Talking Your Way Out of Burnout

Before the COVID-19 pandemic, physician burnout was its own epidemic with radiologists consistently ranking among the most burned-out medical specialties. The acute and now chronic stressors of the COVID-19 pandemic further exacerbated radiologists’ wellness with 54% of radiologists reporting symptoms of burnout, according to the 2023 Medscape report. In addition to radiologists’ wellness, burnout has significant adverse implications on patient care and outcomes.

In its most simplistic dissection, burnout is composed of three parts: depersonalization, physical and emotional exhaustion, and low sense of personal accomplishment. As such, the very fundamental aspect of our job as physicians, that of connecting and communicating with patients, may play a central role in physician wellness. A direct association can be observed between physicians’ level of satisfaction with their job and their ability to build rapport and connect with patients. Rapport and relationship building both decrease depersonalization and increase a sense of personal accomplishment. Although anxiety related to challenging physician interactions, which have been shown to last for days beyond the interaction, can lead to fatigue, if cumulative, these interactions may lead to exhaustion. Furthermore, anxiety surrounding challenging patient interactions, like delivering bad news, is more likely to occur if one is faced with such interactions infrequently, and thus feel unprepared or unskilled to navigate them. Demonstrating the critical impact of patient-physician communication interaction on physician mental health, a recent national study of breast radiologists’ wellness found that less time spent connecting with, educating, and consulting patients was statistically significantly associated with greater odds of reporting psychological distress and anxiety. Interestingly, although increase in frequency of more negative and charged patient interactions were reported by some radiologists in the study, no association between negative interactions and mental health was found. It thus appears that it is the length of time allotted for physicians to build rapport and make meaningful connections with their patients to educate and inform, rather than the nature of the interactions themselves, which significantly affects radiologists’ wellness.   

As institutions, practices, and individual physicians devise strategies for burnout mitigation, time and adequate focus should be allotted to patient-centered communication.  Operational leadership should be intentional in incorporating sufficient time for radiologists to discuss results and consult with patients into the daily workflow, not limiting interactions in favor of increased volume. Communication skill training should be increasingly integrated into radiology training curricula. In addition, training and effective communication skill resources should be emphasized and made readily available for all faculty to equip radiologists with the confidence to approach a variety of challenging patient interactions, thus diminishing communication-related anxiety. Radiologists themselves should emerge from behind the workstation, seeking out opportunities to consult and educate patients—as our very own wellbeing depends on it.

<strong>Katerina Dodelzon</strong>, MD, FSBI
Katerina Dodelzon, MD, FSBI

Department of Radiology
Weill Cornell Medicine

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