{"id":2936,"date":"2020-08-05T14:38:22","date_gmt":"2020-08-05T18:38:22","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2936"},"modified":"2020-08-05T14:44:26","modified_gmt":"2020-08-05T18:44:26","slug":"can-we-rename-resident-burnout-please","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/","title":{"rendered":"Can We Rename Resident Burnout, Please?"},"content":{"rendered":"
\"Dr.<\/a>

Dr. Orlovich is a Chief Resident of Wellness at Stanford University<\/p><\/div>\n

It is time we stopped framing resident burnout in a certain way. Let\u2019s be honest, the current descriptions give us nothing to build on.<\/span><\/p>\n

How is burnout currently framed?\u00a0<\/b><\/h4>\n

In a strict academic sense, we are guided by clear, globally accepted definitions. <\/span>We are familiar with Maslow\u2019s Hierarchy of Needs, depersonalization, emotional exhaustion, and reduced personal accomplishment, as well as the various questionnaires and indexes.\u00a0<\/span><\/p>\n

However, in the real world, in the hospital and clinics, burnout is inevitably <\/span>framed as something\u00a0 to be <\/span>avoided. B<\/span><\/i>urnout comprises three themes: The first says resident burnout can lead one to leave medicine and likely be saddled with debt. The second says that resident burnout might lead to an unhealthy path of addictions. And finally, burnout is framed as the ultimate endpoint \u2014 ending one\u2019s life.<\/span><\/p>\n

To be clear, all those topics <\/span>are<\/span><\/i> important and they <\/span>are<\/span><\/i> parts of resident burnout. However, my experience is that this tells us <\/span>only\u00a0part of the story. It instructs us on what to avoid <\/i>and fails to inspire us with meaningful, actionable direction.<\/p>\n

All of us in medicine intuitively comprehend this concept. Take for example, when we present a patient. We often invoke the fundamental teachings of pertinent negatives and pertinent positives. Simply, we report what is<\/em> <\/span>not<\/span><\/i> there and what <\/span>is <\/span><\/i>there.\u00a0<\/span><\/p>\n

So, what <\/b>is <\/i><\/b>there, when we talk about burnout?\u00a0<\/b><\/h4>\n

A simple answer, and one commonly given, is wellness. W<\/span>hile the way we frame <\/span>burnout<\/span><\/i> is too negative, the way we present <\/span>wellness<\/span><\/i> is too vague.\u00a0<\/span>This cursory approach to wellness is akin to filler in our notes, a litany of boxes checked on the review of systems, and rambling when we present. In short, saying a lot while hardly saying anything.\u00a0<\/span><\/p>\n

So, I fully comprehend why the new interns, and other residents, aren\u2019t eager to engage in the way that burnout and wellness are commonly presented. I don’t blame them. It is up to those of us whose interests include burnout and wellness work to present it a different way.<\/span><\/p>\n

Let\u2019s consider a new approach<\/b><\/h4>\n

My introduction to the <\/span>concept <\/span><\/i>of wellness preceded my acknowledgement of the official term. As an intern, I leaned forward in the stuffy computer lounge and zipped up my new navy fleece. I sighed as I noted that I was only 12% done with the modules. Then, I noticed a fellow intern stand up, grab his black backpack, and walk out of the room. <\/span>How did he finish so quickly?<\/span><\/i><\/p>\n

Is that the meaning of wellness \u2014 to\u00a0 finish orientation modules more quickly? Not quite. I must admit, that <\/span>would <\/span><\/i>be nice. But what I am saying is that my co-intern found a way to process and organize information quickly. And, that day in the computer lab was my first exposure to this talent, one that I deeply admire. <\/span><\/p>\n

I saw first-hand, <\/span>specifically,<\/span><\/i> what organization meant.\u00a0<\/span>Instead of espousing generic benefits, like \u201cwork-life balance,\u201d my co-intern showed <\/span>me the concrete tangible aspects of wellness. Clinically, he was a tour de force.\u00a0 <\/span>He would arrive <\/span>after <\/span><\/i>I did in the morning and still get done with rounding <\/span>before <\/span><\/i>I did. He was able to present in a methodical, coherent, and insightful manner. He anticipated questions and answered in a thoughtful way. While I was scrambling to update my notes he was enjoying a warm breakfast burrito and casually looking up studies. He carried an aura of appropriate confidence and found the humor in situations.<\/span><\/p>\n

