How to Help Recognize the Signs of Burnout

It is well known these days that burnout is a widespread point of discussion in the medical community – especially among surgeons. As much as we talk about it, many physicians don’t even realize that they’re burned out. We talk a lot about how surgeons can prevent and treat symptoms of burnout when they arise, but an essential first step in that process is getting the burned out surgeon to realize that they are experiencing burnout. In this article, we are going to address this issue and offer some tips for helping surgeons recognize the signs and symptoms of burnout so they can take appropriate action.

 
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Demands of the Job

The system and culture expects a lot of our physicians – too much, in fact. Many of us were trained to power through adverse situations and solve problems on our own, without asking others for help. The strategy of working harder and longer does nothing to improve our situation. Rather, it leads to unprocessed anxiety, stress, and fatigue – classic symptoms of burnout.

Burnout is not typically caused by a single event. It usually builds slowly over the course of months or years, much like the frog in the boiling pot – making it even more difficult to recognize and address. When we do finally exhibit the signs, it is important to effectively identify them as such.

Recognizing the Signs

Keeping an eye out for red flags is an important first step. Even asking simple questions can bring heightened awareness to our current situation.


Here are three simple questions you can start with.

Do you find yourself or a colleague “checking out” or disengaging from patients?
Do you find yourself or a colleague overwhelmed and disengaging from family, friends, or colleagues?
Do you find yourself or a colleague losing the joy of your (their) career and accomplishments?

These signs can be hard to recognize in ourselves, so it’s also important to keep an eye on our friends and colleagues as well. If you notice any of these red flags in a friend or colleague, go beyond asking them how they’re doing and if they need any help. Most will say they are fine and “no thanks.” Come at it from the side of compassion. You could offer support in ways that you might want others to give it to you, or you could share with your colleague one of our resources, blogs, or podcasts that really resonated with you.

SurgeonMasters Wellness & Resilience Services

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Source - Helping Physicians Recognize They're Burned Out, Steph Weber, Physicians Practice, April 9, 2018

Weaponized Praise Does Harm in Healthcare

Weaponized praise is an unfortunately common tactic used by many leaders and administrators in the healthcare industry to manipulate physicians and even other healthcare professionals into doing more work, often in lieu of a raise, a promotion, or helping us solve our most pressing issues. I also think that there is a more sinister twist to how it is used against physicians.

Weaponized praise is a pervasive tool used in medicine by most leaders and the entire healthcare system. I would describe the technique of weaponizing praise as leveraging a doctor’s ethics and drive for quality and the passion to provide patient care. In fact, I have been victim to this and I see many other victims, where the praise is weaponized to get doctors to make up for the failings of a system.

In my first job, I was given titles and lots of praise. For a while, I responded to it with increasing case volume and continued effort to receive that praise. It was confirming of my worth as a physician and provider of care. Within my second year, I had the second highest RVU's (a measure of productivity) in the department. I responded to the praise by picking up other people's responsibilities.

I received encouragement to delegate more, whether to the residents or to my administrative assistant, but I was not guided in the process of HOW to do that.

I was added to committees. I had ever increasing responsibilities.

 
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This might describe almost every early academic career. It is a common tactic for onboarding others in private practice as well. When it comes to raises or promotions, I was told that it was beyond my boss's control. Promotions had to go through the university process. Appropriate raises were just not possible due to departmental financial constraints or the shrinking dollar in healthcare.

Sounds like a flawed process.
Sounds unsustainable. And it was.

When I finally started adjusting my work schedule to more sustainable levels, the only thing that seemed to change was that the praise went away.

I think that navigating this complex dynamic would have been easier with professional coaching. It is a balance between operating at high performance and the understanding that simply taking on more work does not necessarily equal greater results. Creating efficiency and building strategies to develop a lifestyle-friendly surgical practice that is sustainable would be a more effective process. If I was taught then the 8 PRACTICEs of Highly Successful Surgeons, and if I was provided coaching, I might have stayed in an academic practice. I know I would have been much further along in my career growth. Knowing how to operate and take care of patients is simply not enough.

So what are the shields and opposing weapons to this kind of weaponized praise?

“Accept your boss’s praise. Politely decline extra work, and try to offload what you’ve already taken on.” - Jessica Wildfire

In a recent article on the topic, Jessica Wildfire outlines the following recommendations for combating weaponized praise:

  • Accept the praise

  • Don’t whine about doing extra work

  • Politely decline extra work, and even try to offload what you’ve already taken on

  • Learn and implement a strategy to say “no”

  • Highlight your desire to do high quality work

  • Remind your boss of what you are already doing

  • Only take on projects that will raise your knowledge or value**

  • Find out who should actually being doing the work and redirect

  • Doing extra work should eventually lead to some kind of reward

Each of these tips has potential value. Most are often part of an overall strategy of learning to say “no” and setting priorities.

