Why Some Doctors Thrive In Stressful Settings, While Others Burnout

Feb 12, 2018

WUWM has previously reported on the issue of doctor shortages, especially in already underserved areas.  Many efforts are underway to attract new doctors to practice in these places - efforts like UW’s TRIUMPH program.

READ: UW-Madison Program Places Med Students in Milwaukee's Underserved Communities

But recruiting new doctors is only part of the equation, another part is retaining the ones already in practice.  There are studies that show more than 60% of family practice physicians experience burnout symptoms - and the numbers are even higher when you look at doctors working in underserved areas.

Several Milwaukee doctors are trying to get to the root of what causes some doctors to leave the profession, and what keeps others motivated to stay.  Doctors Anne Getzin and Kjersti Knox are physicians with the Aurora Family Medicine residency program; and Deb Simpson is director of the medical education programs for Aurora Health Care.

Dr. Getzin and Simpson authored an article, Sustaining Family Physicians in Urban Underserved Settings, that appeared in the journal of the Society of Teachers of Family Medicine.

A question they sought to answer was: What keeps physicians in these settings going?

"There are a lot of people who are well intentioned and excited and it's very meaningful for them to practice in underserved settings, and then we get out here and it's hard," Getzin notes. "Burnout is intense across all fields of specialties, but I think it's particularly concentrated in underserved setting because of the unique obstacles that are faced."

Dr. Knox notes that the heart of why doctors go into medicine is critically important in how they handle burnout. Many go into practice to address social justice and health equity issues, and while that can be rewarding, there is greater long-term success when doctors feel they have a good work-life balance and good internal support.

"There were also some really interesting components of the brain-part of it - cognitive processes, re-framing challenges as rewarding and developing resiliency through those kinds of approaches were also really important," adds Knox.

Simpson says that health care is in a crisis across the country. Tools such as information technology in clinics "is taking physicians away from the thing that supports their meaning - which is the direct contact with patients and team members," she notes.

Nearly all doctors are finding difficulties working with patients due to transportation challenges and working with a curriculum that has not adapted over time. Therefore, the implications of this research for doctors who do not have the additional training to practice in underserved communities is crucial, Simpson says.

"Nationally there is recognition that all physicians are being challenged by these elements and there are starting to be requirements to incorporate things like how do you support patients and yourselves around health disparities," she says.

Getzin says that doctors "face tremendous grief and challenges as well as share in a lot of joy with our patients." A supportive work environment, she says, would not only help prevent burnout, but promote physician retention.  "I think that community helps us keep that heart lit in going forward."

"Knowing that I have community partners, that I have clinic partners, that I have system partners that are all looking at these various challenges from different perspectives helps me feel like I'm not alone - and then I can keep going forward," adds Knox.