One day after signout, when he picked up that black backpack, I asked him if he had plans for the rest of the day.\u00a0 <\/span>“I do,\u201d he said. \u201cI’m going apple picking with my girlfriend.”\u00a0<\/span><\/p>\n

\"apples<\/a>

Photo by Elizabeth Tr. Armstrong from Pexels<\/p><\/div>\n

At that moment, I realized he had wellness figured out. While my mind was stuck in avoiding the negative aspects of burnout he was reaping the rewards of a positive approach. He didn\u2019t need to convince me \u2014 he was living proof. It was self-evident. A prestigious pedigree, a competitive specialty, stacks of publications, time to visit his family, and, yes, enough time to pick apples with his girlfriend.<\/span><\/p>\n

 <\/p>\n

My final take<\/b><\/h4>\n

When I tell people I\u2019m interested in resident burnout, invariably the discussion turns to the <\/span>negative<\/span><\/i> aspects. In my experience, these are well known \u2014 but unconvincing. Then I usually pause for a bit. I ask them to name the upsides, the advantages, the benefits they\u2019ve experienced first-hand from habits that lead them to be well. I make it a point to avoid the word wellness. Instead, I want to hear what that vague concept specifically means to them. While there are common foundations of wellness, how it is applied to each person is unique<\/span>.<\/span><\/i><\/p>\n

Wellness is a competitive advantage in our ever-competitive medical training: It applies to test-taking, applying to specialties, residencies, fellowships, places of employment, receiving evaluations, and interacting with staff. Wellness restores the awe we experienced when we wrote our personal statements. Wellness allows us to recognize, really recognize, the profound meaning and privilege we share in taking care of another human being. Wellness is a performance boost. And, for the sake of our own humanity, as humans, it is a basic saving grace.\u00a0<\/span><\/p>\n

Allowing us to pick apples with our loved ones.\u00a0<\/span><\/p>\n

Interested in a new take on resident burnout? After a two year-grant I distilled up-to-date practical solutions from over about 275 studies in an easy to read book here<\/a>.<\/em><\/h5>\n

 <\/p>\n

\"NEJM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

It is time we stopped framing resident burnout in a certain way. Let\u2019s be honest, the current descriptions give us nothing to build on. How is burnout currently framed?\u00a0 In a strict academic sense, we are guided by clear, globally accepted definitions. We are familiar with Maslow\u2019s Hierarchy of Needs, depersonalization, emotional exhaustion, and reduced […]<\/p>\n","protected":false},"author":1301,"featured_media":2937,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[1042,756,757,1043],"class_list":["post-2936","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-about-residency","tag-burnout","tag-resident-burnout","tag-resident-wellness","tag-wellness"],"yoast_head":"\nCan We Rename Resident Burnout, Please? - Insights on Residency Training<\/title>\n<meta name=\"description\" content=\"Dr. Orlovich discusses the two sides of the residency coin \u2014 burnout and wellness.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Can We Rename Resident Burnout, Please?\" \/>\n<meta property=\"og:description\" content=\"Dr. Orlovich discusses the two sides of the residency coin \u2014 burnout and wellness.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2020-08-05T18:38:22+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-08-05T18:44:26+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/07\/red-apples-635705.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"5184\" \/>\n\t<meta property=\"og:image:height\" content=\"3359\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Daniel Orlovich, MD, PharmD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Daniel Orlovich, MD, PharmD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/\",\"name\":\"Can We Rename Resident Burnout, Please? - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2020-08-05T18:38:22+00:00\",\"dateModified\":\"2020-08-05T18:44:26+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/05498911aa0855df284fbfc403c64087\"},\"description\":\"Dr. Orlovich discusses the two sides of the residency coin \u2014 burnout and wellness.\",\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/08\/can-we-rename-resident-burnout-please\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Can We Rename Resident Burnout, Please?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/05498911aa0855df284fbfc403c64087\",\"name\":\"Daniel Orlovich, MD, PharmD\",\"description\":\"Daniel is an anesthesiology resident at Stanford University. 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