As physicians face increased administrative responsibilities and reduced time delivering direct patient care, the stress of it all can lead to physician burnout.
Andy Arwari, M.D shares his story and how through resources available at The Carle foundation Hospital, he was able to take the necessary steps to overcome it and to avoid getting burnt out again.
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Overcoming Burnout
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Learn more about Andy Arwari, MD
Andy Arwari, MD
Andy Arwari, MD is an Experienced Assistant Clinical Professor of Medicine with a demonstrated history of working in the higher education industry. Skilled in Healthcare Consulting, Palliative Care, Physician Relations, Advanced Cardiac Life Support (ACLS), and U.S. Health Insurance Portability and Accountability Act (HIPAA).Learn more about Andy Arwari, MD
Transcription:
Melanie Cole, MS (Host): Expert Insights is an ongoing medical education podcast. The Carl division of continuing education designates that each episode of this enduring material is worth a maximum of .25 AMA PRA Category 1 credit. To collect credit, please click on the link and complete the episode’s posttest.
We’re talking today about overcoming physician burnout. My guest is Dr. Andy Arwari. He’s physician specializing in hospital medicine and palliative care at the Carl Foundation Hospital. Dr. Arwari, tell us a little bit about yourself. How many hours a week do you work in general? Tell us your story of physician burnout.
Andy Arwari, M.D. (Guest): Well thank you very much Melanie. So, I do several roles. I've done several roles here at Carl working as a physician and also in physician leadership. I don't know if I can quantify the hours. The problem with that is really that my work also extended well beyond the time that I spent in the hospital or in the clinic because of my administrative responsibilities. It seemed like I was on a hamster wheel. Go, go, go, go, go, go. Over the course of time, that did lead me to burnout.
Burnout is becoming a very common word in the medical profession. It has to do with, from my perspective, the interaction of physicians with the system, but it also has to do with physician limits. What I mean by that is it becomes very easy to get lost in the system and to take on more things and more responsibilities without realizing your limits. When you start to also not take care of yourself and to focus too much on the role of your job, then it’s easy to dive into that phase that leads into burnout. It became very easy for me to be asked to do more and more and more and more. Then the best way I can describe this is it started to feel as if I was not myself. Things start to change.
At first, I didn’t know what it was, but I couldn’t recognize that I had a problem. It started to affect me in a lot of different ways. Luckily it didn’t cause any problems with patient care, but it started to affect my life as far as personal relationships and also how I felt about myself. It slowly got to the point where I started to realize that… It almost felt surreal. Like I wasn’t myself anymore. It got to the point where I was not enjoying medicine anymore and I had thoughts of actually leaving medicine and stop practicing as a physician.
Host: Wow. It’s fascinating to me, Dr. Arwari, because we think of doctors and physicians as superhuman. But we are all human after all. So, what were some of your frustrations because you’ve got increasing administrative responsibilities, reduced time with patients, electronic health records to maintain. There’s so much stress in your job. What were some of the things as you were examining this that you could point to that said this is one of those things that’s making me nuts?
Dr. Arwari: You know, I don't think that there's anything in particular that I would say that made me nuts. It was sort of… I don’t know if nuts is really the word to use, but the stress was really more of doing too many things and not taking the time to stop and reflect that maybe it was too much. Also, as you said, boundaries. Being in administrative leadership roles sometimes also puts you in a position where you're having to deal with other people’s problems. Somehow that line can also get blurred when all of a sudden you start to think well now they’ve become my problem. They really are not your problem. They're someone else’s problems. You're there to help and facilitate someone resolving those problems. Sometimes difficult things have to be done to move those issues along. It becomes very easy in the mix of the day to get caught up in all of this.
So, I think that that’s really what got me into a lot of trouble. I know that there’s been a lot of discussion about the EMR, and certainly it frustrates everyone. EMRs have evolved from when they were first introduced. When utilized appropriately, they're a great tool. But they also are a great stressor. It seems to me like they are things that have become a little bit hard to navigate, but we need to focus on the why we’re doing it and how they are really helping us take better care of patients.
