Wednesday, October 17, 2018 The Nugget Newspaper, Sisters, Oregon
15
Oregon project addresses burnout as an issue for doctors
By Kristian Foden-Vencil
Oregon Public Broadcasting
BEND (AP) — Lynn
McDonald practiced medi-
cine in Bend for 27 years. His
wife, Jan, said he excelled in
the often-chaotic, fast-moving
environment of the ER.
“The great thing about
emergency room medicine,
which seemed to fit him,
was because he was a really
good diagnostician,” she said,
“he would say that he really
enjoyed trying to figure it out.”
But by the early 2000s,
his wife says, Dr. McDonald
began saying he no longer
enjoyed the job. He worked
all the time.
“He would come home,
and he would be exhausted,
emotionally exhausted —
even to the point of being
somewhat sarcastic,” she said.
“You could tell that he really
did not love who he was.”
McDonald tried to change
his career by investing in
a residential development
called The Shire, where the
homes had thatched roofs
and the tool sheds looked like
hobbit holes. It was whimsi-
cal, his wife said, and it made
him happy. But then came
the crash of 2008. McDonald
eventually killed himself.
“I think he was getting
burned out big time the last
six years of his life,” she said.
Looking back, Jan
McDonald wishes she’d done
more. But at the time, she was
worried that raising the alarm
would put her husband’s
license in jeopardy. And while
his is an extreme example,
research shows that half of
all doctors exhibit at least one
symptom of burnout.
Some just say they’re
overly tired. But others have
also become disinterested in
work and lost any sense of
innate joy in helping others.
And that burnout rate
appears to be increasing.
A group of physicians in
Central Oregon are address-
ing the problem by ensuring
their troubled peers receive
psychological help anony-
mously and free of charge.
Dr. Frances McCabe, an
ER physician at St. Charles
Health System in Bend, says
she started to feel the symp-
toms of burnout after agreeing
to help establish the hospitals’
new $80 million electronic
records system — while still
working her ER shifts.
“Things really do start to
suffer,” McCabe said. “Your
family gets the short end of
the stick. You don’t take care
of yourself, you don’t exer-
cise enough. You eat to sur-
vive instead of eating healthy.
It doesn’t take long to turn
yourself into a train wreck.
And over the last couple of
years, I was definitely getting
to that point.”
McCabe said she was
lucky — the records system
she was helping create had a
deadline. So after it was done,
she could pull back from work
and spend more time with
family. But in the thick of
things, she was worried about
possibly making mistakes.
“Something happens and
you go, ‘Whoa, if I hadn’t
asked that one more question,
I might have sent that one
person home. And this per-
son definitely should not have
gone home,’” she said. “So
second-guessing of yourself
is a common theme.”
McCabe said medicine
used to be practiced at a much
more leisurely pace. Doctors
had the time to get to know
their patients. Now many are
rationed to 20 minutes, and
it’s tough to build a relation-
ship in that time.
She said there’s also all the
new technology doctors have
to learn, the constant threat of
lawsuits, the piles of paper-
work, large college and medi-
cal school loans to repay and
ever more complex medicine
as people now live well into
their 80s and 90s.
“They may be on a mul-
titude of new medications,
which are aggressively adver-
tised on TV: ‘Go ask your
doctor for this medicine, go
ask your doctor for that medi-
cine,’” she said. “And I’m
watching those commercials
going, ‘Don’t ask your doctor
for any of those medicines.’”
McCabe sits on the pro-
fessional practice evaluation
committee at St. Charles,
where she deals with doc-
tors who are frustrated, over-
worked and sometimes even
rude to their team.
“There was a time in med-
icine when that was OK. It
was almost an expectation if
there was a surgeon who was
dissatisfied with conduct or
outcome, (they) might yell or
even throw an instrument in
an ER,” she said. “That is con-
sidered disruptive physician
behavior, and there is really no
tolerance for that anymore.”
The program estab-
lished by the Central Oregon
Medical Society allows
healthcare providers to get up
to eight free, anonymous psy-
chological visits a year.
Society President Dr. Matt
Eschelbach said he thinks the
old way of doing things is no
longer sufficient. Years ago,
a doctor who was rude with
a patient might have gotten a
brief scolding from a supervi-
sor. Today, that kind of behav-
ior would receive a different
response.
“Today, we’re more apt
to go, ‘You need help,’”
Eschelbach said.
He said there are three
basic signs of burnout among
doctors: being so physically
and emotionally tired that it’s
hard to continue working; not
seeing patients as people any-
more — regarding them as just
“the broken leg in bed two,”
for example; and no longer
getting any joy from the job.
He cites a study from
the Mayo Clinic in which
researchers interviewed
almost 700 physicians.
“Fifty percent of them had
at least one symptom of burn-
out,” he said. “Exhaustion,
depersonalization, loss of
accomplishment.”
Eschelbach said he’s
learned a few tricks to combat
burnout over the years, say
when he’s working with an
ER patient and they’ve been
waiting for lab results for
three hours.
“I can do a few things. I
can go over to the lab and
start yelling. Or I can under-
stand that in a busy hospital,
it’s the price you pay at that
moment, that your labs are a
little bit late because some-
body else is a little bit sicker
than your patient,” he said.
Eschelbach said his wife
also gave him a smart watch
for Christmas. At first, he
thought it was a fancy waste
of money. But then he’s pro-
gramed the watch to tell him
when his heartrate starts to
increase.
“It tells me when I’m
under stress, and I take a
couple of minutes for myself.
And I say to my associate or
my partner: ‘I’m going to take
five. I need a break,’” he said.
Bend psychiatrist Dr.
Angelina Montoya has coun-
seled a half dozen doctors
through the Central Oregon
Medical Society program.
She said some physicians find
it difficult to put into words
what’s bothering them. But
with some analysis, they fig-
ure things out, she said.
“Some people have
stopped working. With some,
they’ve decided to try to find
work that maybe will be less
stressful within their field.
And with some people they’ve
decided to maybe take a little
more time to themselves,” she
said.
The Foundation for
Medical Excellence out of
Portland put up some money
for this pilot project. Other
funds come from doctors who
are members of the Central
Oregon Medical Society.
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