As GI physicians, you are undoubtedly aware of the demanding nature of
gastroenterology. The specialty requires long hours, often spent
standing during procedures, and is compounded by the burden of extensive
administrative duties. The 2023 Medscape Gastroenterologist Lifestyle, Happiness & Burnout Report highlights the ongoing challenges in achieving work-life balance, particularly since the conclusion of the COVID-19 pandemic. This profession continues to demand both physical endurance and exceptional organizational skills.
In the Medscape report, 83% of gastroenterologists said they were “happy” or “very happy” with their personal lives prior to the pandemic. Since the pandemic, 36 percent said they were burned out, while 5 percent reported feeling depressed, and 18 percent said they felt both burned out and depressed. Forty-seven percent said the burnout has had a “strong/severe” impact on their lives. Sixty-four percent reported bureaucratic tasks like charting and paperwork as the top reason for their burnout, and 49 percent said lack of control or autonomy.
When asked about the impact of their burnout on patients, 35 percent said they get easily exasperated with them, 16 percent said they get frustrated in front of them, 12 percent said they make uncharacteristic errors and 12 percent said they are less diligent with patient notes. Clearly, the health and well-being of the physician have an impact on patient care. This article will discuss four key strategies gastroenterologists can implement to maintain health, wellness and an optimal work-life balance.
Focus on Nutrition
Unfortunately, 26 percent of gastroenterologists in the Medscape report said they drink alcohol to cope, and 25 percent said they eat junk food. In a study exploring physician beliefs about the impact of nutrition on their personal and professional lives, many said that “inadequate nutrition at times led to an inability to complete their work.” They reported a lack of focus, decreased efficiencies, challenges discussing patient care with colleagues and the need to be “much more deliberate” in their work when hungry. Some research suggests that the fact that physicians receive minimal, if any, nutritional education during medical school may be partly to blame for their lack of nutritional knowledge and poor nutritional habits.
Proper nutrition is vital to maintaining the energy levels and cognitive function necessary for optimal patient care.
While there are many debates in the media about which diets are the healthiest, most nutritionists agree that the best diets rely heavily on fruits, vegetables, whole grains and legumes. Physicians should consider reducing their consumption of red meat and avoiding processed foods like bacon, sausage and lunchmeat. These have all been shown to have a clear connection to “heart disease, cancer, diabetes, and premature death.” Sugary drinks should also be avoided as they have no nutritional value and provide nothing but empty calories.
Some might find it surprising, but research has found that moderate consumption of coffee, considered two to five cups a day, is linked to “lower likelihood of type 2 diabetes, heart disease, liver and endometrial cancers, Parkinson’s disease, and depression.” Of course, those sensitive to caffeine should consider decaffeinated drinks or abstain.
Exercise as a Pillar of Health
There was good news in the Medscape gastroenterologist survey. When asked what they did to cope with burnout, the top answer (48 percent) was exercise. The role of exercise in improving mental health and lowering stress cannot be overemphasized. It reduces stress hormones like cortisol and adrenaline while stimulating the production of endorphins, brain chemicals that naturally relieve pain and elevate mood.
For healthy adults, the U.S. Department of Health and Human Services (HHS) suggests at least 150 to 300 minutes of moderate exercise or 75 minutes of vigorous exercise per week. This doesn’t necessarily mean going to the gym. Any moderate or vigorous activity will work. The HHS also recommends strength training that addresses all major muscle groups at least twice a week.
Busy gastroenterologists may find it challenging to get enough exercise each week, but with a bit of creativity, it doesn’t have to be difficult. Physicians Practice suggests the following:
- Walk 15 minutes each morning and evening, vigorously swinging the arms
- Walk for a couple of minutes before and after each meal
- Use the stairs instead of an elevator, park at the far end of the parking lot or get off the bus/train a few stops earlier
- If going to a gym, working out in front of a mirror can prompt individuals to work out longer
- Consider taking five-minute breaks for every 30 to 45 minutes spent charting to help maintain focus and reduce fatigue
The Vital Role of Routine Health Examinations
Physicians always emphasize to their patients the importance of regular checkups, lab work, vaccinations and preventative screenings. Yet, they aren’t always as diligent in taking their own advice. How often do they recommend colonoscopies but fail to follow their own compliance guideline? Being an example to their patients can have a real impact.
It is important for physicians to consider family history as a part of their health journey. In addition to sharing genes, individuals of the same family often share behaviors like diet and physical activity. These factors, as well as environmental factors, are vital information for determining disease risk and the optimal timing for checkups and screenings. The Centers for Disease Control and Prevention provides an online resource with a list of preventative care screenings and vaccinations, along with other resources.
Maintaining good health with regular health examinations and preventative screenings can help physicians better empathize with and guide patients through their health journeys.
Prioritizing Mental Health
Crises like the pandemic tend to spotlight system issues and weaknesses. Such is the case with mental health care in the U.S., which has become a crisis. While the pandemic caused an increase in mental health conditions, it also highlighted how poorly our country performs at identifying and treating mental health conditions.
According to the National Alliance on Mental Illness (NAMI), “Nearly half of the 60 million adults and children living with mental health conditions in the United States go without any treatment.” Gastroenterologists are no different. When asked if they have sought help for burnout outside of the workplace, just 14 percent said yes. Another 47 percent said no and that they had no intention of seeking help.
As established above, burnout is considered a mental health condition and one that can impact patient care. One of the best steps gastroenterologists can take is to honestly evaluate the state of their mental health and take action to address burnout and stress proactively. One of the most impactful actions they can take is to schedule regular time away from work. If taking a whole week off isn’t viable, taking off one or two days regularly or scheduling a long weekend away can help. There are also steps they can take to reduce administrative burdens, such as hiring additional staff, like data entry assistants, to help with electronic health record work. Virtual scribes are another excellent option.
The Journey Forward
Gastroenterology is a high-pressure specialty. To be successful, gastroenterologists must view their health as a critical component of their professional responsibility to their patients and take the steps necessary to achieve and maintain optimal health and wellness. The concepts of “physician as patient” and “physician, heal thyself” highlight the value of self-care in maintaining a long and fulfilling career.
Explore AMA resources on burnout and go to the link below:
What is physician burnout? | American Medical Association (ama-assn.org)
Harish Gagneja, MD, FASGE, is the chief medical officer at Austin Gastroenterology and a member of the GI Alliance Physician Executive Board.