Now some will argue that there are functions in EMR that are really not useful. Yes. I think that there’s a way that we can help streamline that EMR function. There’s definitely feedback that we can all provide and work on it, but EMR is really… It is a stressor, but it’s not the only stressor in the job. There’s a lot of regulatory things that have happened over the last couple of years that have put a lot of new challenges on physician practices. These are regulatory things that effect every physician and every provider across the country. There’s a lot of things that the government has asked physicians to provide. Healthcare has moved in tremendous strides towards new horizons. There’s a lot of changes. With those changes, a lot of stress comes along. That’s what really effects physician practices on a day to day basis.
For me, it was, again, noticing changes and not recognizing what was going on with myself. I think I’ll jump the gun here to say that I was very fortunate because I reached out to my chief medical officer who was a tremendous help who was able to give me his hand and say, “Hey, we’re gonna help you.” I was able to get the support. There were resources here at Carl that were provided to me, and kind of that also helped me reflect on myself and to change some of the things that had led me into burnout. It was obviously very uncomfortable for me to be in that position because physicians don’t want to ask for help. We’re used to giving help, not receiving it. But I'm glad I did, and because of that, I'm in a much better place today. I know what got me into trouble. So those are things that I am able to look and able to recognize today and able to avoid. With that also comes the responsibility of being able to help other physicians and other colleagues who might be entering phase. Say, “Hey, how can I help you? I've been there. I know what it’s like. Let me tell you what we can do to help.”
Host: Which is exactly what you're doing now. I certainly appreciate you coming on like this because, as you say, other physicians don’t necessarily know where to turn. What steps did you take to overcome it? How long did it take you to find joy in your profession again? And how are you avoiding getting burnt out again?
Dr. Arwari: Great question. So, I actually had to deescalate what I was doing; and was actually, thanks to my chief medical officer, was put in another role to help me decompress. That allowed me to have time to reflect on myself. I also had the help and support of, we have a burnout committee here. I was able to start to recognize that it’s okay not to have to be involved in everything. Learning how to delegate and also how to say thank you so much for offering me this or thank you so much for considering me, but I cannot do this. But I do know someone who can and someone who will be great and fantastic at this job. Learning to also focus a little bit on myself of recognizing what’s important to me. What would I like to do for myself that is not job related? So also finding time and definitely spending more time with my family, focusing more on my family, and being part of that, which at times was not always that easy to be in.
Host: What would you like to tell other providers if they are feeling some of these things that you are feeling Dr. Arwari? And you turned to your chief medical officer. What would you like them to know about the resources at the Carl Foundation Hospital to help with physician burnout? Give them your best advice.
Dr. Arwari: That it’s okay to reach out. That it’s absolutely, it’s hard because, again, we don’t want to recognize that there may be issues. But it’s absolutely okay to ask for help or to just talk to a colleague and say, “Hey, I'm experiencing this. What can I do?” I think Carl’s been phenomenal at putting the resources available for physicians to just reach out and find ways to be helped as far as recovering from burnout so that they can continue to find that joy and continue to be a physician and take care of patients. So, what I would say is that there are resources. I think the organization does take this very seriously. It is possible. But that first step has to be taken. It has to be that recognition of burnout.
Burnout doesn’t also mean that anytime that there’s a change or something changes in the organization that well I'm going to feel burnt out. It really has to do with self-awareness of yourself and how you're interacting with the system. There’s a great analogy that I just heard of about the canary and the coal mine. Well, you may not be able to change the coal mine, but you can certainly change the canary. So that’s really what burnout prevention focuses on. How do we help physicians reengage, reenergize, and not feel overstressed? And to recognize what the stressors may be. I think everyone’s a little bit different and they're going to be different stressors. There may be common stressors, but what is it about the individual that we can help focus and help them stay out of burnout or recover from burnout?
