Doctors With Disabilities May Experience Depersonalization and Burnout

(HealthDay News) — Physicians with disabilities (PWDs) are significantly more likely to experience depersonalization but not emotional exhaustion when compared with their peers without disabilities, according to a research letter published online May 9 in JAMA Network Open.

Lisa M. Meeks, Ph.D., from the University of Michigan Medical School in Ann Arbor, and colleagues investigated the burnout experiences among U.S. PWDs. The analysis included data from the Association of American Medical College 2022 National Sample Survey of Physicians (5,917 physicians; 3.1 percent reported having a disability).

The researchers found that the most frequently selected disabilities were chronic health (32.4 percent) and mobility (24.9 percent). The odds of reporting daily depersonalization among PWDs were higher than for their peers (adjusted odds ratio, 1.45). While not statistically significant, PWDs reported emotional exhaustion more frequently than physicians without disability.

“Compared with peers, PWDs were significantly more likely to experience depersonalization at least once during the previous year, but not emotional exhaustion. This finding suggests PWDs have some protective qualities against exhaustion,” the authors write. “However, it simultaneously amplifies growing concerns about the structural environments in which PWDs work, including lack of protections against mistreatment, harassment, and pay inequity. Future research may include qualitative studies to identify factors in burnout among PWDs.”

What is depersonalization?

Depersonalization, a core component of physician burnout, is a distressing experience characterized by a feeling of detachment from oneself or one’s surroundings. Doctors, constantly bombarded with emotional demands, can be particularly susceptible to this phenomenon.

Depersonalization manifests as a sense of being on autopilot, emotionally numb, or disconnected from one’s body. Imagine feeling like an observer in your own life, unable to fully engage with patients or experience empathy for their struggles. This emotional distancing can be a coping mechanism for chronic stress, a way to shield oneself from the emotional toll of the job.

Doctors so susceptible to depersonalization in relation to the well-documented phenomenon of physician burnout. A long-term stress reaction, burnout is characterized by three key features: emotional exhaustion, depersonalization, and a sense of decreased personal accomplishment.

Why are doctors so likely to experience burnout and depersonalization?

Multiple factors contribute to this burnout epidemic. Administrative burdens, long work hours, and a complex health care system can leave doctors feeling overwhelmed and undervalued. The constant pressure to meet quotas, navigate electronic health records, and deal with insurance companies can chip away at a doctor’s sense of purpose and fulfillment.

Furthermore, the emotional intensity of the job takes its toll. Doctors regularly witness suffering, deliver difficult diagnoses, and grapple with patient mortality. While empathy is crucial for patient care, the constant emotional investment can lead to compassion fatigue, a precursor to depersonalization.

The consequences of depersonalization for both doctors and patients are significant. Detached doctors may exhibit cynicism, reduced communication skills, and a decline in patient-centered care. This not only impacts patient satisfaction but can also lead to poorer clinical outcomes.

Do Black doctors experience depersonalization?

Research suggests Black doctors might experience burnout and depersonalization at similar, or even slightly lower rates, compared to other racial/ethnic groups.

A study published in JAMA Network in 2020 analyzed data from over 4,000 physicians and found that burnout rates were actually lower for Black doctors compared to non-Hispanic white doctors (38.5% vs 44.7%).

This doesn’t necessarily mean Black doctors are immune to burnout and depersonalization. There could be other factors at play, and the reasons behind this difference are not fully understood.

How to reduce physician burnout

Fortunately, there are steps to address depersonalization and promote physician well-being. Individual strategies like mindfulness exercises and self-care can help doctors manage stress and build resilience. Additionally, systemic changes that address administrative burdens, promote work-life balance, and foster a supportive work environment are crucial in combating burnout and depersonalization.

By recognizing the signs of depersonalization and addressing the root causes of physician burnout, we can ensure a healthier and more engaged medical workforce, ultimately benefiting patients and the healthcare system as a whole.

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