**Since many physicians want to gain new skills and knowledge, one needs to proceed here with caution. There must be a limit to the work or the timeframe over which it should be completed. Research notes that rest and recovery are necessary in between these periods of challenge. Has your boss accounted for that?

We can certainly challenge ourselves. Research shows we often grow the most when we are challenged just outside our comfort zone. Your boss might not have a clear picture on where that threshold is for you. You might not even know that threshold yourself. Are we being realistic with ourselves that the increased value and reward will be achieved? Could it be done over a more realistic timeframe?

I hope you can incorporate some of these tips into your shield against weaponized praise.

If not, these challenges are a great reason to use a coach.

SurgeonMasters is building a community of surgeons and physicians looking to change the culture in medicine. A coaching mindset and skills are powerful tools to start creating the change we need. Email Team@SurgeonMasters.com to get involved.

Source: Watch Out for Weaponized Praise

Steps to Control Social Media

This week’s guest blog on steps to control social media is from Jonathan Cabin, MD, a practicing plastic surgeon in Beverly Hills, California. Social Media, with great advances and substantial pitfalls, is here to stay. Navigating this can seem like an overwhelming challenge. Jonathan lays out simple, actionable steps we can take to manage our participation in social media platforms to avoid the overwhelm and minimize the pitfalls! - Jeff Smith

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In a recent Doximity Op-(M)ed blogpost, I discussed the intentional and dangerously addictive properties of social media, and the potential pitfalls for, and responsibilities of, the physician who chooses to engage with these platforms. I alluded to a set of positive constraints that could be employed to leverage the positive benefits of social media, while minimizing detriment. Below are some accessible, low-effort and highly actionable ways to positively transform social media use:

NOTIFICATION TAILORING

One of the most powerful ways to control social media – or the addictive nature of smartphones in general - is to selectively opt-out of those non-stop pop-up notifications. Notifications are purposefully designed to create a sense of false urgency, leading to a feedback loop of addiction. But there is rarely, if ever, urgency in social media (or nearly all of the other apps that constantly ping us). Even with the best intentions to contain use, the list of notifications on your locked screen creates a sometimes-irresistible urge to peek at the action. 

DELETING APPS

By selectively deleting social media apps from your phone, use is inherently restricted to an actual computer. This relegates engagement to specific, limited settings and eliminates the temptation to mindlessly scroll during opportunities for reflective moments. For certain services, like Instagram or Snapchat, phone use is unfortunately the only straight-forward option. But in the case of Facebook, removal of the app is an excellent way to create a powerful boundary.

SELECTIVELY OPTING-OUT

Yes, you can forgo one or more of the social media networks. This allows you to reallocate your time to specific networks (or other activities) that are personally or professional higher yield. Of course, depending on your marketing goals, this may not be feasible. But it is worth considering, especially if you are deriving most your professional and personal value from a select few services.

PLANNING

If you are trying to positively leverage social media for marketing - like any marketing effort - it’s best to have a plan. Instead of deciding day-to-day what, where and how to post, sharing can be pre-determined on a weekly or monthly basis. This not only leads to more thoughtfulness about overall messaging, but reduces the inefficiency of posting randomly and on-the-fly. If you're looking for organization ideas, a quick online search will lead to various templates and data-driven recommendations for maximizing your social media ROI.

BATCHING & SCHEDULING

In conjunction planning, social media use can be made intentional and meaningful by batching and scheduling. There are several online services that allow you to centralize all your accounts and schedule posts in creative and practical ways. And most of these programs allow you to post without actually logging into the service, which is an added bonus – especially if you tend to get sucked into content consumption when just intending to share your own.

SELECTIVE OUTSOURCING

If you find social media to be a necessary evil, it may be worth the added expense to dedicate staff to it. This could be as little as physically posting photos and captions you generate, and as hands-off as putting someone in charge of all content, posting and responses. Although potentially expensive, consider the time-intensiveness of social media management. What additional value could you generate by outsourcing in order to focus on more high-yield professional (or personal) activities?

BLOCKING OR UNFOLLOWING

There is pressure on social media to reciprocally follow, and there can be strong FOMO (fear of missing out) at the idea of no longer getting someone’s content updates. But if you truly find joy in consuming social media content, but notice little value or even negative emotion related to the posts of certain individuals, it is a wise choice to eliminate their content from your feed. In some networks, like Facebook, this can be achieved without actually “de-friending” but by merely “unfollowing”. With so little time in the day, why waste a moment interacting with something that hold little or no personal value.   

The objective is not necessarily to eliminate social media use (although for some this may be a reasonable conclusion). Instead, pick and choose from the above tools to establish systems and boundaries with the goal of an intentional practice. This will help to maximize personal and professional value, while minimizing unintentional distraction and negativity: for yourself and for your patients.

