Medical Technology

Patients can also experience burnout

Initiatives to combat burnout among health professionals can be extended to include patients suffering from chronic conditions — who can display some of the same signs like stress that is prolonged and hopelessness, or feeling a loss of control.

Identifying these patients and acknowledging their increased burnout risk could improve the doctor-patient relationship as well as make patients more likely to follow treatment guidelines and boost outcomes, according to Adrienne Martinez-Hollingsworth, PhD, and colleagues.

The “Burnout Dyad Model” was developed by researchers. This strategy takes into account both the health care professional aspects either individually or in conjunction. It can also help reduce stress outside of the workplace.

“The unique part about the model is that traditionally, burnout has only been described as an employment-based illness; it has to be connected to your occupation,” says Martinez-Hollingsworth, a professor and associate dean of the College of Nursing at Samuel Merritt University in Oakland, CA.

“But if you look at what patients of chronic illness experience, there’s a lot of overlapping features, [including] the idea that there’s some kind of long-term exhaustion,” she says.

The study was published in an issue of the Journal of Continuing Education in Health Professions.

Other experts in burnout applaud the inclusion of patients.

“Dr. Martinez-Hollingsworth and colleagues are breaking important new ground in developing the concept of the ‘Burnout Dyad Model,’ which reframes the burnout conversation to recognize the pervasiveness of patient burnout and how it may affect clinical relationship, the quality of care, and numerous patient-centered outcomes,” says Michael J. Brenner, MD.

Screening could be a great aid

“It’s an excellent idea to ask patients with chronic illnesses if they feel burned out in their treatment,” Mark Thomas Hughes MD Professor of assistant medicine at Johns Hopkins Medicine, Baltimore.

He says, “If the antidote for burnout is a greater focus on well-being and resilience, and chronic illness directly affects one’s feeling of well-being then it is evident that screening patients for burnout can be an option to help them manage their chronic illnesses.”

Brenner agrees.

Brenner is an associate professor at University of Michigan Medical School, Ann Arbor, says that “there is no doubt that chronic conditions take toll on patients and health professionals, as well as caregivers.”

Brenner published guidance online Nov. 22 about how leaders can avoid burnout, and how to build resilience in health professionals.

Research that is centered around the patient

It is well-documented that the effects of burnout in the field of health care is a common occurrence. 42% of doctors reported being burned out in “Death By 1000 Cuts” Medscape’s National Practitioner Burnout & Suicide Report 2020.

It is not known how often it occurs and the severity of it in patients.

To learn more, the investigators asked a diverse group of health care professionals as well as patients and caregivers about the effects of burnout on patients during the Medicine X Conference at Stanford University. Interestingly, the group included those who self-described as chronic patients.

Hughes supports this approach.

“This is a very thought-provoking study that was informed by a workshop experience that brought together patients and providers… [thatis] a fresh dimension to our understanding of chronic disease management in a patient-centered manner.”

Patients may also benefit from the strategy.

Hughes says, “Seeing the patient as an integral member of a team in their own care, opens up a dimension of burnout as a caregiver for themselves.” Hughes’ most recent publication on Burnout is a November. 16 article about how the COVID-19 epidemic has contributed to health professional burnout.

Diabetes is a prime example

The idea for the Burnout Dyad Model came from Martinez-Hollingsworth trying to understand a disconnect in patient-provider communication during diabetes treatment.

Diabetes sufferers are at risk of burnout particularly when it comes to lifestyle choices or treatment guidelines.

“It’s an everyday thing that influences every single decision you make throughout the day: how you exercise, how much sleep you get, how often you’re eating and how much you’re eating,” she says.

“To claim that it is less grueling than treating diabetes, which is exhausting for providers for me, seems like a very simplified view.”

Social Explanations of Burnout

When evaluating burnout, using social factors that determine patient health also is important, Martinez-Hollingsworth says. People who are from communities that have been historically displaced may be at greater risk of burnout risk because they can lack resources that help other patients afford medications to manage their chronic health issues.

“Hopefully that shared understanding and open communication space will improve trust which is one of the most difficult challenges,” she says.

Some health care professionals traditionally saw non-compliance as a moral failing, Martinez-Hollingsworth says.

“But we’re not taking note of all the actions that led to them being in this position. It’s important to recognize patients who have a history of lost trust opportunities … or a gap that the person has shouldered through their entire life course.”

“But all we’re seeing is that they show up late to every appointment,” Martinez-Hollingsworth says.

One solution is to get more health professionals from the same community.

“If you have a patient with this background and you are also a provider, it can aid you in understanding patient disease management and burnout.

Damian McNamara is a staff journalist who is based in Miami. He covers a variety of medical specialties including gastroenterology, neurology, infectious diseases, and gastroenterology. Follow Damian on Twitter: @MedReporter.

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