Impairment comes in many forms. Most often people think of a problem with alcohol or drugs. However, impairment applies to many aspects of a physician’s career. Just as with drug or alcohol abuse, people can function for a while impaired. It is not until that critical sentinel event when people realize the addiction. Many people talk about physician burnout without seeing the entire spectrum. Physicians often keep their job and practice it safely while their degree of impairment from burnout increases gradually. For instance, a physician at 25% impairment by burnout is likely performing clinically at the same level as always. However, as the percentage of burnout increases, there could be a higher likelihood of a sentinel event like poor patient outcomes or even suicide.
With compounding complexity, the avenue for help is often clouded by fear of punitive actions by many systems. For instance, the stigma placed on behavioral health services places physicians at risk of losing their livelihood. If a physician is significantly impaired by burnout, they risk disability, job displacement, or a licensure restriction. All of these are unfortunate outcomes that make burnt out physicians seek care under aliases in towns they don’t live in, often far away.
Furthermore, this type of impairment, like drug and alcohol addiction, is seen as a problem of the individual and not a chronic ailment (of a broken system.) This places further blame on the physician which only raises the pressure on the individual. I have seen this happen to physicians from coast to coast; it is universal. Once the level of impairment reaches a point where disciplinary actions by systems or medical boards are taken; careers are crippled despite the potential for a full recovery. It is only at this point where some seek guidance regarding career change that may be more beneficial to their health, psyche, and life overall.
Think of someone that used to come to the job very happy and helpful, but now they may seem like they’re very irritable or just didn’t get their daily dose of coffee. Signs and symptoms of burnout vary, but usually is a combination of the following symptoms:
- Cynicism
- Irritability
- Depressed affect
- Objectification of patients
- Loss of empathy
- Rudeness
Understanding the analogy of burnout and impairment, one sees that symptoms may be unnoticed to many including the person affected. Pay particular attention to your colleague who may have had these symptoms and suddenly feels happy. These may be the person at risk for that sentinel event. The next three episodes of my podcast Licensed To Live will focus on impairment from burnout and provide solutions to help. If you feel that you are impaired, you can always set up a time to talk at www.timewithdoctorjarret.com.
