Knowing how to cope with stress and burnout has become more important than ever to spine surgeons.
Paperwork, surgery and research are just some of the tasks piled on surgeons' plates each day. Five spine surgeons told Becker's their strategies for managing everyday stress in their practice and after the workday is done.
Note: Responses were edited for style and clarity.
Question: How do you manage stress and burnout during and outside of work?
Heidi Hullinger, MD. New Jersey Spine Specialists (Summit): During COVID-19, stress about the pandemic was compounded by a sense of being helpless while our critical care and anesthesia colleagues were stretched beyond thin. Luckily, one of my hospitals offered the ability to redeploy as a critical care extender, offering a helping hand to the critical care teams. I found my niche by heading up the weekend "proning" team, since in spine surgery we are used to turning patients prone in a safe manner. This duty was, if anything, as much or more of a help to me as it was to those on the critical care team, giving me a role to fill during the difficult days of the early COVID-19 surge in New York and New Jersey.
Otherwise, I find my outlet outdoors to help cope with stress and burnout. I run with friends whenever possible, satisfying both a social outlet and also giving me an endorphin boost. My staff all know when I haven't been able to run or work out as much!
Our family tries to unplug at least once a year, escaping the city and going somewhere more remote. Going hiking as a family, going out on the water and doing puzzles on rainy days are a way for all of us to reset and escape the craziness of our daily lives.
Rahul Shah, MD. Premier Orthopaedic Spine Associates of Southern New Jersey (Vineland): Particularly helpful for managing stress is a practice of routinely taking a minimum of 30 minutes daily to exercise. Even if the exercise is as simple as walking at a brisk pace, I find the clarity of mind such time spent yields is well worth the investment.
During work, I find the practice of asking my patients what they found particularly helpful, especially during their office visit, yields many surprise concerns that I did not even think of. These "patient pearls" allow me to serve my patients in a more effective manner, thus working to promote enjoyment and prevent burnout.
Brandon Hirsch, MD. The CORE Institute (Mesa, Ariz.): The management of stress and burnout for spine surgeons is an important topic in our field and one that I am glad is gaining notoriety. I’ve found regular meditation to be helpful in managing stress levels. There are now many apps for guided meditation that are inexpensive and easy to use. This can take as little as five minutes per day but can be very effective. Beyond that, I have found that regular exercise and spending time with those close to me are very helpful in managing stress. Surgeons dealing with this problem should evaluate their job situation to determine whether there are any modifiable contributing factors present in their day to day work. This may relate to the numbers of patients they schedule in their office to the number of physician extenders they utilize to the amount or type of call that they take.
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): Burnout is real. Despite extraordinary advancements in the way we provide care to our patients, the actual practice of the art of medicine remains stressful and consuming from a physical and mental standpoint. The pandemic has certainly unmasked everything that we have been trying to subdue.
When the goal is to prevent burnout, it helps me to think of the term "burnout" literally. According to Merriam Webster, burning fuel is "to consume fuel," and fuel, as we know, is an energy source — so, we become depleted of energy as we burn out!
For me, managing this stress and burnout revolves around taking a step back and keeping everything in perspective. Spending uninterrupted time with my family and friends reminds me why life is so much more important than the work tasks that often fuel the stressors. Taking time to enjoy the outdoors, playing sports and listening to music often provide me with that renewed sense of energy.
Lastly, as academic and cliche as it sounds, I try to refocus my growth mindset a bit. In her seminal book Mindset, psychologist Carol Dweck describes how years of research has shown that "... the view you adopt for yourself profoundly affects the way you lead your life. It can determine whether you become the person you want to be and whether you accomplish the things you value." Taking some random opportune mornings or afternoons away from work to engage in any activity to mentally refresh is a nice way to reset and remind myself of what I value the most. Then, talking to the huge number of people who are going through the same things I am, provides me with the sense that I am not in this alone, and we, as a group, can do a better job of helping out each other — then, taking this attitude back to the workplace!
Usman Zahir, MD. ScopeSpine-The Orthopaedic Group (Dulles, Va.): Successful time management is the main issue I have dealt with over the past year. For me, the key is having a schedule. It is easy to get pulled in numerous directions during the week, and a schedule keeps a sense of discipline. In addition, the key for me is to avoid developing just a work routine. I incorporate opportunities to travel, to teach and do other activities throughout the month. My schedule changes from week to week, and I incorporate one or two new extracurricular activities every week. By keeping a dynamic schedule, it helps minimize stress and burnout.