other areas," Dr. Windover said.

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