Skip to main content
SpringerLink
Log in

Prevention of Burnout Through Resilience, Wellness Programs, and Civility in the Work Environment

  • Chapter
  • First Online:
Depression, Burnout and Suicide in Physicians

  • 843 Accesses

Abstract

Given the high prevalences of burnout, more so in medical students, residents, and junior doctors than experienced physicians, prevention is paramount for a healthier future. The workplace culture needs to be based on respect and civility. Such an ethos is built on competence and compassion, recognition and rewards, teamwork and collegiality, and the use of initiative and personal control while also normalizing a work-life balance that is equitable, respectful, and free of role ambiguity. Medical student selection is wisely based on traits of openness to new experience, agreeableness, conscientiousness, and determination – characteristics that are linked to resilience. Training programs need to nurture self-efficacy and robustness, foster social support, promote mentoring, and ensure sensible rostering of work hours. Individuals ought to choose their specialty based on what is fulfilling and meaningful, build stress management into their lives, and include regular exercise, self-reflection, and debriefing. Organizations require formal wellness systems such as Balint groups, Schwartz Center Rounds, near-peer mentoring, and zero tolerance programs about bullying and sexual harassment. The physician can be blessed with a life of creativity, accomplishment, and success if this is inspired by virtue and generosity yet balanced with common sense.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Editorial. Physician burnout: a global crisis. Lancet 2019; 394: 93. Citing https://www.who.int/mental_health/evidence/burnout/en/.

  2. British Medical Association. Caring for the mental health of the medical workforce. https://www.bma.org.uk/media/1365/bmacaring-for-the-mental-health-survey-oct-2019.pdf. Accessed 13 May 2020.

  3. Thomas NK. Resident burnout. JAMA 2004; 292:2880–2889. https://jamanetwork.com/. Accessed 10 May 2020.

  4. Beyondblue. National mental health survey of doctors and medical students, Oct 2013. https://www.beyondblue.org.au/docs/default-source/research-project-files/bl1132-report%2D%2D-nmhdmss-full-report_web. Accessed 13 May 2020.

  5. Mian A, Kim D, Chen D, Ward WL. Medical student and resident burnout: a review of causes, effects, and prevention. J Fam Med Dis Prev. 2018;4(094):1–8. https://doi.org/10.23937/2469-5793/1510094.

    Article  Google Scholar 

  6. Physicians Foundation. 2018 Survey of America’s physicians: practice patterns and perspectives. https://physiciansfoundation.org/wp-content/uploads/2018/09/physicians-survey-results-final-2018.pdf. Accessed 13 May 2020.

  7. Maslach C, Leiter MP. New insights into burnout and health care: strategies for improving civility and alleviating burnout. Med Teach. 2017;39:160–3. https://doi.org/10.1080/0142159X.2016.1248918.

    Article  PubMed  Google Scholar 

  8. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388:2272–81. https://doi.org/10.1016/S0140-6736(16)31279-X.

    Article  PubMed  Google Scholar 

  9. Guest RS, Baser R, Li Y, Scardino P, Brown AE, Kissane DW. Cancer surgeons’ distress and well-being, I: the tension between a culture of productivity and the need for self-care. Ann Surg Oncol. 2011;18:1229–35. https://doi.org/10.1245/s10434-011-1622-6.

    Article  PubMed  Google Scholar 

  10. Guest RS, Baser R, Li Y, Scardino P, Brown AE, Kissane DW. Cancer surgeons’ distress and well-being, II: modifiable factors and the potential for organizational interventions. Ann Surg Oncol. 2011;18:1236–42. https://doi.org/10.1245/s10434-011-1623-5.

    Article  PubMed  Google Scholar 

  11. Kissane DW, Bylund CL, Banerjee S, et al. Communication skills training for oncology professionals. J Clin Oncol. 2012;30(11):1242–7. https://doi.org/10.1200/JCO.2011.39.6184.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Shanafelt TD, West CP, Zhao X, et al. Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med. 2005;20:559–64. https://doi.org/10.1111/j.1525-1497.2005.0108.x.

