NEW ORLEANS - Radiologist burnout is becoming more common, and it may seem that the best way to foil it is to focus on prevention. But a better tactic for radiologists is to find the higher purpose of their work, according to a presentation at the American Roentgen Ray Society (ARRS) meeting.
"The approach we're taking toward burnout is misdirected -- even dangerous," said presenter Dr. Richard Gunderman, PhD, of Indiana University. "You can't prevent burnout by focusing on it. Instead, you have to figure out what's satisfying about your work and have a vision grounded in that reality."
As context, Gunderman referred to the work of Christina Maslach, PhD, from the University of California, Berkeley. In the 1980s, Maslach developed what is now called the Maslach Burnout Inventory (MBI), defining burnout as a job-related psychological syndrome with three aspects:
- Emotional exhaustion: Feelings of being emotionally overextended and exhausted by one's work.
- Depersonalization: An unfeeling or impersonal response toward those who receive one's service, care, treatment, or instruction.
- Personal accomplishment: Perceived lack of competence and successful achievement in one's work.
Addressing the problem of burnout means asking bigger questions about a practice's culture -- the "higher purpose" idea, Gunderman said. Radiologists who are engaged in their work tend to be less susceptible.
"Do you do the best work of which you are capable?" he asked. "If the answer is no, then why not, and what can you do about that? What would it take for you to do work you're even prouder of?"
Breaking through burnout
Gunderman outlined a number of factors that contribute to burnout and offered some questions to consider to counter them.
Workload
Burnout occurs when the amount of work required doesn't match what an individual thinks is appropriate. Inappropriate workload can mean long hours, or it can refer to the intensity of the work.
"If the work you do is complex, yet you're asked to do as much as others who don't have such complex work, that can lead to burnout," he said.
In addition to considering these factors, practices should also offer professional development to their members and sufficient time off.
"Does your organization value the lives people have outside of the workplace?" Gunderman asked. "Does it support the professional development of its members?"
Reward
Reward for meaningful work is crucial to avoiding burnout, Gunderman said. Rewards include compensation and recognition for a job well done, but also personal time off, professional development, and discretionary time at work to think creatively and solve problems.
"Ask yourself: 'How rewarding do I find it when I perform these particular procedures, teach these students, read these exams?' " he said. "Also ask: 'Is there another kind of reward your practice can foster, such as a sense of individual and group alignment to a common purpose?' "
Community
A lack of connection with others in the workplace is a major contributing factor to burnout, Gunderman noted.
"Many of us like achieving, doing good work," he said. "But it's also important to have a sense of affiliation at work. If the people in your workplace don't feel like they're part of the same team, they're at risk."
Gunderman also cautioned that resentment and jealousy in a practice can lead to burnout.
"Ask yourself whether the work environment is collaborative," he said. "Is it enough just to show up on time and stay until the work is done, or is there something more there?"
Fairness
The perception of unfairness, whether real or imagined, erodes confidence in the workplace and can lead to burnout, according to Gunderman. The system needs to be organized in a fair way so that members' contributions are recognized and rewarded accordingly.
"If people are playing favorites, that will chip away at others' motivation to contribute," he said. "People need to trust that the hiring, promotion, compensation, and scheduling processes are transparent and fair. And they also need to trust the practice's leaders to put those processes into place."
Values
The best antidote to burnout is a clear sense of purpose, Gunderman said.
"What do we stand for around here? Maximizing our capital equipment budget? Vigorously defending our turf?" he said. "Perhaps, but we might also want to stand for the value of giving our patients the same care we would give our own families, or teaching our students in the way we would want our sons and daughters to be taught."
Ideals into action
How can radiologists put these higher ideals into action, especially when they may work in an environment that doesn't support them? Gunderman conceded that it's a challenge.
"The world isn't perfect, and neither are our workplaces," he said. "But the point is to reconnect to what makes it satisfying to be a radiologist -- and the difference we can make in patients' lives."
