Michel Jeffrey B, Sangha Denisse M, Erwin John P
Cardiology Division, Scott and White Memorial Hospital, Temple, Texas; Texas A&M University Health Science Center College of Medicine, Temple, Texas.
Cardiology Division, Scott and White Memorial Hospital, Temple, Texas.
Am J Cardiol. 2017 Mar 15;119(6):938-940. doi: 10.1016/j.amjcard.2016.11.052. Epub 2016 Dec 18.
Burnout is a loss of enthusiasm for work, cynicism, and a low sense of accomplishment. Loss of autonomy and authority, complex regulatory requirements, report cards, quality metrics, the rise of large integrated health care systems, and the demise of solo practice are just a few realities of medical practice that contribute to physician burnout. Physicians suffering burnout often focus on compensation and perceived status as antidotes, although evidence suggests they play no role. Randomized controlled trials suggest that interventions designed to improve coping and resiliency including cognitive behavioral therapy and physical and mental relaxations to reduce stress can be effective. Reduced work hours have also been shown to mitigate burnout. Successful prevention and management requires adaptations by both physicians and the health care systems in which they work. We believe that burnout also involves a loss of faith in the practice of medicine itself. Advances in cardiovascular medicine have led to large reductions in mortality and morbidity. However, the disruptive changes to health care that accompanied this success have contributed to physician alienation. In conclusion, we believe that to overcome burnout, cardiologists should dedicate themselves to a collective mission of patient care and work to restore faith in their profession.
职业倦怠是指对工作失去热情、产生愤世嫉俗的态度以及成就感低落。自主权和权威的丧失、复杂的监管要求、业绩考核、质量指标、大型综合医疗保健系统的兴起以及个体行医模式的衰落，这些只是导致医生职业倦怠的部分医疗执业现状。尽管有证据表明薪酬和感知地位并无作用，但遭受职业倦怠的医生往往将注意力集中在薪酬和感知地位上，以此作为应对方法。随机对照试验表明，旨在改善应对能力和恢复力的干预措施，包括认知行为疗法以及减轻压力的身心放松方法，可能会有效果。减少工作时长也已证明能缓解职业倦怠。成功的预防和管理需要医生及其工作的医疗保健系统双方都做出调整。我们认为，职业倦怠还涉及对医学实践本身的信心丧失。心血管医学的进步已大幅降低了死亡率和发病率。然而，伴随这一成功而来的医疗保健领域的颠覆性变革导致了医生的疏离感。总之，我们认为，为克服职业倦怠，心脏病专家应致力于患者护理的集体使命，并努力恢复对其职业的信心。
