The Emergentologist - Burnout & the Specialty

Curious about the specialty of Emergency Medicine? And as a woman?

1. Emergentologist Burnout and the Speciality The

2. Dr. Myiesha Taylor - BAFERD

3. About Dr. Taylor Emergency Medicine Physician Attending Assistant Professor Faculty at UT Southwestern Medical Center Physician Partner at Vituity Associate Partner at Kaiser Permanente Medical Group Associate Medical Director at County of Los Angeles Chief Resident at Los Angeles County King Drew Medical Center College Counseling at UC San Diego Medicine at University of Southern California Chemistry/Pre-Med at Xavier University of Louisiana Homeschooling Mother Daughter 17 and 2L Son 14 and TCC grad + Junior at UNT Daughter 12 at TCC Wife Daughter/Aunt/Sister/Friend Sorority Chapter Vice-President Advisor of Youth Group Vice-President of Chapter of National Mothers’ Group (Jack & Jill of America, Inc.) Member of various Social Clubs Educational Strategist Community educator (Disney Jr. etc) M edical Advisor at Cannformatics Health & Safety Expert Content Advisor at Texas State Board of Education Chief Medical Officer at InDoc Owner and CEO at Taylored Physician

4. Emergency Medicine E mergency medicine is the medical specialty dedicated to the diagnosis and treatment of unforeseen illness or injury. It encompasses a unique body of knowledge as set forth in the “Model of the Clinical Practice of Emergency Medicine.” The practice of emergency medicine includes the initial evaluation, diagnosis, treatment, coordination of care among multiple providers, and disposition of any patient requiring expeditious medical, surgical, or psychiatric care. Emergency medicine is not defined by location , but may be practiced in a variety of settings including hospital-based and freestanding emergency departments (EDs), urgent care clinics, observation medicine units, emergency medical response vehicles, at disaster sites, or via telemedicine. Emergency medicine encompasses planning, oversight, and medical direction for community emergency medical response, medical control, and disaster preparedness. Emergency medicine professionals provide valuable clinical, administrative, and leadership services to the emergency department and other sectors of the health care delivery system. Emergency physicians are the foundation of the United States healthcare system's patient safety net. They possess a clear understanding of the health care delivery system and the needs of their patients. Emergency physicians are uniquely positioned to evaluate, plan, and implement community and regional health policy initiatives.

5. Physician Stress & Burnout Being a physician is a stressful job. Dealing with sick and dying people , their grieving families, and basically seeing the worst of humanity and the ramifications of those actions, takes a mental/emotional toll. This, combined with our training system that rewards self-abuse, expects perfection, being wholly responsible for outcomes of which you have little control over contribute to physician burnout. It would make sense that high-intensity fields such as EM would have high levels of stress and therefore higher levels of burnout as a result. When doctors are held accountable for things outside of our control (that add little value to medicine) such as medicare quality indicators and, patient satisfaction feedback, frustration grows. Further the dichotomy between doing the actual right thing for the patient and following the "approved guidelines" developed by the payors are often at odds. Because we are there to "do right by the patient" there is an intense internal conflict that is difficult to reconcile.

6. Physician Burnout Burnout — a psychological syndrome featuring emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment Burnout has widespread consequences, including poor quality of care, increased medical errors, patient and provider dissatisfaction, and attrition from medical practice, exacerbating the shortage and maldistribution of EPs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526882/?fbclid=IwAR0Mr0HGH2qO63-7QQjUDKnHCQuuI-BfbaPkiGntQ-Jhek8MSpyyARkdyeg Burned-out physicians are unlikely to seek professional treatment and may attempt to deal with substance abuse, depression and suicidal thoughts alone Each year more than 400 physicians take their lives, likely related to increasing depression and burnout.

7. Physician burnout Burnout not only affects the physician and her/his quality of life, but also adversely affects patient care and outcomes. Leading cause of burnout is high administrative burden (bureaucratic tasks). Other causes include EHRs, lack of autonomy, lack of respect, regulations. Also mid-career is a time when more docs tend to feel burned out, maybe due to lots of roles outside of medicine (such as caring for children, and elderly parents, have lots of bills, mortgage, car-notes, etc).

8. Physician burnout Women tend to be more burned out than men , probably due to the larger role women tend to play in maintaining household duties (even while working full-time) combined with our tendency to take on work that isn't compensated (such as mentoring and other collaborative "helpful" positions) and are sometimes even relegated to roles that aren't promotable. Also there is a possibility that women may have more doubt about whether they are living their purpose when they have many competing interests in their lives such as being a care-provider for children and parents. There have been many great articles written about how Covid-19 pandemic is adversely affecting women's careers when duty calls at home as we bear a great proportion of childcare and household duties.

9. Physician Burnout For the most stressful medical job, the highest percentages of burnout occurred among these medical specialties: Critical care: 48 percent. Neurology: 48 percent. Family medicine: 47 percent. Obstetrics and gynecology: 46 percent. Internal medicine: 46 percent. Emergency medicine: 45 percent. https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460#1

10. Energy Levels & Burnout (stop the drain and replete when depleted) EM contributions Depleted levels may manifest as Replete your levels via Physical Energy Shift work with rotating hours can disrupt self-care including sleep cycles, and ability to eat healthy foods. Physical assault by patients. A training system that rewards self-abuse. when its low you feel physically exhausted. Self-care. Good diet, exercise, adequate quality sleep Mental/Emotional Energy Highly stress work that carries with it a heavy emotional toll. Dealing with sick and dying people, grieving families, and seeing the worst of humanity and the ramification of those actions are draining. Work-schedule may separate us from our families and that necessary human emotional connection. when its low you depersonalize, become cynical, overly sarcastic, and have “compassion fatigue” Spend time with important people in your life (including yourself). Spiritual Energy Loss of autonomy, appreciation, administrative burdens, and unfair adjudication from external interests often have physicians asking themselves if their role is truly added value. when its low you lack efficacy and doubt the value of your work and life purpose. Connect with your purpose

11. Women in Emergency Medicine Emergency Medicine is like a valuable gem that many fail to fully appreciate. There is always a need (somewhere) for a physician that can take care of very sick people. The pay is good. I won’t say recession or pandemic proof, however, but you’ll fare better than many others. The work is meaningful Medicine is not “a calling” or some sort of “special” state of being. It is a career. A way to make a living and contribute to society professionally Allows you to “everything in its proper place” in the ranking of your life priorities and medicine can be an excellent career. EM allows a physician to have the flexibility to prioritize various aspects of their lives.