Not too long ago, an Austin, Texas, primary-care doctor--operating under a pseudonym--funneled his professional stress into an Internet site dedicated to "medical burnout." The response was so overwhelming that on Oct. 5, only three weeks after the site's debut, the doctor had to move the site to a more powerful computer.
The popularity of the medical burnout Internet site would be no surprise to John-Henry Pfifferling. For 18 years, he and his Durham, N.C.-based Society for Professional Well-Being have been counseling physicians suffering from professional burnout, the sort of stress a Pfifferling associate says has pushed a few of his group's clients to the brink of suicide.
The number of physicians suffering from stress is increasing as the business of medicine moves further from the autonomous, fee-for-service environment most doctors expected when they graduated from medical school, Pfifferling says.
Pfifferling and others in the business of relieving doctors' stress increasingly are involving executives in learning to create healthier environments.
Sometimes, it's the executives, not the physicians, who call, either for help handling doctors they believe are out of control, or to address their own stress about "loneliness at the top," Pfifferling says.
"We're pleased at getting more physician executives calling us saying we want to deal with quality of life and physician satisfaction," says Pfifferling, a medical anthropologist. Although he doesn't have an exact number of how many cases he has handled, his associates say his group is booked through January.
It's not news to administrators that many physicians are struggling with the fact that profit motive continues to gain momentum in healthcare. But counselors and consultants say executives must recognize that struggle and come up with ways to help both themselves and their doctors cope with the rapid and massive change.
Ignoring such changes will be bad for business if organizations send out distracted and disturbed physicians, says Martha Snider, M.D., a stress consultant based in Oakland, Calif.
"When things go wrong, it's not always the professional's fault," Snider says. "It's often an unworkable system or a less than ideal system."
Since 1994 Snider has worked as an independent consultant to physicians and physician organizations to help them reduce stress and burnout. A onetime executive at a Kaiser Permanente hospital in Vallejo, Calif., Snider has had a lot of experience listening to physician complaints. She says her stress consulting grew out of her attempts to handle problems at Kaiser.
Although she has no specific numbers, Snider has noticed more physicians and others are focusing not only on physicians' stress but also on the problem of physician burnout. In a recent survey of 455 Sacramento, Calif.-area doctors, Snider and consultant Dina Zvenko found that 81% believed burnout was a "medium- to high-level problem," while 76% said burnout posed a risk to patient satisfaction.
There are many ways to handle stress-related problems, consultants say; their methods are as varied as their training.
Louise Andrew, a Baltimore-based physician attorney who works with Pfifferling's organization, has a three-step system she uses when she works with physicians and their administrators:
Andrew says there's no particular amount of time these steps take, nor is there a guarantee that all problems will be solved.
But, she says, "We have been told individually by many . . . whether or not their situation has improved dramatically, that they have achieved a measure of equanimity because someone cared to come in."