Host: Thank you so much Dr. Arwari for coming on today and sharing your story. It’s not easy to do. We really applaud your efforts in helping other providers so that they know where to turn if they feel some of those things and they feel that they're headed towards physician burnout. Thank you so much for being with us today. You're listening to Expert Insights with the Carol Foundation Hospital. For a listing of Carl providers and to view Carl sponsored educational activities, please visit carlconnect.com. That’s carlconnect.com. We hope the information gained will be applicable to your work and life. This is Melanie Cole. Thanks so much for tuning in.
Melanie Cole, MS (Host): Expert Insights is an ongoing medical education podcast. The Carl division of continuing education designates that each episode of this enduring material is worth a maximum of .25 AMA PRA Category 1 credit. To collect credit, please click on the link and complete the episode’s posttest.
We’re talking today about overcoming physician burnout. My guest is Dr. Andy Arwari. He’s physician specializing in hospital medicine and palliative care at the Carl Foundation Hospital. Dr. Arwari, tell us a little bit about yourself. How many hours a week do you work in general? Tell us your story of physician burnout.
Andy Arwari, M.D. (Guest): Well thank you very much Melanie. So, I do several roles. I've done several roles here at Carl working as a physician and also in physician leadership. I don't know if I can quantify the hours. The problem with that is really that my work also extended well beyond the time that I spent in the hospital or in the clinic because of my administrative responsibilities. It seemed like I was on a hamster wheel. Go, go, go, go, go, go. Over the course of time, that did lead me to burnout.
Burnout is becoming a very common word in the medical profession. It has to do with, from my perspective, the interaction of physicians with the system, but it also has to do with physician limits. What I mean by that is it becomes very easy to get lost in the system and to take on more things and more responsibilities without realizing your limits. When you start to also not take care of yourself and to focus too much on the role of your job, then it’s easy to dive into that phase that leads into burnout. It became very easy for me to be asked to do more and more and more and more. Then the best way I can describe this is it started to feel as if I was not myself. Things start to change.
At first, I didn’t know what it was, but I couldn’t recognize that I had a problem. It started to affect me in a lot of different ways. Luckily it didn’t cause any problems with patient care, but it started to affect my life as far as personal relationships and also how I felt about myself. It slowly got to the point where I started to realize that… It almost felt surreal. Like I wasn’t myself anymore. It got to the point where I was not enjoying medicine anymore and I had thoughts of actually leaving medicine and stop practicing as a physician.
Host: Wow. It’s fascinating to me, Dr. Arwari, because we think of doctors and physicians as superhuman. But we are all human after all. So, what were some of your frustrations because you’ve got increasing administrative responsibilities, reduced time with patients, electronic health records to maintain. There’s so much stress in your job. What were some of the things as you were examining this that you could point to that said this is one of those things that’s making me nuts?
Dr. Arwari: You know, I don't think that there's anything in particular that I would say that made me nuts. It was sort of… I don’t know if nuts is really the word to use, but the stress was really more of doing too many things and not taking the time to stop and reflect that maybe it was too much. Also, as you said, boundaries. Being in administrative leadership roles sometimes also puts you in a position where you're having to deal with other people’s problems. Somehow that line can also get blurred when all of a sudden you start to think well now they’ve become my problem. They really are not your problem. They're someone else’s problems. You're there to help and facilitate someone resolving those problems. Sometimes difficult things have to be done to move those issues along. It becomes very easy in the mix of the day to get caught up in all of this.
So, I think that that’s really what got me into a lot of trouble. I know that there’s been a lot of discussion about the EMR, and certainly it frustrates everyone. EMRs have evolved from when they were first introduced. When utilized appropriately, they're a great tool. But they also are a great stressor. It seems to me like they are things that have become a little bit hard to navigate, but we need to focus on the why we’re doing it and how they are really helping us take better care of patients.
Now some will argue that there are functions in EMR that are really not useful. Yes. I think that there’s a way that we can help streamline that EMR function. There’s definitely feedback that we can all provide and work on it, but EMR is really… It is a stressor, but it’s not the only stressor in the job. There’s a lot of regulatory things that have happened over the last couple of years that have put a lot of new challenges on physician practices. These are regulatory things that effect every physician and every provider across the country. There’s a lot of things that the government has asked physicians to provide. Healthcare has moved in tremendous strides towards new horizons. There’s a lot of changes. With those changes, a lot of stress comes along. That’s what really effects physician practices on a day to day basis.
