PHYSICIAN BURNOUT AND MITIGATING ITS PREVALENCE
Advisor: Mr. Winchester
Internship Location: American Academy of Ophthalmology
Onsite Mentor: Mark Lukaszewski
Have you ever wondered why the rate of some physicians in different fields has decreased over the years? Or why doctors that have worked for so long and hard to get their MD finally quit and leave their job? This phenomenon, known as Physician Burnout, has gathered attention over the past couple of years, yet the root causes remain complex and multifaceted. My Senior Project addresses this issue and proposes interventions to mitigate its escalating prevalence. The project aims to contribute to existing research by exploring the numerous causes behind the surge in burnout rates among physicians. I chose to conduct my research at the American Academy of Ophthalmology because of their specialized knowledge in addressing Physician Burnout, particularly within the field of Ophthalmology. Collaborating with experts from the American Academy of Ophthalmology allowed me to gather data from a variety of sources, including longitudinal case-control studies, cross-sectional, cohort studies, and systematic reviews. Additionally, I conducted my own research by interviewing doctors to gain firsthand insights into the root causes of physician burnout. While I anticipate that much of the research will indicate a significant spike of physician burnout during the COVID-19 pandemic, my hope is to uncover evidence suggesting improvements within healthcare systems. Given the prevalence of physician burnout, my research on this issue is crucial. With 65% of emergency medicine physicians experiencing burnout, understanding its causes and implications is vital. We cannot afford to lose our doctors to burnout when their services are indispensable.
Project Blog
Post 1: Introduction
Hey everyone! I am Ava Farboudmanesch. I am excited to begin my research on physician burnout and its effects on individuals in the DMV area and the rate at which it's occurring. I'm also really looking forward to finding ways to prevent or minimize the rate of burnout within the medical field. I came across this topic over the summer after talking with the vice president of academic affairs for MedStar Health. She talked to me about the prevalence of physician burnout and how it has become a bigger issue since COVID-19 started. After our conversation, I conducted some of my own research and became more interested as I found out more information. I will be interning at the American Academy of Ophthalmology with Mr. Mark Lukaszewski, where I will observe physicians in their working environment, conduct surveys, find and analyze research, and administer interviews. I may need to make some adjustments to my project along the way, but I'll assess as I progress through the next ten weeks. '
I'm eager to share my experiences and findings in the weeks to come!
Ava Farboudmanesch
Week 1: Research Question Finalization, Interview Questions, and Literature Reviews
Hello Everyone! This week, I worked on finalizing my research question, aiming to make it more focused on a specific group. Additionally, I've been crafting interview and survey questions for physicians and other medical professionals affiliated with the American Academy of Ophthalmology, as well as those outside of it.
With progress on finalizing my research question, my next step involves reaching out to GME leaders such as the Medical Society of the District of Columbia, the Virginia Board of Medicine, and Johns Hopkins Hospital. My goal is to gain access to ACGME survey data pertaining to well-being from the past two years, which will provide me with more insights into the burnout rates among physicians and residents, along with other burnout indicators. By combining this external data with the data I'll collect at the American Academy of Ophthalmology, I aim to enhance the depth of my study.
I will also be working on my literature review, developing inclusion and exclusion criteria in order to narrow down my research question more. With all the sources I have looked at. The one that has intrigued me the most is the Stanford Model of Professional Fulfillment. There are three parts of Professional Fulfillment: Culture of Wellness, Efficiency of Practice, and Personal Resilience. Demonstrating that overall well-being is influenced not solely by individual personal resilience, but also by an organization's commitment to nurturing a culture of wellness and efficiency. The article shows the positive factors in improving those three parts of Professional Fulfillment. The article detailing this model will serve as one of many foundations for my study, guiding my research toward identifying factors that contribute to improving these parts of Professional Fulfillment and mitigating burnout.
In the coming week, I plan to delve deeper into my Literature Review, continuing to refine my research question. Stay tuned for updates!
Ava Farboudmanesch :)
WellMD & WellPhD. “The Stanford Model of Professional FulfillmentTM.” The Stanford Model of Professional Fulfillment, Stanford Medicine, wellmd.stanford.edu/about/model-external.html. Accessed 9 Mar. 2024.
Week 2: Finishing Literature Review and Planning for Next Week
Hey! Welcome back to week 2 of my Senior Project journey.
This week, I completed the analysis and data collection for my literature review. I managed to narrow down the criteria that intrigued me and focused on topics such as the data from 2020 to the present and more specifically, the experiences of frontline healthcare workers in hospitals. Through various articles and studies, I looked into the experiments conducted and the results.
One article that stood out to me is "The Impact of COVID-19 on Physician Burnout Globally: A Review." This article discusses the effects of burnout on physicians during the COVID-19 pandemic, identifies potential contributing factors, and proposes strategies to minimize its impact. Utilizing tools like the MBI (Maslach Burnout Inventory) and the "Professional Quality of Life Questionnaire" (ProQoL), along with databases such as Medline and Embase (OVID), the author concluded that key predictors of burnout during the pandemic include occupational factors like department of work, gender (specifically female), and increased work hours.