  13. Chunming WM, Harrison R, McIntyre R, et al. Burnout in medical students: a systematic review of experiences in Chinese medical schools. BMC Med Educ. 2017;17:217. https://doi.org/10.1186/s12909-017-1064-3.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Altannir Y, Alnajjar W, Ahmed S, et al. Assessment of burnout in medical undergraduate students in Riyadh, Saudia Arabia. BMC Med Educ. 2019;19:34. https://doi.org/10.1186/s12909-019-1468-3.

    Article  PubMed  PubMed Central  Google Scholar 

  15. McManus IC, Keeling A, Paice E. Stress, burnout and doctors’ attitudes to work are determined by personality, and learning style: a twelve year longitudinal study of UK medical graduates. BMC Med. 2004;2:29. https://doi.org/10.1186/1741-7015-2-29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Kwarta P, Pietrzak J, Miśkowiec D, et al. Personality traits and styles of coping with stress in physicians. Pol Merkuriusz Lekarski. 2016;40:301–7. https://pubmed.ncbi.nlm.nih.gov/27234861/

    Google Scholar 

  17. IsHak W, Nikravesh R, Ledeerer S, et al. Burnout in medical students: a systematic review. Clin Teach. 2013;10:242–5. https://doi.org/10.1111/tct.12014.

    Article  PubMed  Google Scholar 

  18. Petrie K, Crawford J, LaMontagne AD, et al. Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: a cross-sectional survey. BMJ Open. 2020;10(1):e033525. https://doi.org/10.1136/bmjopen-2019-033525.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Farquhar M. Fifteen-minute consultation: Problems in the healthy paediatrician – managing the effects of shift work on your health. Arch Dis Childhood Educ Pract. 2017;102(3):127. https://doi.org/10.1136/archdischild-2016-312119.

    Article  Google Scholar 

  20. Hamilton-Fairley D, Coakley J, Moss F. Hospital at night: an organizational design that provides safer care at night. BMC Med Educ. 2014;14 https://doi.org/10.1186/1472-6920-14-S1-S17.

  21. Shanafelt TD, Noseworthy JH. Executive leadership and physician wellbeing: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc. 2017;92:129–46. https://doi.org/10.1016/j.mayocp.2016.10.004.

    Article  PubMed  Google Scholar 

  22. Shanafelt TD, Mungo M, Schmitgen J, et al. Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin Proc. 2016;91:422–31. https://doi.org/10.1016/j.mayocp.2016.02.001.

    Article  PubMed  Google Scholar 

  23. Horowitz CR, Suchman AL, Branch WT, Frankel RM. What do doctors find meaningful about their work? Ann Intern Med. 2003;138:772–5. https://doi.org/10.7326/0003-4819-138-9-200305060-00028.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Shanafelt TD, West CP, Sloan JA, et al. Career fit and burnout among academic faculty. Arch Intern Med. 2009;169:990–5. https://doi.org/10.1001/archinternmed.2009.70.

    Article  PubMed  Google Scholar 

  25. Regehr C, Glancy D, Pitts A, LeBlanc VR. Interventions to reduce the consequences of stress in physicians: a review and meta-analysis. J Nerv Ment Dis. 2014;202:353–9. https://doi.org/10.1097/NMD.0000000000000130.

    Article  PubMed  Google Scholar 

  26. Ruotsalainen JH, Verbeek JH, Marine A, Serra C. Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2015; 4: CD002892. https://www.cochrane.org/CD002892/OCCHEALTH_preventing-occupational-stress-inhealthcare-workers.

  27. Goldhagen BE, Kingsolver KO, Stinnett SS, Rosdahl JA. Stress and burnout in residents: impact of mindfulness-based resilience training. Adv Med Educ Pract. 2015;6:525–32. https://doi.org/10.2147/AMEP.S88580.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Podgurski L, Greco C, Croom A, et al. A brief mindfulness-based self-care curriculum for an interprofessional group of palliative care providers. J Palliat Med. 2019;22:561–5. https://doi.org/10.1089/jpm.2018.0550.

