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Physicians Are More Burnt Out, and a Contributing Factor is Loss of Connectedness

May 20, 2020
by Jordan Sisson

Physicians are feeling more burnout, and a contributing factor is loss of connectedness, writes a Yale Psychiatry faculty member in a recent paper.

The piece, titled “The Loss of Social Connectedness as a Major Contributor to Physician Burnout: Applying Organizational and Teamwork Principles for Prevention and Recovery,” was co-authored by Steven Southwick, MD, Glenn H. Greenberg Professor Emeritus of Psychiatry at the Yale School of Medicine, and Frederick Southwick, MD, Professor of Medicine and former Chief of Infectious Diseases at the University of Florida. It was published in the May 2020 edition of the American Medical Association’s JAMA Psychiatry journal.

“We decided to write a Viewpoint on social connectedness and burnout because research has repeatedly shown that social support is a fundamental need for all human beings,” Steven Southwick said, “and we realized that our modern health systems have created conditions that are fostering social isolation by requiring many hours to enter data in electronic records and emphasizing the importance of maximizing the volume work. These conditions have left little time to socialize.”

In the paper, Steven Southwick and Frederick Southwick emphasized that social connectedness is a basic human need that, when lost, leads to burnout. They encourage health care institutions to apply lessons from team and organizational literature, to increase social connectedness and enhance well-being.

Belonging is a fundamental need, and social support significantly contributes to both mental and physical health, they wrote. Conversely, according to research, burnout is associated with loneliness and social isolation, inadequate support from colleagues and leaders, and insufficient time to connect and form meaningful relationships with patients, or to maintain supportive and caring relationships with colleagues, among others.

To combat burnout among physicians, Steven Southwick and Frederick Southwick advise implementing organizational and teamwork principles from the business world into health care; team and organizational literature “has emphasized psychologic safety as a vital condition for fostering social support and creating socially connected teams and organizational cultures,” they said.

One of the most important ways to foster social connectedness is to create effective interprofessional health care teams, they wrote. This behavior can flatten the hierarchy and improve team members’ sense of importance within a team, as well as reduce errors and improve the coordination and efficiency of care, and create a shared purpose and mental model that fosters social connectedness and a sense of belonging.

“If we are to reduce burnout and enrich the practice of medicine, we must prioritize our basic biological need to belong and to experience positive and rewarding human connections as part of our working environment. When our need to belong is not satisfied, we suffer mentally and physically,” they said. “Social connectedness, particularly in the form of teamwork, addresses the psychological needs of friendship and esteem and is not a luxury but rather a basic human necessity that is built into our biology.”

“Physicians are scientists. As scientists, it is our responsibility to apply what is known from the neuroscience and management literature about how to create positive and supportive work environments that are conducive to professional engagement and optimal patient care.”

Steven Southwick said while the piece was written before the COVID-19 pandemic, “we believe that social connectedness and sense of belonging are even more important now that healthcare workers are facing a prolonged and lethal epidemic.”

“A large volume of scientific data suggests that bolstering social connectedness at all levels of healthcare systems will help to mitigate the negative psychological consequences of this pandemic, and hopefully improve the coordination of medical care in the future,” Steven Southwick said. “In our own medical institutions, along with tragedy and sadness, we have witnessed inspiring examples of courage and camaraderie. Staff from different departments have left their silos in response to a shared threat and bonded together in a common cause. Can we maintain and foster this shared emotional bond and social connectedness as a way to brighten the future of our healthcare institutions?”

Submitted by Jordan Sisson on May 18, 2020