Addressing Depression among Residents

Depression and burnout prove to be spreading far and wide in the healthcare industry. Among residents, a study published in the Journal of the American Medical Association found that 43% experience depression or depressive symptoms. Moving further into the field, the same journal reported that 50% of physicians in the US are burning out, which leads to dire consequences such as reducing time spent on clinical work, leaving the profession, or early retirement.

The numbers on depression have also been found to rise yearly at 0.5% throughout the past half-century. This increase is attributed to many factors. For starters, medicine today is more challenging compared to 30 years ago. Patients are sicker, treatment options are more varied, and clinical guidelines have expanded. Physicians need to know a lot more to address the needs of patients properly.

physicians in the US are burning out

Also, the work that is required of them has increased, but often hospitals are understaffed. This results to shorter interaction time with patients. Hours of clerical work can be draining, and instead of contributing to the healing of a patient, residents spend most of their time filling out forms, managing the EMR, and completing an enormous amount of paperwork. First-year residents, in particular, look more like secretaries rather than physicians. This scenarioreduces a hospitalist’s job satisfaction and creates the feeling that they have been relegated to a minor position instead of having a direct impact on patient care.

So what is needed for change? Hospitals and hospitalists must work together to achieve change on a systemic level. Otherwise, depression and burnout will continue to grow and cripple the healthcare industry.

Finding the right balance between work and life is a crucial fix. For this, flexible schedules may be the answer. Currently, residents are thankful for feast and famine cycles of seven-on and seven-off working blocks. But this is not sustainable for the long-term. There is the issue of working overnight call shifts, too. Getting stuck with a few nights with this schedule is equivalent to taking a couple of transatlantic flights! How can any person function well if he or she is sleep deprived and is working around 90 hours a week?

Physicians must be given more flexibility so that they can devote time to their family, significant others, and to themselves. Much of the depression and burnout comes from being chained to the work and the feeling of missing out. They are in the hospital working day and night and, at the same time, they are seeing the lives of their loved ones grow without them. It can be a lot to take.

Similarly, providing more incentives and fixing compensation can help. Often, residents are asked to do more work without added compensation. Some have bonus targets that are not realistic, while others are working under high pressure performance metrics.

It is recommended to reduce incentive components to make it more achievable. Alternatively, hospitals can base incentives on engagement and satisfaction. Reward doctors for efforts geared at improving quality or serving the community. This includes time spent on volunteer work, doing a free clinic, leading hospital initiatives, and writing order sets. Introducing sabbaticals is also a good idea. For long-time hospitalists, taking a few months off to unload stress can lead to feeling refreshed and revitalized.

Remember that residents are people, too. The work they do is far from normal, and exposure to patient suffering everyday is not easy. These can wear a person down, and the everyday stress brought about by the nature of the work can manifest as depression or burnout later on. Taking active steps to have a more balanced life is keyto retaining a solid workforce.

Author: Robin Gupta