    Article  PubMed  Google Scholar 

  29. Weight CJ, Sellon JL, Lessard-Anderson CR, et al. Physical activity, quality of life, and burnout among physician trainees: the effect of a team-based incentivized exercise program. Mayo Clin Proc. 2013;88:1435–42. https://doi.org/10.1016/j.mayocp.2013.09.010.

    Article  PubMed  Google Scholar 

  30. Gunasingam N, Burns K, Edwards J, et al. Reducing stress and burnout in junior doctors: the impact of debriefing sessions. Postgrad Med J. 2015;91:182–7. https://doi.org/10.1136/postgradmedj-2014-132847.

    Article  PubMed  Google Scholar 

  31. West CP, Dyrbye LN, Rabatin JT, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014;174(4):527–33. https://doi.org/10.1001/jamainternmed.2013.14387.

    Article  PubMed  Google Scholar 

  32. West CP, Dyrbye LN, Satele D, Shanafelt TD. A randomized controlled trial evaluating the effect of COMPASS (Colleagues Meeting to Promote And Sustain Satisfaction) small group sessions on physician wellbeing, meaning, and job satisfaction. J General Intern Med. 2015;30:S89.

    Article  Google Scholar 

  33. Ghetti C, Chang J, Gosman G. Burnout, psychological skills, and empathy: Balint training in obstetrics and gynecology residents. J Grad Med Educ. 2009;1:231–5. https://doi.org/10.4300/JGME-D-09-00049.1.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bar-sela G, Lulav-Grinwald D, Mitnik I. “Balint group” meetings for oncology residents as a tool to improve therapeutic communication skills and reduce burnout level. J Cancer Educ. 2012;27:786–9. https://doi.org/10.1007/s13187-012-0407-3.

    Article  PubMed  Google Scholar 

  35. Taylor C, Xyrichis A, Leamy MC, et al. Can Schwartz center rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews. BMJ Open. 2018;8:e024254. https://doi.org/10.1136/bmjopen-2018-024254.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Akinla O, Hagan P, Atiomo W. A systematic review of the literature describing the outcomes of near-peer mentoring programs for first year medical students. BMC Med Educ. 2018;18:98. https://doi.org/10.1186/s12909-018-1195-1.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Coopes A. Operate with respect: how Australia is confronting sexual harassment of trainees. BMJ Br Med J (Online). 2016;354 https://doi.org/10.1136/bmj.i4210.

  38. Compton RL, McManus JG. Employee assistance programs in Australia: evaluating success. J Work Behav Health. 2015;30:32–45. https://doi.org/10.1080/15555240.2015.998971.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Paediatrics, Royal Children’s Hospital, Parkville, VIC, Australia

    Caroline M. Kissane

  2. University of Notre Dame Australia and Cunningham Centre for Palliative Care Research, St Vincent’s Hospital, Sydney, NSW, Australia

    David W. Kissane

  3. Cabrini Health Psycho-oncology Unit, Monash University, Malvern, VIC, Australia

    David W. Kissane

Authors
  1. Caroline M. Kissane
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David W. Kissane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David W. Kissane .

Editor information

Editors and Affiliations

  1. Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy

    Luigi Grassi

  2. Department of Medicine, Northwell Health Cancer Institute Lenox Hill Hospital, New York, NY, USA

    Daniel McFarland

  3. Department of Psychiatry, University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA

    Michelle B. Riba

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kissane, C.M., Kissane, D.W. (2022). Prevention of Burnout Through Resilience, Wellness Programs, and Civility in the Work Environment. In: Grassi, L., McFarland, D., Riba, M.B. (eds) Depression, Burnout and Suicide in Physicians . Springer, Cham. https://doi.org/10.1007/978-3-030-84785-2_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-84785-2_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84784-5

  • Online ISBN: 978-3-030-84785-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation