14 votes

A peek inside doctors’ notes reveals symptoms of burnout

7 comments

  1. [7]
    metoosalem
    Link
    I found this most interesting. Ironically, from my own experience, managing your inbox well is also NOT an indication of if you are or will burn out soon... I guess the sheer flood of messages...

    The study revealed which measures best predicted burnout at the individual and clinic levels. The most predictive variable was the number of automated messages a physician receives. “All sorts of messages come into the clinician’s inbox in the electronic record, similar to email,” Tawfik says. “Things they need to respond to and act upon, creating a sort of inbox burden.”

    I found this most interesting. Ironically, from my own experience, managing your inbox well is also NOT an indication of if you are or will burn out soon... I guess the sheer flood of messages that need responding is enough.

    9 votes
    1. [6]
      patience_limited
      Link Parent
      I get to see so many bad administrative decisions made for fear of liability, box-checking, KPI metrics, you name it, with little understanding of what promotes good clinical practice. From long...

      I get to see so many bad administrative decisions made for fear of liability, box-checking, KPI metrics, you name it, with little understanding of what promotes good clinical practice.

      From long experience, I can say that the vast majority of medical personnel get their sense of purpose and life satisfactions from alleviating pain, curing disease, and restoring healthy function. It's important to understand that many of the technical tools they're surrounded by are optimized for billing, meeting legal requirements, or making vendor profits, not patient care.

      It's absurd that so much data exchange in EMRs still arrives as PDFs attached to e-mail, or (quantum help us) via fax. It's insane that over-communication via e-mail messages, popup alerts, wireless phone or SMS forwarding, alarms, flashing fields, etc., each with its own visually incompatible UI, are causing everyone cognitive overload. You'd think medical software would go through the same kind of review process, ergonomic user interface design, standardization, and QA as aviation software (just as many lives are on the line), but no.

      I've seen the coming and going fads for medical scribes and voice transcriptionists, who are meant to offload EMR documentation from clinicians. As the study notes, the clinical staff still have to read and correct all that (electronic) paperwork - in the end, it's just more labor and opportunity for miscommunication. I dread what's going to happen with opportunistic AI grafts into this interaction.

      12 votes
      1. [4]
        metoosalem
        (edited )
        Link Parent
        Thank you for that insight, I’m beginning to realize the cause of my burnout might have been at least in part related to all the bullshit pop ups, random software errors, spam mails, cold calling...

        Thank you for that insight, I’m beginning to realize the cause of my burnout might have been at least in part related to all the bullshit pop ups, random software errors, spam mails, cold calling salespeople, ON TOP of all the legitimate helpdesk tickets, red fields in the Monitoring System, emails, phonecalls, shitfucking ms teams, or random fucking people making ample use of the enforced open door policy.

        If I were to use all these social media apps with their endless notifications I would go insane and yet that’s how a lot of people are living. Are we in for a collective burn out?

        Also this makes it sound like burnout is essentially an exhaustion of the dopamine system. I really need to read up on all that again.

        6 votes
        1. Gaywallet
          Link Parent
          Honestly your time is probably better spent reading about how to tackle burnout with strategies like MBSR, or how to talk with leadership (CMO or physician counsels) to articulate your needs or...

          Also this makes it sound like burnout is essentially an exhaustion of the dopamine system. I really need to read up on all that again.

          Honestly your time is probably better spent reading about how to tackle burnout with strategies like MBSR, or how to talk with leadership (CMO or physician counsels) to articulate your needs or design processes to put other people in the process to remove distractions.

          If I were to use all these social media apps with their endless notifications I would go insane and yet that’s how a lot of people are living. Are we in for a collective burn out?

          Social media app notifications can be fine tuned (in some cases) and turned off! As someone who works in medicine who moved to the tech side of things, the bullshit pop ups and annoyances in your EHR were configured or are a choice of software selected - you can, and should talk with leadership about getting those changed. Alert fatigue is a well-studied phenomenon and in the realm of patient care is a vitally important factor. These things can and should be managed by the teams involved with them not only because they annoy you and your colleagues but because they decrease the quality of care and can lead to important information being ignored.

          shitfucking ms teams

          probably not gonna win that battle though... I hate teams too 😩

          2 votes
        2. [2]
          R3qn65
          Link Parent
          Impressive instinct - there's no concrete proof, but a dopamine hypothesis is one of the leading hypotheses regarding burnout.

          Also this makes it sound like burnout is essentially an exhaustion of the dopamine system. I really need to read up on all that again.

          Impressive instinct - there's no concrete proof, but a dopamine hypothesis is one of the leading hypotheses regarding burnout.

          1 vote
          1. metoosalem
            (edited )
            Link Parent
            Let’s say I’ve had ample time to conduct self study… I can imagine that much like depression it’s too much of an umbrella term for an unknown amount of different causes with similar symptoms

            Let’s say I’ve had ample time to conduct self study…

            I can imagine that much like depression it’s too much of an umbrella term for an unknown amount of different causes with similar symptoms

      2. whbboyd
        Link Parent
        We would need a highly empowered NTSA (and plausibly FAA) for medicine. Guess at the odds of that happening while there's Republicans in the government. There is an important qualitative...

        You'd think medical software would go through the same kind of review process, ergonomic user interface design, standardization, and QA as aviation software (just as many lives are on the line), but no.

        We would need a highly empowered NTSA (and plausibly FAA) for medicine. Guess at the odds of that happening while there's Republicans in the government.

        There is an important qualitative difference between medicine and aviation, though. Aviation has bright lines. A plane crash is a "never" event; no crash should happen, and so every plane crash can and should be investigated, with an appropriate presupposition that something went wrong and that should be identified and corrected. In contrast, in medicine, some patients will die. (Arguably, more patients should die, or at least earlier and with less futile ICU care, than actually do.) You can't treat every patient death or significant morbidity as a mistake to be corrected, because for many, many of them the cause is "the patient was too sick to keep living". Most planes eventually get mothballed or scrapped without crashing, but every person dies.

        2 votes