LIFESTYLES
WEEKEND, OCTOBER 6-7, 2018
BURNED OUT
Photos by Kristian Foden-Vencil/OPB
CLOCKWISE, FROM TOP LEFT Jan McDonald was married to Bend physician Lynn McDonald for decades. They had twins and a residential development
business when he took his life while suffering symptoms of burnout. ♦ Dr. Frances McCabe said physician burnout is tough. “Your family gets the short
end of the stick. You don’t take care of yourself, you don’t exercise enough. You eat to survive instead of eating healthy. It doesn’t take long to turn yourself
into a train wreck.” ♦ Dr. Matt Eschelbach has sat on physician oversight boards. “We had a provider who would go in cycles and I knew when and when
he was not on his medication. Just based on the patient complaints. Today, we’re more apt to go, ‘You need help.’” ♦ Bend psychiatrist Angelina Montoya
has counseled a half-dozen doctors under the Central Oregon Medical Society program.
Central Oregon program aims to help doctors combat burnout
By KRISTIAN FODEN-VENCIL
Oregon Public Broadcasting
L
ynn McDonald practiced medicine in Bend for
27 years. His wife, Jan, said he excelled in the
often-chaotic, fast-moving environment of an
emergency room.
“The great thing about emergency room medi-
cine, 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. McDon-
ald 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 invest-
ing in a residential development called The Shire,
where the homes had thatched roofs and the tool
sheds looked like hobbit holes. It was whimsical, 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 jeop-
ardy. 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 other people.
And that burnout rate appears to be increasing.
Help is near
A group of physicians in Central Oregon are
addressing the problem by ensuring their troubled
peers receive psychological help anonymously and
free of charge.
Dr. Frances McCabe, an ER physician at St.
Charles Health System in Bend, says she started to
feel the symptoms of burnout after agreeing to help
establish the hospitals’ new $80 million electronic
records system — while still working her emer-
gency room 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 exercise
enough. You eat to survive 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 defi-
nitely getting to that point.”
McCabe said she was lucky — the records sys-
tem 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 person defi-
nitely 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 relationship
in that time.
She said there’s also all the new technology doc-
tors have to learn, the constant threat of lawsuits,
the piles of paperwork, large college and medical
school loans to repay and ever more complex medi-
cine as people now live well in to their 80s and 90s.
“They may be on a multitude of new medica-
tions, which are aggressively advertised on TV: ‘Go
ask your doctor for this medicine, go ask your doc-
tor for that medicine,’” she said. “And I’m watching
those commercials going, ‘Don’t ask your doctor for
any of those medicines.’
“… It’s not any one thing. It’s everything piling
up on you.”
McCabe sits on the professional practice evalua-
tion committee at St. Charles, where she deals with
doctors who are frustrated, overworked and some-
times even rude to their team.
“There was a time in medicine when that was
OK. It was almost an expectation if there was a sur-
geon who was dissatisfied with conduct or outcome,
[they] might yell or even throw and instrument in an
ER,” she said. “That is considered disruptive phy-
sician behavior, and there is really no tolerance for
that anymore.”
The program established by the Central Oregon
Medical Society allows health-care providers to get
up to eight free, anonymous psychological 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 supervisor. Today, that kind of behavior would
receive a different response.
“Today, we’re more apt to go, ‘You need help,’”
Eschelbach said.
Looking for signs
Eschelbach 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 anymore — regarding
them as just “the broken leg in bed two,” for exam-
ple; 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
burnout,” he said. “Exhaustion, depersonalization,
loss of accomplishment. Fifty percent.”
Eschelbach said he’s learned a few tricks to com-
bat 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 understand that in a
busy hospital, it’s the price you pay at that moment,
that your labs are a little bit late because somebody
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 programed
the watch to tell him when his heart rate 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 asso-
ciate or my partner: ‘I’m going to take five. I need a
break,’” he said.
Bend psychiatrist Dr. Angelina Montoya has
counseled 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 figure
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 of the money for this pilot
project. Other funds come from doctors who are
members of the Central Oregon Medical Society.
“Your family gets the short end of the stick. You don’t take care of yourself, you don’t exercise enough.
You eat to survive instead of eating healthy. It doesn’t take long to turn yourself into a train wreck.”
Dr. Frances McCabe, an ER physician at St. Charles Health System in Bend