Physician Health

Why physician well-being is a two-way street

Marc Zarefsky , Contributing News Writer

Waguih IsHak, MD, loved the adulation he and his fellow health professionals around the world received in the early days of the COVID-19 pandemic. He and his colleagues at Cedars-Sinai Medical Center in Los Angeles appreciated the clapping every night at 6 p.m. and enjoyed seeing how communities came together to honor front-line heroes such as physicians.

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Unfortunately, cheering can only go so far, Dr. IsHak said, particularly for a workforce that was already struggling to take care of itself prior to the pandemic.

"We've seen a lot of physicians really having to juggle so many aspects of not just taking great care of patients, but also focusing on making their own wellness a priority," he said. "COVID brought it totally to the front, where it became a lot harder to balance all the demands as well as keeping one's wellness in check."

Two-plus years since the onset of the pandemic, physicians and other health professionals continue to cope with burnout and exhaustion. Dr. IsHak, who is a professor and clinical chief of psychiatry at Cedars-Sinai, spoke about the warning signs for burnout and what physicians and health systems need to do to prioritize physician well-being during a recent episode of "AMA Moving Medicine."



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Dr. IsHak identified three signs of burnout: exhaustion, cynicism and inefficiency. When those factors combine, they can lead to anxiety and poor work performance.

When someone has burnout, that person becomes indifferent to joy, he said. Their energy level becomes low, they have trouble sleeping or perhaps begin to sleep too much. They might not eat at all, or again, overeat to compensate for their feelings. From there, things can quickly spiral, Dr. IsHak said.

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 and reduce the challenges physicians face. 

By focusing on factors causing burnout at the system level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction. 

Read about survey research showing that doctors hit hardest by the pandemic are at higher risk of burnout.

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From an individual physician’s perspective, Dr. IsHak said advises a three-pronged approach to the treatment for burnout: medicine, therapy or life coaching, and wellness activities. The medicine is to help regulate body functions and reduce the severity of the condition.

The coaching is intended to help reengage someone back into their day-to-day life activities and pursuit of happiness. Wellness activities range from exercise and eating well to simply appreciating the environment and forging meaningful connections with people.

While it is important for individuals to look after themselves, the burden must not fall entirely on them, Dr. IsHak explained.

"Physician wellness is not a one-way street," he said. "It's a two-way street. The individual has to do things to keep their body and mind in a good place. … That's the individual's responsibility. The health care system responsibility [is] maintaining and preventing burnout and improving wellness."

Cedars-Sinai hosts a monthly educational session for employees about health and wellness, Dr. IsHak said. To find the right balance between individual and system responsibility, the series alternates topics of conversation between individual interventions and workplace interventions.

AMA Moving Medicine” highlights innovation and the emerging issues that impact physicians and public health today. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.