RESILIENCE AND
BURNOUT: LESSONS FROM DR. WAYNE SOTILE PHD AT THE ANNUAL FEAGIN LEADERSHIP
CONFERENCE DUKE UNIVERSITY.
I am indebted to Dean Taylor, MD for
inviting me to the Feagin Leadership Program Annual meeting at Duke University.
The topic on RESILENCY was one that I often pondered but was seldom able to
locate real experts to learn from. After our surprise visit from Coach Mike Krzyzewski, Wayne Sotile, PhD, discussed the role of building resistance
to BURNOUT as a key process when developing a resilient leader.
The first shocker came when Dr. Sotile
explained that the development of a ‘balanced’ life is a MYTH. All we ever hear
is how we need to balance our lives. He stated that inevitably what occurs when
one tries to balance out work, family, themselves and an intimate relationship,
is that you and those around you end up feeling angry, guilty or anxious, which
is certainly not the model of a “balanced” life. Unfortunately, surgical
professionals are at the top of the “most likely to be burnt out” list, so it
behooves us to understand and take charge of this process. So why are medical
professionals and especially surgeons so prone to burnout? As expected we are
all high producers used to high demands. When we have high control we do great,
but when we begin to lose control, then the stress levels go up. What happens
when we are stressed? We get temperamental, angry, distressed and develop
reduced mental processing powers: we
“get mean and stupid”. What happens when we become mean, stupid and
narcissistic? Those around us hate us and then we fight each other.
So who suffers when physicians hit the
burnout threshold? Well asides from us and our families, it turns out that our
patients and teammates suffer. There have been multiple studies that correlate
signs and symptoms of burnout to reduced quality of care due to an increase in
medical errors, increase in litigations, and decrease in patient compliance and
satisfaction.
How do we know if we are burnt out? Dr.
Sotile said that is easy, just look into the eyes of the ones we love, our
teammates and our patients. If you see a look of distrust, then rest assured
you are burnt out. If you are feeling guilty over or stressed over or arguing
over priorities in your daily life…. You are burnt out.
Is there anything we can do about this? The
obvious choice is to blame and correct the system: increase efficiency and
support, reduce documentation burden, develop leaders who foster engagement,
work on our community,…. And on and on…. Dr. Sotile said that ultimately, you
need to look into yourself and find what you personally can do for any real
change to occur. Sure, you cannot control 90% of the stuff going on around you
but if you really want to make a stance, figure out what 10% you can change. To
make any changes you need to: “use realistic roadmaps. Honestly assess
yourself. Counter hassles with uplifts, and deepen your relationships.”
At
the end of it all Dr. Sotile left us with these messages to take home:
“Face what is beneath your feet not what you are grasping for.”
“ You don't just decide to be resilient…You need health, You need
collaboration, you need career satisfaction, you need family satisfaction and
to have that you must be satisfied at work.”
“It's not the number of hours you work but your attitude when you
come home that affects your family- in the end you will see that, how you treat
someone at work affects how they
react when they get home.” So be nice to one another.
“Little changes (in your thinking, behavior, self-care, and ways
of dealing with others) go a long way.”
“Find meaning- see the familiar in unfamiliar way”
“Rethink balance- only inanimate objects have balance. Don't mix
your obligations - switch rocks regularly.”
“Look for joy in others- don't ruin it.”
“Don't share irritability, anger...”
“Give gratitude.”
“Enjoy moments of serenity.”
“Believe, have hope and have Interest.”
“Find Amusement, wonderment, pride, awe, and love as often as you
can”.
After
discussing this summary with Dr. Sotile, I had a few questions
- In dealing w very busy, very focused, and very skeptical physicians- what's the one thing you do that captures their attention to instill the desire to make a change (assuming they were not deemed a disruptive physician and this was recommended to them)?
- As one takes on additional roles from being a clinician and family partner and parent to include major leadership roles (Department Chair or Chief Surgery) you essentially have gone from two to three "competing" interests all of which are equally important. What's your advice to the leaders about making sure everyone senses that you have not deprioritized them- that is you are not even more distant?
- It's easy to say "I don't sweat the small stuff" but in family, clinical care and organizational leadership, what you class as the "small" stuff likely is not small to your patients, family, or organization. So how does one prioritize three seemingly non-intertwined worlds?
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