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Key points
- The major drivers of burnout are at the system level. However, needed changes at this level are likely to be slow in coming.
- A study of physicians with high emotional exhaustion showed that one-on-one coaching decreased burnout by 20 percent over 5 months.
- Recent research indicates mindfulness-based interventions (MBIs) aid burnout in the short term.
- Peer support groups have proven helpful with a range of issues, from burnout to leadership development.
This post was co-authored by Kim Garver, M.D., and Amy Young, Ph.D.
Burnout is rampant. What helps?
Lighter workloads, more efficient systems, and greater support for mental health are sorely needed. Given the financial and staffing challenges many organizations are currently facing, near-term progress in these areas is likely to be slow at best.
Recent research notes several “lifelines” individuals can leverage in the short term as long-term, system-level changes unfold in parallel. We describe three such strategies and the research that supports them.
One-on-One Coaching Helps
A proven strategy that aids burnout is 1:1 coaching. A 2019 randomized clinical trial published in JAMA Internal Medicine by Liselotte Drybe, M.D. and colleagues from the Mayo Clinic showed a statistically significant decrease in physician burnout with 1:1 coaching over a 5-month period. Absolute rates of high emotional exhaustion at 5 months decreased by about 20 percent in the intervention group and increased by about 10 percent in the control group.
While coaching carries some cost (around $1400/individual in this report), the price of burnout is much higher, running in the billions per year. The Cleveland Clinic estimates its coaching program has saved over 133 million in physician retention alone, while also improving wellness and leadership skills.
Mindfulness-Based Interventions Aid Burnout
As with coaching, recent research indicates mindfulness-based interventions (MBIs) aid burnout in the short term. A 2021 meta-analysis of 25 studies involving 925 physicians examined the impact of MBIs on burnout and stress and demonstrated they were associated with small-to-medium benefits that persisted on follow-up.
This study and others have noted MBIs are also associated with increased compassion and dedication to work, and an improved therapeutic alliance between providers and clients. MBIs include breath- and body-based practices. They offer flexibility in when and how they are used and are not tied to a specific place or time, like a gym, making them an attractive option for busy individuals.
When offering MBIs in our health system, one of us (DF) has noted that sessions on “mindfulness of feelings” and “self-compassion” are especially resonant for healthcare workers who continue to navigate the impact of COVID-19.
Burnout and the Benefits of Support Groups
A third short-term strategy that individuals can leverage is a peer support group. Such groups have proven helpful with a range of issues from burnout to leadership development.
One way support groups help is by normalizing the range of emotions individuals experience, from exhaustion to the stresses of navigating career and family life. Such support, coming directly from those with similar experiences, can be especially resonant.
In a 2021 randomized controlled trial by Colin West, M.D., and colleagues from the Mayo Clinic, support groups reduced the rate of overall burnout in the short term. In this study, groups of six to eight individuals met every two weeks over a six-month time period to share a meal and discuss relevant topics. Follow-up assessment six months after the program ended showed statistically meaningful changes in overall burnout and depressive symptoms in the intervention arm versus the control group.
Coaching, mindfulness interventions, and support groups can all be accessed online, supporting privacy and convenience. Importantly, these three strategies are not mutually exclusive. Two or more can be used in the same day or week to support growth, health, and wellness. Many other approaches, like CBT, may also be effective in aiding burnout at the individual level.
We have first-hand experience using and offering these three strategies. Clearly, they are not substitutes for organizational-level efforts to address the fundamental system-level drivers of burnout. For lasting change to occur, root causes must be addressed. Both short- and long-term strategies can aid these efforts.
Organizations must intensify efforts to decrease workload, create more efficient systems, and support mental health for long-term improvements in burnout. Meanwhile, if you are facing burnout, know that evidence-based help is available now.
References
Dyrbye LN, Shanafelt TD, Gill PR, et al. Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA Intern Med. 2019;179(10):1406-1414.
Fendel JC, Burkle JJ, Goritz AS. Mindfulness-Based Interventions to Reduce Burnout and Stress in Physicians: A Systematic Review and Meta-Analysis. Acad Med. 2021;96:751-764.
West CP, Dyrbye LN, Satele DV, Shannafelt TD. Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Groups for Physician Well-Being: A Randomized Clinical Trial. Mayo Clin. Proc. 2021;96:2606-2614.
