Physician Health

In battle against doctor burnout, reading—for fun—is fundamental

Sara Berg, MS , News Editor

Doctor burnout affects about half of American practicing physicians and appears to be on the rise. Systemic interventions have been shown to decrease rates of physician burnout and must be the first line of defense against the burnout scourge. But now research is showing how individual physicians can find some doctor burnout relief by picking up a book.

Physician burnout demands urgent action

The AMA is leading the national effort to solve the growing physician burnout crisis. We're working to eliminate the dysfunction in health care by removing the obstacles and burdens that interfere with patient care.

Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing, issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand the challenges physicians face.

The AMA Ed Hub™—your center for personalized learning from sources you trust—offers CME on professional well-being that can help you prevent physician burnout, create the organizational foundation for joy in medicine, create a strong team culture and improve physician resiliency.

Meanwhile, the AMA’s STEPS Forward™ open-access platform offers innovative strategies that allow physicians and their staff to thrive in the new health care environment.

“There is an effect of literature on physicians that nothing else can have,” said AMA member Daniel Marchalik, MD, at the International Conference on Physician Health in Toronto. The event was cosponsored by the AMA, Canadian Medical Association and British Medical Association.

“Literature creates attention you really can’t create through anything else. ... It creates a better connection to patients,” said Dr. Marchalik, the medical director of physician well-being at MedStar Health. He also is director of ambulatory urologic surgery and medical education at MedStar Washington Hospital Center.

To determine how reading impacts physician burnout, Dr. Marchalik and his colleagues sent surveys to 2,500 doctors. Questions addressed burnout, demographics and reading patterns, as well as the type of curricular offerings the doctors had in their undergraduate medical education.

Here is how reading for pleasure reduces physician burnout by improving empathy and combating depersonalization.

Through the process of reading, physicians often exhibit empathy. A study from the journal Science completed five experiments where people read literary fiction, nonfiction and nonliterary fiction, which is often referred to as “airport novels,” said Dr. Marchalik.

Researchers then looked at theory-of-mind testing, which is often used when screening for autism.

“What they show is those who read literary fiction actually performed better in theory of mind, which is actually a surrogate for measuring empathy,” said Dr. Marchalik. “It’s doing something special. ...

“It is moving the needle on what is probably the most difficult part of burnout to move the needle on, which is depersonalization,” he added.

One survey of 513 physicians examined the impact of non-medical reading habits on burnout. The chances of emotional exhaustion or depersonalization fell as physicians became more consistent readers.

When compared to nonreaders, the relative risk of burnout for consistent readers—those who read at least one book per month—fell by 19 percent across the emotional exhaustion and 44 percent across the depersonalization domain.

In an unpublished study by Dr. Marchalik, more than 200 urology trainees were surveyed about work characteristics, as well as relaxation techniques. These included watching movies, meditation, yoga, reading and other ways of relaxing. Meditation, exercise and yoga were not protective against burnout— but reading was.

Controlling for the biggest predictors of burnout, which were resident level, work hours and gender, reading made an impact: the odds of burnout decreased by 59 percent for residents who read for relaxation. A similar effect was seen in Dr. Marchalik’s national survey of palliative care providers, in which the odds of burnout dropped by 39 percent for readers, even when controlling for age, clinical discipline and the presence of fatigue.

Chances of being a reader later in life are significantly higher when literature curriculum is offered in medical school. This raises the chances of being protected from physician burnout too.

“Planting those seeds early makes a huge difference,” said Dr. Marchalik, who leads Georgetown University’s Literature and Medicine Track. Medical students complete four years of the literature program, reading one book a month and conclude the program with a capstone writing project.