If you had met Jillian Horton, MD, six years ago, you would have thought she was at the pinnacle of her career. The reality was, Dr. Horton had been cycling in and out of doctor burnout for her entire physician career. But what ultimately pulled her out of this burnout cycle was the ability to share her personal story.
“As clinicians and individuals who are dedicated to addressing the physician burnout crisis, we know that there are two other groups of stakeholders: patients and the organizations that we work for,” Dr. Horton said during the closing keynote at the American Conference on Physician Health 2021 in Scottsdale, Arizona. She is associate chair of the internal medicine department at the University of Manitoba Max Rady College of Medicine, in Winnipeg, Canada.
If physicians only publish their writing in places where other doctors will see it, “then we don't ever really give those other groups the information that they need to help us,” said Dr. Horton, author of the national bestseller, We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing. “This is part of why I believe it is critical for all of us to … put our narratives in places where people aside from only physicians will read them and we will begin to get their buy-in, their feedback, their perspective and also their health.”
To find the courage to tell their own stories, Dr. Horton outlined some steps that physicians can follow to do so.
“When we write about really deeply personal experience or trauma ... we’re not just doing it for catharsis,” she said. “That’s just downloading our difficult experiences, getting them out of our head and putting them on a piece of paper, but that’s not writing with intent.”
Don’t just write “to exorcise demons,” but to “elicit a response from someone to try to accomplish something,” said Dr. Horton. “As we become sophisticated in our skills, we develop intent, and we come to recognize, hopefully, that when we write there’s a purpose.”
“We all know that organizational factors are the primary driver of burnout, and that we don't have a resiliency deficit—we have a resiliency mismatch,” said Dr. Horton. “What has been so important for me is that this work fortifies me so that I can continue to do the work of changing the system.
Such writing is not meant “to let the system off the hook. It gives me a way to continue to survive with minimal personal collateral damage so that I can keep doing the work that we must do,” she said. “So brace yourself first. Do what you can to strengthen yourself so that you can feel that you have the courage and reserve to do this work.”
Think about survivor bias.
“The narratives that we don’t hear … are the people who we have lost tragically, unacceptably to completed suicide,” Dr. Horton said. “What we need to do is try to help normalize the experience of sharing narratives so that those people who sustain those other injuries—the ones that we don't normally talk about—feel able to share their narratives in a safe and supportive way.”
The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.