Remoralization

by Christina on November 19, 2012

Moving from a busy OB month to an even busier ICU rotation followed by 2 weeks of night shifts, this weekend was full of burnout prophylaxis — exercise, sleep, baths, phone calls, haircut, watching Lincoln viewing (terrific!), decluttering, and lots of nonmedical reading.

There have been several articles lately on physician demoralization and burnout, including this excellent one from the American Academy of Family Physicians:

There have been days in residency, particularly at the end of a busy clinic days, where I have felt demoralized: the clinic day is a constant rush and I feel incapable of spending sufficient time with patients. I can never go fast enough. The worst part is observing in myself a lack patience, compassion, and willingness to listen — attributes that have always been central to my identity as a physician. What kind of physician am I learning to become? I finish the day feeling overwhelmed by paperwork, notes to write, labs to follow up, patients to call, and I get home drained and knowing I have to do it all over again the next day.

The article discusses this exact state that many of my colleagues share (emphasis mine below):

“Demoralization is a state of hopelessness and helplessness that is akin to, but separable from, depression. It is associated with a sense of subjective incompetence, the belief that a person is unable to express his or her values and achieve his or her goals…

Moving past demoralization involves remoralization, of the renewal of one’s personal values and the activities that stem from those values.  This may be difficult if the individual does not or cannot envision a path forward to renewed energy and commitment. However, if not addressed, persistent feelings of demoralization are likely to result in or contribute to burnout.”

So how do we “remoralize” ourselves? The article suggests:

  • Advocate more strongly with clinic administrators for needs and importance of the clinic.
  • Join stakeholder or advocacy groups that address these same issues on larger scale.
  • Promote needs of patients.
  • Clarify physician’s own values and how to express them – this may come from personal reflection or mindfulness of what satisfies her and makes her work feel meaningful, it may come from reducing hours at work, spending more time in pursuits that allow for contemplation and reflection, a recharging that should be accompanied by recognition of what is personally significant.
And as the article points out, in a way perhaps some demoralization is good for us now and then?

“Demoralization can be painful, but it can also present opportunities for individuals to recognize what is really important to them, and to take action based on that recognition.”

{ 5 comments… read them below or add one }

Laura November 19, 2012 at 9:10 am

Hey Tina! What a great post! And relevant and helpful to keep in mind in my line of work as well. I’ve been feeling some burnout lately, but will try to reflect on this with this article in mind. Good luck with your current rotation, miss you, and hope to catch up one day soon! xo

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Christina November 28, 2012 at 5:10 pm

Laura!!! what a nice surprise to get this comment from you! I’m sorry you’re feeling some burnout too. I’m thinking of you and miss you – when do you come back? (email me!)

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Chris Palmer November 20, 2012 at 5:18 am

I love the list following “burnout prophylaxis”!

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Shah Coco December 7, 2012 at 11:06 pm

Wow, I am very excited to have found your blog. Yoga and wellness (among other factors) have also directed me toward medicine after undergrad . I’m currently working at a yoga studio in the South Bay and starting a post bacc premed through UCB extension. SO looking forward to reading through your blog!

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Christina December 24, 2012 at 1:49 pm

Hi Shah, great to hear from you! I’m so glad to hear about your yoga and medicine interests — best of luck with your post bacc program and definitely keep in touch!

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