By Danielle Aslan, DC
Burnout syndrome was defined by Maslach and Jackson in 1981 as a three-dimensional syndrome characterized by exhaustion, cynicism and inefficiency.1,2 They described burnout as the opposite to engagement, which is defined as energy, involvement and efficacy.2 One aspect of inefficiency may be a sense of low personal accomplishment – an area frequently looked at in studies regarding healthcare provider burnout.
Providers experiencing burnout have been shown to commit more medical errors, have decreased job satisfaction and have earlier retirement.3 Additionally, burnout can have an effect on the personal lives of healthcare providers, with links to increased substance abuse, depression and even suicide.4 Because of the nature of the job, healthcare providers tend to experience higher exposure to prolonged stress, which can bring about burnout and its negative consequences.5 Given these concerns, the question researchers are asking is, “What, if anything, can we do to address this pressing issue?”
From a complementary and integrated healthcare perspective, one arena that is beginning to receive recognition is mindfulness-based stress reduction (MBSR). Mindfulness is defined as “paying attention in a particular way: on purpose, in the present moment and non-judgmentally ”encouraging individuals to try and center themselves in the present moment without worry about the future or past.6 Findings of a systematic review of MBSR techniques utilized in healthcare providers include a decrease in perceived stress, reduction in burnout and anxiety, and improvement in overall well-being.4 Additionally, some studies showed an increase in physical well-being amongst healthcare providers participating in MBSR. Furthermore, healthcare providers in 82 percent of studies assessed found an increase in their own mindfulness, or “dispositional attention and awareness of the present moment experiences.” Additional outcomes included an improved sense of empowerment and self-efficacy, and very importantly, improvements in empathy.
MBSR has started to be implemented in the Department of Veteran Affairs’ (VA) Whole Health initiative managing chronic pain, and we often recommend MBSR as a treatment option for our patients, especially those suffering from chronic pain. However, we also often fail to heed our own advice in implementing the same concepts to improve the quality of our lives. Burnout among all healthcare providers is a real and tangible issue that may be helped, and MBSR is one of the practices we can employ. Some evidence suggests that implementing continuing education based on MBSR is associated with significant improvement in burnout scores and mental health – a possible direction for the future of continuing healthcare education.2
Below I have attached a link to a simple five-minute MBSR practice from one of our Whole Health physicians at St. Louis VA Healthcare System, Dr. Eric Dinenberg. I invite you to implement this practice in your daily lives, and to take notice of how it may affect your mental and emotional state.
Dr. Aslan is the chiropractic resident at the VA in St. Louis, MO. She graduated summa cum laude from University of Bridgeport College of Chiropractic in May 2018, where she was a recipient of the Chiropractic Professional Award and Student Research Award. Dr. Aslan grew up in Whitestone, N.Y., and went to Adelphi University in Garden City, N.Y. for her undergraduate degree in Biology.
- Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99-113. doi:10.1002/job.4030020205
- Goodman, M. J., & Schorling, J. B. (2012). A Mindfulness Course Decreases Burnout and Improves Well-Being among Healthcare Providers. The International Journal of Psychiatry in Medicine,43(2), 119-128. doi:10.2190/pm.43.2.b
- Romani, M., & Ashkar, K. (2014). Burnout among physicians. Libyan Journal of Medicine,9(1), 23556. doi:10.3402/ljm.v9.23556
- Lamothe, M., Rondeau, É, Malboeuf-Hurtubise, C., Duval, M., & Sultan, S. (2016). Outcomes of MBSR or MBSR-based interventions in health care providers: A systematic review with a focus on empathy and emotional competencies. Complementary Therapies in Medicine,24, 19-28. doi:10.1016/j.ctim.2015.11.001
- Lastovkova, A., Carder, M., Rasmussen, H. M., Sjoberg, L., Groene, G. J., Sauni, R., Pelclova, D. (2018). Burnout syndrome as an occupational disease in the European Union: An exploratory study. Industrial Health,56(2), 160-165. doi:10.2486/indhealth.2017-0132
- Kwee, M. (1995). Wherever you go, there you are: Mindfulness meditation in everyday life. Behaviour Research and Therapy,33(8), 996. doi:10.1016/0005-7967(95)90133-7