For me, it was, again, noticing changes and not recognizing what was going on with myself. I think I’ll jump the gun here to say that I was very fortunate because I reached out to my chief medical officer who was a tremendous help who was able to give me his hand and say, “Hey, we’re gonna help you.” I was able to get the support. There were resources here at Carl that were provided to me, and kind of that also helped me reflect on myself and to change some of the things that had led me into burnout. It was obviously very uncomfortable for me to be in that position because physicians don’t want to ask for help. We’re used to giving help, not receiving it. But I'm glad I did, and because of that, I'm in a much better place today. I know what got me into trouble. So those are things that I am able to look and able to recognize today and able to avoid. With that also comes the responsibility of being able to help other physicians and other colleagues who might be entering phase. Say, “Hey, how can I help you? I've been there. I know what it’s like. Let me tell you what we can do to help.”
Host: Which is exactly what you're doing now. I certainly appreciate you coming on like this because, as you say, other physicians don’t necessarily know where to turn. What steps did you take to overcome it? How long did it take you to find joy in your profession again? And how are you avoiding getting burnt out again?
Dr. Arwari: Great question. So, I actually had to deescalate what I was doing; and was actually, thanks to my chief medical officer, was put in another role to help me decompress. That allowed me to have time to reflect on myself. I also had the help and support of, we have a burnout committee here. I was able to start to recognize that it’s okay not to have to be involved in everything. Learning how to delegate and also how to say thank you so much for offering me this or thank you so much for considering me, but I cannot do this. But I do know someone who can and someone who will be great and fantastic at this job. Learning to also focus a little bit on myself of recognizing what’s important to me. What would I like to do for myself that is not job related? So also finding time and definitely spending more time with my family, focusing more on my family, and being part of that, which at times was not always that easy to be in.
Host: What would you like to tell other providers if they are feeling some of these things that you are feeling Dr. Arwari? And you turned to your chief medical officer. What would you like them to know about the resources at the Carl Foundation Hospital to help with physician burnout? Give them your best advice.
Dr. Arwari: That it’s okay to reach out. That it’s absolutely, it’s hard because, again, we don’t want to recognize that there may be issues. But it’s absolutely okay to ask for help or to just talk to a colleague and say, “Hey, I'm experiencing this. What can I do?” I think Carl’s been phenomenal at putting the resources available for physicians to just reach out and find ways to be helped as far as recovering from burnout so that they can continue to find that joy and continue to be a physician and take care of patients. So, what I would say is that there are resources. I think the organization does take this very seriously. It is possible. But that first step has to be taken. It has to be that recognition of burnout.
Burnout doesn’t also mean that anytime that there’s a change or something changes in the organization that well I'm going to feel burnt out. It really has to do with self-awareness of yourself and how you're interacting with the system. There’s a great analogy that I just heard of about the canary and the coal mine. Well, you may not be able to change the coal mine, but you can certainly change the canary. So that’s really what burnout prevention focuses on. How do we help physicians reengage, reenergize, and not feel overstressed? And to recognize what the stressors may be. I think everyone’s a little bit different and they're going to be different stressors. There may be common stressors, but what is it about the individual that we can help focus and help them stay out of burnout or recover from burnout?
Host: Thank you so much Dr. Arwari for coming on today and sharing your story. It’s not easy to do. We really applaud your efforts in helping other providers so that they know where to turn if they feel some of those things and they feel that they're headed towards physician burnout. Thank you so much for being with us today. You're listening to Expert Insights with the Carol Foundation Hospital. For a listing of Carl providers and to view Carl sponsored educational activities, please visit carlconnect.com. That’s carlconnect.com. We hope the information gained will be applicable to your work and life. This is Melanie Cole. Thanks so much for tuning in.