America, land of the strong and brave! The satirical newspaper The Onion summarizes us this way: “Life, liberty, and the reckless pursuit of happiness at any cost — even life and liberty.” Although it’s a joke, it hits on a deeper truth. What exactly are we pursuing at such a dizzying pace?
- A survey by Hotwire reported that Americans left nine days of vacation on the table in 2012, partly out of fear that they will be perceived as lazy, or that their jobs will be eliminated while they’re away.
- A 2011 “vacation deprivation study” by Expedia found that workers in the United States are given fewer vacation days (14 on average) and take fewer of them compared to workers in other countries like France and Denmark, where people receive more days of vacation (30) and use them all.
But all this work isn’t exactly making us more productive. Stress has real consequences, both for health and business. A study by Middle Tennessee State University estimates that this all-work-and-no-play approach costs American businesses more than $300 billion a year in stress-related health care losses.
Symptoms such as withdrawal, isolation, depression, insomnia, anxiety, headaches, irritable gut, and anger commonly result from persistent, unrelenting stress. Behaviors associated with burnout include smoking, excessive drinking, depression, and overeating. According to research done by the Wisconsin Initiative to Promote Healthy Lifestyles, these adverse behaviors lead to 40% of all deaths and instances of chronic disease every year. That results in lost productivity, higher health insurance premiums, and other expenses for Wisconsin employers to the tune of $5 billion per year. What’s more, health care costs for patients with depression alone are 1.5 times greater than for patients who are not depressed or burned out.
Aside from working too much without taking restorative breaks, what causes professional burnout, and what exactly is it? Technically, burnout is characterized as a loss of emotional, mental, and physical energy due to continued job-related stress. What’s more, any profession can experience burnout.
The Maslach Burnout Inventory (MBI) is the main research tool used worldwide to measure the three main aspects of burnout: emotional exhaustion, depersonalization, and lack of personal accomplishment. In the workplace, burnout stings — it hurts both employees and employers with higher rates of absenteeism, staff turnover, depression, general dissatisfaction, and suboptimal performance. It is clear that trying to squeeze more work out of a person is counterproductive. No employee who is chronically overtaxed and feels like a flogged racehorse will be productive.
To the contrary, research shows that happiness can improve work productivity. A study from the University of Warwick set out to investigate the link between happiness and economic behavior. Specifically, the study’s authors asked, “Does happiness make people more productive in a paid work task or not?” It turns out that happier individuals are motivated to work harder and overall are more productive.
While some might say efforts to research and curb burnout are “fluff,” the consequences are as serious and dire as they come. For example, in my own profession, up to 60% of physicians, especially in primary care, report having experienced burnout. There is considerable evidence suggesting that this isn’t good for patients because burned-out physicians provide suboptimal patient care, make more medical errors, and miss important things that can be life-threatening. A 2008 review of burnout published in the Annals of Internal Medicine warned that death by suicide is a major occupational hazard for physicians. Unfortunately, a comparison of other normative samples on the MBI shows that burnout is present and widespread across other professions as well.
A recent physician burnout study I coauthored with colleagues that was recently published in the Annals of Family Medicine ultimately found lasting results on measures of burnout using a tailored mindfulness intervention that better addressed the needs of this particular group in an efficient and meaningful way. Another timely study published in the same issue of AFM went on to show that doctors who were more mindful with their patients were more upbeat, better listeners, and showed more empathy. Less mindful doctors were less attentive to their patients’ needs. Perhaps most interesting, “mindful physicians” remained efficient in their daily work even while making the extra effort to really listen and be present.
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So what’s so special about mindfulness, and what is it? Mindfulness means paying attention, on purpose, in the present moment, without judgment. A mindful state of mind can be honed and developed with practice like any other skill. It is a fluid, nonreactive framework of perception that can help us respond more thoughtfully to life’s various and inevitable daily stressors. Fr. Thomas Keating, a Trappist monk and priest, once told me that a contemplative practice like mindfulness can help us work through hard times and avoid being blown away and overwhelmed by stress.
Mindfulness in the workplace can help, but it isn’t a cure-all. In addition to getting restorative sleep, eating a healthy diet, and getting regular exercise, it appears that training in mindfulness is helpful in easing burnout, even when relatively brief. A commentary in AFM noted that the positive effects of an “abbreviated” intervention suggest that mindfulness training is similar to exercise, in that any amount of intervention is better than none.
Burnout is “low-hanging fruit” that, if left unaddressed, can have negative effects on a personal and business level. Employers can find resources at wiphl.org and individuals at meriter.com/wellness.
Dr. Luke Fortney is a family medicine physician who is part of the Meriter Medical Group at the McKee Clinic in Madison. He is lead author of a physician burnout study, which he completed with colleagues from the University of Wisconsin School of Medicine and Public Health. The study was recently featured in the New York Times and Huffington Post.
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