I found the section on occupational factors more intriguing than the other key predictors of burnout listed before. The article showed that burnout rates were significantly higher among physicians in frontline care roles. However, the study showed that during COVID-19, the frequency of burnout in frontline wards was actually 13% lower than that of physicians working in usual wards. This suggests that frontline workers may have greater control over the situations encountered in their jobs due to the consistent symptoms of COVID-19, as opposed to the more varied nature and symptoms of other illnesses. These findings sparked my interest even further, prompting me to explore the experiences of frontline care workers in greater depth.
Additionally, I had a call with my mentor, Mr. Lukaszewski, to discuss my upcoming first week at the American Academy of Ophthalmology. We deliberated on the research we'll be conducting, focusing on how financial strain can impact physicians and potentially contribute to burnout. I'm looking forward to doing more research on this topic during my internship.
More updates next week!
Ava Farboudmanesch :)
Amanullah, Shabbir, and Rashmi Ramesh Shankar. “The Impact of Covid-19 on Physician Burnout Globally: A Review.” MDPI, Multidisciplinary Digital Publishing Institute, 22 Oct. 2020, www.mdpi.com/2227-9032/8/4/421.
Week 3: First Week at Internship
Hey! Welcome back to week 3 of my Senior Project journey.
I've officially started my first week at the American Academy of Ophthalmology! During this time, I had the opportunity to discuss my Senior project and outline my ideas for the upcoming weeks with the staff. They are very supportive of my future endeavors and are willing to assist me as much as they can. That said, they sent me multiple articles to read and analyze. The main topic they wanted me to research was Prior Authorization and Step Therapy, which is how health insurance companies decide whether patients need one drug over another. In most cases, these companies will give a lesser quality drug to the patient to see if any progress has been made, and if it hasn't, then they supply them with a better drug. Although this is generally the topic I read about in many of my articles, I was also given an article about how physicians were reluctant to get help with their emotional wellness.
The main article they wanted me to focus on was about Dr. Lorna Breen, a physician who dealt with burnout. Her hesitance to seek assistance stemmed from concerns about potential repercussions, including the risk of losing her medical license and facing ostracism at her workplace. Unfortunately, she died by suicide on April 26, 2020. However, her passing prompted the introduction of the Dr. Lorna Breen Health Care Provider Protection Act, which was eventually signed into law by professionals review on March 18, 2022. This new law offers recommendations to improve the working conditions in US healthcare organizations.
Dr. Lorna Breen is one of many affected by the pandemic's increased burnout rate among US physicians. The enactment of the Dr. Lorna Breen Health Care Provider Protection Act marks a pivotal step towards fostering a culture of support and safety within the healthcare sector. It underscores the importance of creating environments where physicians feel encouraged to seek mental health or substance use treatment without fear of adverse consequences.
This is one way I have seen the federal government impact and support the Act for physicians undergoing burnout. I hope to read more about ways the federal government or other healthcare companies are doing to improve the conditions for physicians going through burnout.
Stay tuned for more updates next week!
Ava Farboudmanesch :)
Week 4: Which specialties are most affected? How does this affect my family?
Hello, and welcome to week 4 of my research journey!!
This week at my internship was spent delving into resources provided by the American Medical Academy (AMA), the National Library of Medicine (NIH), and many more. However, there were two articles in particular that I read that really stood out to me: "Top 10 physician specialties with the highest rates of depression" and "Burnout is a crisis for young physicians—and their spouses."
Some of the 10 physician specialties with the highest rates of depression are...:
Urology: 38.5%
Emergency medicine: 38.3%
Family medicine: 35.8%
Obstetrics and gynecology: 33.6%
General internal medicine: 33.3%
Physical medicine and rehabilitation: 32.7%
Radiology: 32%
Pediatric subspecialty: 31.9%
Psychiatry: 31.8%
Dermatology: 31.6%
These statistics intrigued me because some of these specialties align with my own possible career interests for the future. The impact of these results made me realize the potential implications for the future of healthcare, considering the possible deterrent effect on aspiring medical professionals.
The second article, "Burnout is a crisis for young physicians—and their spouses," discusses how a physician's burnout can affect their family. According to the article, spouses and other members of the family undergo "secondary psychological distress" when the physician is experiencing burnout or symptoms of burnout such as depression and anxiety. As someone with both parents in the medical field, I've witnessed firsthand how the toll of exhaustion and tension can spread to the family, leading to "secondary psychological distress."
Looking ahead, my focus for the upcoming week will be on refining the structure of my slideshow for the final presentation and exploring strategies employed by organizations and healthcare facilities to mitigate burnout among physicians.
See you next week!
Ava Farboudmanesch :)
20, Feb, and Sara Berg. “Top 10 Physician Specialties with the Highest Rates of Depression.” American Medical Association, 20 Feb. 2024, www.ama-assn.org/practice-management/physician-health/top-10-physician-specialties-highest-rates-depression.