Author Bio:

Dr. Jonathan Cabin is a board-certified facial plastic & reconstructive surgeon with a private practice in Beverly Hills, California. His areas of expertise include surgical and non-surgical facial rejuvenation, primary and revision rhinoplasty, facial reconstruction, and migraine surgery. In addition to caring for his patients, Dr. Cabin writes on the topics of performance-enhancement for physicians, surgical coaching, and bringing joy and meaning back into the practice of medicine.

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The Importance of Online Reputation Management for Surgeons

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What many physicians don’t realize is that they have an online presence already – even if they haven’t set up a website, or a social media account. I’m talking about third-party listings like ratemds.com, healthgrades.com, and ucomparehealthcare.com. These third-party listing sites have a lot of ranking authority and will almost always appear on the first page of Google when a potential patient searches a physician’s name. If you aren’t actively monitoring these listings and proactively reaching out to patients to leave positive reviews, you are endangering your online reputation.

A HealthGrades Nightmare

Here’s a recent example we had to deal with. One of my clients (an orthopedic surgeon with his own private practice) noticed a decrease in new patients coming in. This particular client gets about 75% of his patients through his website – as well as the online ad campaigns we run for him. What made this drop in patients particularly baffling is that we’d been having a fantastic quarter in terms of web traffic and conversions via the website and Google ad campaigns. So why were new patients dropping?

After a bit of investigating, we pinpointed the culprit – Healthgrades. If you’re unfamiliar, Healthgrades is a third-party doctor listings website where patients can leave reviews of their physicians. Though my client had an overall rating of 4.3 / 5 stars (with 82 total ratings), the most recent three reviews were very negative – and from patients who were only mad because they couldn’t get all of the prescription pain medications they wanted.

Three negative ratings on a third party site were killing new patient referrals for my client. Potential patients were finding my client via Google search, and since Healthgrades lists reviews with the most recent first, their first impression was these 1 star reviews.

Solving the Problem

Once we figured this out, we went to work right away to resolve the issue. Working with my client’s clinical staff, we reached out to previous patients to see if they would be willing to write positive reviews on Healthgrades. Most were more than happy to, and within a week we had populated the listing with seven new 5-star reviews from happy patients – burying the negative reviews in the process.


 

Author Bio:

Ryan McGinty is the founder and CEO of Oil Can Marketing – a Twin Cities based web design and digital marketing company. For the past five years, he has been helping physicians and surgeons build their online reputations and grow their practices.

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3 Tips for Burned Out Surgeons to Communicate with their Bosses

Surgeon Communication Tips

When surgeons experience burnout, it can impact their ability to communicate effectively. That goes for patients, as well as co-workers and bosses. Whether you’re dealing with a ranking doctor, or a hospital administrator, it can be difficult to communicate effectively with your boss when you’re burnt out. In this article, we are going to discuss a few tips for communicating with your boss if you are feeling burnt out in your practice. Keep in mind that I am not taking sides.

Be Polite

Burnout is often coupled with stress and anxiety, which can cause some doctors to be rude or curt when talking with their co-workers or boss. Always do your best to be polite when you are talking with your boss (or your co-workers for that matter). Our goal here is to lessen your stress!

Explain How You Feel

It’s also helpful to talk to your boss (or a colleague) and explain to them what you are feeling. I don’t deny that this might be quite challenging. Empathy is not a principle exclusive to patient communication. Lower emotional intelligence/empathy and poor communication are correlated, and burnout is more common in environments that have these weaknesses. Someone has to break the ice. If your boss even understands just a little better how you’re feeling, they may be able to offer assistance or support.

Ask for Help if you Need it

I need you to step out of your shoes and take an independent perspective. If you think your boss truly has the desire and ability to help you be as successful at your job as possible, then don’t be afraid to talk with your boss about a recovery plan. If you think your boss is challenged in their empathy or resources to help, you may need to work with others. Either way, your goal is to improve communication through mutual understanding. You might arrange regular brief meetings that allow you to share the factors that are contributing to your decreased job satisfaction, such as: excessive paperwork, EHR, or long work hours.

Preventing Surgeon Burnout

Burnout can be damaging and debilitating for any surgeon. I know from my own experiences throughout my decades of work in medical school, training, and private practice. Through these experiences, I have crafted a methodology called The 8 PRACTICEs of Highly Successful Surgeons that is meant to help surgeons prevent and recover from burnout. This methodology can be utilized by any physician in any sub-specialty and aims to help you find rhythm between your work and family life so you can get the most out of both. Contact me today to talk about The 8 PRACTICEs of Highly Successful Surgeons and how they can be applied to your practice.