The Department of Internal Medicine’s November 7, 2019 Medical Grand Rounds, “Thriving: Wisdom and Life Lessons From Happy Physicians,” was presented by Benjamin Doolittle, MD, MA Div, associate professor and program director, Combined Internal Medicine & Pediatrics Residency Program and Katie Gielissen, MD, MHS-Med Ed, assistant professor and associate clerkship director of the internal medicine clerkship.
Doolittle and Gielissen warmed up the audience with two validated questions on burnout: “How often do you feel burned out from work?” and “How often do you feel you’ve become more callous to people since you took your job?”
Burnout, originally defined in the 1970s, is defined as long term stress reaction marked by emotional exhaustion, depersonalization, and lack of personal accomplishment.
“These three dimensions hang together,” explained Doolittle. ”And there are some key differences with other mental health issues. It looks a lot like depression, but it is different because on Saturday morning if you have the day off, then you can prune your tomato plants and whack the tennis ball, and you’re back in the game.”
He cited the April 18, 2019 Medical Grand Rounds at which Tait Shanafelt, MD, discussed burnout and personal fulfillment. Shanafelt’s recent survey results showed which specialties experienced the highest rates of burnout as compared to the general population. In addition, burnout has a significant impact on physicians and institutions, as Shanafelt has shown in his 2018 Journal of Internal Medicine paper.
“The one piece about burnout that has plagued me for a long time is the idea that this is a disease model, right?” said Doolittle. “There is an emotional charge to that word. But we haven’t really looked at the opposite of that. We haven’t looked at the positive deviants - what does the opposite of burnout look like? What does thriving look like?”
Doolittle, Gielissen and their team sought to find out. They found happy physicians. They designed a qualitative study, which Gielissen discussed, looking at primary care physicians. At the conclusion of the study, the team were able to create a ‘thriving physician model’ consisting of these themes: love for the work, grounded and connected, relationships with patients, agency in the workplace, and value-oriented beliefs. In addition to creating this new model, they found common threats to thriving, like bureaucracy.
“So where do we go from here?” asked Doolittle. He suggested that instead of using wellness, which sounds very clinical, and grit, that we think about it differently.
“We need another concept. I want to reintroduce this word into the lexicon of Yale. It’s eudaimonia,” said Doolittle. “The idea of eudaimonia comes from Aristotle. It makes sense to be happy. Life should feel good but then you should also do good.”
To watch Medical Grand Rounds, review the Grand Rounds video.