By John M. de Castro, Ph.D.
“Patients need to believe in their doctor. An empathetic touch can make all the difference and also be the key to medical success. . . The tragedy of burnout is that it effaces genuine empathy, spirituality, and commitment. Nietzsche put it best: “Physician, heal thyself: Then wilt thou also heal thy patient.” – Tom Murphy
Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare and teaching are high stress occupations. It is estimated that over 45% of healthcare workers experience burnout with emergency medicine at the top of the list, over half experiencing burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.
Burnout frequently results from emotional exhaustion. This exhaustion not only affects the healthcare providers personally, but also the patients, as it produces a loss of enthusiasm, empathy, and compassion. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing burnout has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. Religiosity and spirituality are also known to help improve mental health and well-being.
In today’s Research News article “An exploration of the role of religion/spirituality in the promotion of physicians’ wellbeing in Emergency Medicine.” See:
or see summary below or view the full text of the study at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929145/, Salmoirago-Blotcher and colleagues surveyed emergency room physicians measuring burnout, maladaptive behaviors, malpractice, religiosity, religious affiliation, spirituality, private religious/spiritual practice, and religious commitment. They found that high levels of burnout were associated with being single or divorced, and not surprisingly with high numbers of patients seen, hours on call, and shifts each month. There were no significant relationships between religiosity/spirituality and burnout. They did find, however, that the greater the observance of a religious day of rest, the lower the levels of malpractice and maladaptive behaviors. In addition, the greater the attendance at religious services the lower the level of maladaptive behaviors.
These results are interesting and suggest that although not directly associated with burnout, religious practice was associated with higher quality of medical services provided to the patients, as evidenced by fewer malpractice suits, and the better care the physicians took of themselves, as evidenced by low maladaptive behaviors. The maladaptive behaviors included smoking, drug use and addiction, and alcohol use. It is interesting that the results were not due to the levels of spirituality or religiosity themselves but rather to participation in religious services and taking a religious day of rest. This suggests that the effects may be the result taking time off to go to church and rest may be important for physicians well-being. Since, this was a correlational study, however, it’s possible that the causation was in the opposite direction with the kinds of physicians who participated in religious practices also being the type of physicians who take better care of themselves and others.
So, improve physician care of patients and themselves with religious practice.
“We can’t afford to ignore the potential effect of spirituality and religion on health.” – Alexandra Shields
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Salmoirago-Blotcher, E., Fitchett, G., Leung, K., Volturo, G., Boudreaux, E., Crawford, S., … Curlin, F. (2016). An exploration of the role of religion/spirituality in the promotion of physicians’ wellbeing in Emergency Medicine. Preventive Medicine Reports, 3, 189–195. http://doi.org/10.1016/j.pmedr.2016.01.009
Abstract
Background: Burnout is highly prevalent among Emergency Medicine (EM) physicians and has significant impact on quality of care and workforce retention. The objective of this study was to determine whether higher religion/spirituality (R/S) is associated with a lower prevalence of burnout among EM physicians (primary outcome). A history of malpractice lawsuits and maladaptive behaviors were the secondary outcomes. Methods: This was a cross-sectional, survey-based study conducted among a random sample of physicians from the Massachusetts College of Emergency Physicians mailing list. Burnout was measured using a validated 2-item version of the Maslach Burnout Inventory. Maladaptive behaviors (smoking, drinking, and substance use) and medical malpractice were self-reported. R/S measures included organized religiosity, religious affiliation, private R/S practice, self-rated spirituality, religious rest, and religious commitment. Logistic regression was used to model study outcomes as a function of R/S predictors. Results: Of 422 EM physicians who received the invitation to participate, 138 completed the survey (32.7%). The prevalence of burnout was 27%. No significant associations were observed between burnout and R/S indicators. Maladaptive behaviors (adjusted OR = 0.42, CI: 0.19 to 0.96; p = 0.039) and history of medical malpractice (adjusted OR = 0.32; CI: 0.11 to 0.93; p = 0.037) were less likely among physicians reporting to be more involved in organized religious activity and to observe a day of rest for religious reasons, respectively. Conclusion: This study provides preliminary evidence for a possible protective association of certain dimensions of R/S on maladaptive behaviors and medical malpractice among EM physicians.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929145/