Blog | Wednesday, February 25, 2015

Resident burnout--not fixed

An article in Academic Medicine has this conclusion: “Job burnout and self-reported sleepiness in IM resident physicians were unchanged after the 2011 DHRs at 3 academic institutions. Further investigation into the determinants of burnout can inform effective interventions.

This conclusion shows that the authors of the regulations and of this study do not understand the determinants of burnout. Burnout generally follows a lack of control. Changing work hour rules, if anything, worsens lack of control.

To decrease burnout we need a more fundamental residency reform. We need to convince hospitals that trainees are not slave labor. We need to convince attending physicians that micromanagement does not help residents grow.

The ACGME rules are not helping residents. They are not improving patient safety. They are likely impacting education.

They hamper continuity. They make attending physicians unhappy, and therefore because everything flows downhill, resident-attending relations often suffer.

We need to look at programs that are successfully addressing burnout before we speculate on ways to decrease burnout. We need to treat residents with proper respect. We need to remember what being a resident was like.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.