By: Paul O’Leary, M.D.
Healthy residents care for their patients. However, multiple studies focusing on stress, burnout, and well-being demonstrate that the opposite may also be true. Burned-out, unhealthy residents simply don’t do as well at caring for patients.
The study of stress and well-being aids our understanding of how to quantitatively improve the work environment using multiple models and validated scales that measure burnout. Initial studies in the late 1970s focused on how stress affected hotel staff and nurses. Then, in the early 1980s, studies about how stress affects resident physicians began to appear in publications, as well. These publications assisted efforts, during the late 1980s and 1990s, to legislate improvements in resident work environments, culminating in the 80-hour workweek that began in July of 2003. Now, researchers are broadening their focus to include resident well-being and quality of life, as well as including ‘well’ residents and ‘stressed’ residents.
As a resident, I became very interested in improving the well-being of my fellow residents. I understood that even with the changes in the work hours and the oversight of the GRE, residents were still at risk for burnout. However, workload is not the only thing that can affect one’s risk. Research shows there are six major aspects to work satisfaction, and the combination of these factors can lead to either protective or detrimental effects.
Naturally, workload is one of the factors, as being overworked can lead to burnout. Another important factor is the amount of control a resident has over their workload. By having the resources necessary to do work efficiently, and by having flexibility in one’s schedule, residents may protect themselves from burnout. The third factor is collegiality, or how well one gets along with others in the workplace. Fourth is rewards, not only through financial compensation, but also in recognition of a job well done. Fifth is fairness — whether tasks are divided fairly, and everyone is expected to meet the same requirements. The sixth factor is personal values; it is important that residents share the same values as the group for whom they are working.
By discussing these six aspects of work with the Residency Director, we were able to make changes to the program, which reduced the stress and level of burnout a lot of the residents were feeling. As we learn more about how to create a healthier workplace for residents, we create a healthier environment for patients, too. And that makes everyone feel better.
Paul O’Leary M.D.
AMA Psychiatry Section Council
Resident & Fellow Section Delegate
1225 50th St. South
Birmingham, AL 35222