Association, American Medical. “Burnout Is a Crisis for Young Physicians-and Their Spouses.” LinkedIn, 28 Mar. 2024, www.linkedin.com/pulse/burnout-crisis-young-physiciansand-spouses-m3g3c/?midToken=AQH6A_iKQHfa1Q&midSig=3n2Yncv-5niXc1&trk=eml-email_series_follow_newsletter_01-newsletter_hero_banner-0-open_on_linkedin_cta&trkEmail=eml-email_series_follow_newsletter_01-newsletter_hero_banner-0-open_on_linkedin_cta-null-7kunrd~lubibub4~bt-null-null&eid=7kunrd-lubibub4-bt&otpToken=MTYwMDE2ZTIxYTI4YzljNmIxMjQwNGVkNDcxZmUxYjA4OWM2ZDQ0NDkwYWY4ODYxNmNjNjA5NmY0ZTViNTRmN2YzZDdkNmU5NjdmMmUwYzk2N2JjZGM5N2EzZDgyNmViZmMwNWMwZTgxMDE1ZTI2MDM3ZTk4ODhhLDEsMQ%3D%3D%5C.
Week 5: Structuring my Presentation
Hello, welcome to week 5, the latest update of my senior project!
This week, I spent most of my time attempting to figure out the structure of my presentation for the end of the year. With the material I have been given, I was able to find a good structure for my presentation:
Introduction: Where I define burnout, the importance of addressing it, and what my main objective is out of this project.
Literature Review: Summarizing and having an overview of the research I have done, the factors that contribute to burnout, and the effects of burnout on physicians and patients.
Methodology: Descriptions of the research designs I conduct, the research by others, and the methods of collecting the information.
Results: Findings related to the prevalence and severity of physician burnout, identification of the key factors associated with burnout, and an analysis of data on the impact of burnout on job satisfaction and patient outcomes.
Discussion: Summary and thoughts of the results in the context of my literature review, mentioning ways to address physician burnout, and coming up with ways to change healthcare policies and practices.
Conclusion: Summary of key findings and their significance and ways for future research and interventions to mitigate physician burnout
References: List of sources cited in the research project.
Acknowledgments: Recognition of any individuals or organizations who contributed to my research project.
With this information already sorted for my presentation, I hope to have an easier time organizing all the information I have collected over the past three months. Stay tuned next week for more updates on my internship and research!
Byeeee!
Ava Farboudmanesch
Week 6: Academy Congressional Advocacy Day
Hey! Welcome to week 6 of my senior project journey.
This week, I had the privilege of participating in an impactful event hosted by the American Academy of Ophthalmology, focused on addressing pressing issues within the ophthalmology industry. From veterans' eye care to pediatric eye care, step therapy, and prior authorization, the discussions were wide-ranging and passionate.
Our day started bright and early at 7 am, as we gathered to strategize on the key issues to present to congressmen and their aides. We delved into the essence of ophthalmology through insightful presentations by various speakers, followed by demonstrations of effective communication with legislators and their staff for the day.
I joined a group of dedicated ophthalmologists and residents from the DMV area, I was inspired by their passion for driving change within the field. Conversations with these professionals also shed light on the concerning issues of physician burnout, with a consensus emerging on the root causes being financial pressures and administrative burdens such as insurance and paperwork.
Now for the advocacy portion, we visited the offices of five congressmen, sharing our proposals for reforms in ophthalmology in Virginia and across the nation. It was gratifying to see our voices heard and our efforts recognized by those in positions to effect change.
Reflecting on this experience, I am eager to integrate the knowledge and insights gained into my senior project. Every interaction and discussion has added depth to my understanding of all these issues in the healthcare world, fueling my commitment to making a meaningful contribution to my time at this internship and this project.
Come back next week!
Ava Farboudmanesch
Look at my post from the event>>https://www.linkedin.com/posts/ava-farboudmanesch-39069328a_ama-americanacademyofophthalmology-internship-activity-7186813090963824640-Mjoc?utm_source=share&utm_medium=member_desktop
Weeks 7-8: Interviews and Finalizing
Hey everyone, and welcome to week 7/8 of my Senior Project journey!!
As I reflect on the past two weeks, I find myself immersed in the final preparations for the senior showcase. Structuring a good presentation to encapsulate my research findings and experiences has been both exciting and challenging. Amidst this, I've been deliberating over the most effective way to convey the depth of my research journey—should I opt for a comprehensive literature review or dive into the creation of a research paper that shows the essence of my internship and personal findings?
One aspect that has truly enriched my methodology is the invaluable insights gathered from interviews with seasoned physicians regarding physician burnout. This week, I reached out to three doctors to see their perspectives on physician burnout, particularly its prominence to current times. Thankfully, one of them responded with profound insights that promise to shed new light on this pressing issue.
Stay tuned as I delve deeper into my research project and share the enlightening perspectives of experts in the field.
Until next week,
Ava Farboudmanesch
Weeks 9-10: Wrapping it up!
Hello, and welcome to my final blog post before the Senior Showcase!
Over the past two weeks, I have been working diligently on my presentation for the Senior Showcase. I have also finalized my plans for my final project, which will be a two-page synopsis discussing my research and my experience during my internship at the American Academy of Ophthalmology.
Thank you so much for following along with my journey.
Hope to talk again!
Ava Farboudmanesch