Physician burnout and mental health disorders have received a lot of attention in recent years. Burnout rates are high among neurologists in the United States and around the world.1-4 Neurology has the second highest rate of burnout among specialties, with approximately 60% of neurologists in the United States reporting at least one burnout symptom.1,5
While weekly waiting time and amount of paperwork required were associated with higher risk of burnout, meaningful work and effective support staff were among the factors that reduced burnout risk. was.1
In a paper published in October 2022 stroke, Borelli et al. suggest that stroke neurologists may be at higher risk of burnout and mental health problems than other types of neurologists because of their “subspecialty peculiarities.” In contrast to outpatient neurology, stroke management is “a 24/7 enterprise that is unpredictable and disrupts the sleep, rest, and recreation of the provider” and is “intrinsic. It is risky and requires making complex decisions under considerable time pressure,” Borelli said. A colleague wrote6
Researchers cite mental health stigma as one of the biggest factors likely to deter doctors from seeking help for such concerns. Given their nature, such problems can be perceived as signs of weakness.6
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The prevalence of burnout and mental health problems among stroke neurologists is underreported, largely due to the taboos and professional consequences of declaring and reporting psychiatric and psychological strain. It may have been
In addition to negatively impacting physicians’ career satisfaction and personal lives, researchers note that burnout also reduces the quality of patient care and increases the risk of medical harm.6 Other experts suggest that female neurologist burnout could be even worse. Female neurologists face a significant pay gap and underrepresentation of academic leadership compared to male neurologists. could be a factor.7,8
Burnout and mental health concerns among stroke neurologists represent “a problem for the entire healthcare system, not for the individual,” write Borelli et al.6 Addressing these issues requires individualized solutions such as cognitive-behavioral therapy, mindfulness-based interventions, and exercise. Facility level, including efforts to raise mental health awareness and solicit feedback from physicians on issues and solutions related to burnout. Population level, such as providing an emergency hotline for mental health issues.
As described in the review, signs that providers need to seek help include persistent depression and career dissatisfaction, cynicism and indifference, low enthusiasm and self-esteem, and self-harm. I have some thoughts.6
To discuss the mental health needs of physicians, particularly stroke neurologists, and find potential solutions, Christa Ohana S. Nobreza, MD, MD, Medical Director of Neuro-Critical Care Services at Baptist Memorial Hospital, MSCI ) spoke to Department of Neurology, University of Tennessee Health Science Center, Memphis.
Stroke neurologists are at higher risk of mental health problems than others. Other subspecialties.6What are your personal observations regarding this?Is the factor related to the reported risk?
Dr. Nobreza: As explained in this article, the level of stress experienced by stroke neurologists is accurate. You have a stroke neurologist who comes in during the day to manage a stroke patient at home and they are the same neurologist who is on call overnight. Sleep fragmentation and deprivation can take their toll easily.
Other factors that can contribute to burnout and mental health problems in stroke neurologists are unpaid work in academia, where stroke neurologists are required to devote many hours to academic work such as teaching, research and administrative duties. is an obligation.
Rarely mentioned is the impact of gender and racial disparities in the professional development of stroke neurologists, which can play a major role in mental strain and burnout.
The prevalence of burnout and mental health problems among stroke neurologists is underreported, largely due to the taboos and professional consequences of declaring and reporting psychiatric and psychological strain. It may have been
What measures should be taken at the facility level to reduce burnout and other mental health issues in stroke neurology?
Dr. Nobreza: Much work is currently being done to improve physician health and reduce burnout, but institutions and societies still need to work on changing processes beyond the “checklist.” A “pizza night” or a mindfulness lecture is not enough. These are “checklist” actions, and I’ve noticed a lot.
In addition to organizational initiatives, individualized approaches to individual faculty members should also be considered to ensure that physicians are readily available while protecting their identities. We also need to invest in hiring personnel to reduce the amount of paperwork done by doctors to reduce burnout. Their investment vision should be longer term and not just based on ROI in less than 5 years.
Universities need to focus on how to retain faculty beyond five years, and this includes initiatives primarily focused on mental health and burnout. Adding patients to improve profitability is counterproductive. Demanding wellness lectures from an already busy stroke neurologist to prevent burnout is counterproductive.
Wellness coaches should be available free or subsidized to all faculty. All faculty and staff must pay for “wellness” days included in their contract in addition to sick leave, vacation, and educational days. Institution leaders need to be trained on how to approach faculty, either as a group or individually, on burnout and mental health issues, rather than just sitting in a meeting.
Finally, organizational leaders must have a genuine desire to improve burnout and mental health issues.
On an individual level, what are your recommendations for stroke neurologists struggling with mental health issues and needing support?
Dr. Nobreza: The main piece of advice I share with my stroke colleagues is to set boundaries. You have to start asking yourself why you are doing what you are doing. How does this affect our life goals? How does it affect our mental health? How can replying to help improve my health? If not, set that boundary and don’t reply to that email.
Some stroke neurologists may still be thinking about their patients when they go home. It’s also a good idea to find a non-work related hobby or activity that you can focus on and work it into your schedule.
