Burn, baby, burn! Ophthalmologists and life balance

Articles about "ophthalmologist burnout" have lately been coming across my desk.

Articles about "ophthalmologist burnout" have lately been coming across my desk.

The first came in the newsletter of the Association of University Professors of Ophthalmology (AUPO), and is authored by Oscar A. Cruz, MD, professor and chairperson, St. Louis University.1 Dr. Cruz writes that "department chairs are experiencing significant stressors, including increased oversight and bureaucracy associated with patient care, teaching and research, decreased reimbursement for patient care services, and a reduction in time available for teaching and research."

He reported the results of a survey of 101 ophthalmology department chairpersons, looking for the three risk characteristics of burnout: moderate to high emotional exhaustion, increased depersonalization, and decreased personal accomplishment. Ten chairpersons, according to the survey, are in trouble-they scored three-for-three for these risk characteristics (I hope I'm not one of them). The AUPO, according to Dr. Cruz, will be proactive in addressing this problem.

Such is apparently not the case, because I shortly after received an article by Paul Arnold, MD, entitled "Recognizing the causes of ophthalmologist burnout."2 Dr. Arnold describes "the five Ds" of burnout as detachment (withdrawal from patients, staff, and family), depersonalization (loss of empathy for others), depression, divorce, and dependence (drugs, alcohol, food, sex, gambling, and conspicuous consumption). The article does not say how many of us ophthalmologists are afflicted with burnout, but Dr. Arnold says the phenomenon reflects failure to acknowledge that some things are beyond our control (the article stresses economic factors and declining physician reimbursement), and asserts that "the quest for ever-greater efficiency . . . leads directly to burnout."

It is too bad (for them, their families, and the people in their departments) that 10% of ophthalmology department chairpersons are burned out. It is also sad that apparently a goodly number of practicing ophthalmologists are in the same boat. In retrospect, commentaries I wrote recently seem to support that this is a real issue (the equivalent of seven medical school graduating classes are being lost annually to alcoholism and suicide, and the majority of ophthalmologists responding to an Ophthalmology Times on-line survey say they would not encourage a son or daughter to pursue a career in medicine).

So what to do? Dr. Cruz recommends controlling the number of hours worked per week, spending time with a spouse/partner and family, having a mentor, and utilizing individual approaches to reducing stress.

Until recently, the guaranteed solution was for the stressed-out ophthalmologist to treat him or herself and amaze his/her friends by cooking beer-can chicken on the grill, served with a tasty tomato, mozzarella, and basil salad (don't forget to drizzle balsamic vinegar on top) and a well-oaked chardonnay from California or Chile. But then an ophthalmology department chairperson from Los Angeles said to me "doesn't heating the can of beer cause paint chemicals from the can to get into the chicken and cause cancer?" So now, in the absence of any hard data one way or the other to answer this question, my "glass is half-empty" colleague has ruined this weekend activity for me.

There is apparently a science to enjoying life. One spokesperson is Erik Rosegard, PhD, a faculty member in the Department (I kid you not) of Recreation and Leisure Studies at San Francisco State University. In a newspaper article, Dr. Rosegard3,4 comments on a hard-charging Wall Street trader who volunteers to work in a restaurant kitchen: "Brain research shows innovation is spawned when the mind is not cluttered . . . It's a good way to get rid of what's bothering you." One question comes to my mind-do chairpersons of Departments of Recreation and Leisure ever get burned out?

Probably it is inappropriate to make light of what seems to be a serious problem. It seems a terrible shame that we ophthalmologists, with all the tools at our disposal to let people live better lives by helping them see as well as possible, are not constantly thrilled to be able to do what we do.