Treating ‘compassion fatigue’ for doctors
Buddhism-based education helps tired physicians deal with burnout
Three years after completing her residency training in 2011, surgeon Carla Haack found herself in the throes of job burnout. She had been devoting her life to the hospital, working 14-hour days including weekends for months at a time. Often the opportunity to eat a meal wouldn’t arise until the end of the long work day.
“You could have taken the textbook definition of burnout and stuck it on me,” Haack said. “I was exhausted, depleted and probably had some diagnostic features of depression.”
As a result of giving everything to the care of her patients, Haack ended up with nothing left for herself. The combination of long hours, the increasing clerical demands of medicine and constant worries about patients’ health led to symptoms of burnout.
Haack represents a growing number of physicians experiencing job burnout, characterized by emotional exhaustion, feelings of cynicism and a low sense of personal accomplishment. A 2011 survey by the Mayo Clinic found that nearly half of physicians in the U.S. have at least one symptom of burnout, and the phenomenon is more common among doctors than other professions. A type of burnout called “compassion fatigue” often affects health-care professionals and can result in a loss of empathy for patients, emotional numbing and a sense of no control.
This can have a detrimental effect on patient outcomes. Studies have found that higher levels of physician burnout correspond to more medical errors.
To combat this, some medical schools have launched programs to teach “soft skills” to better equip their doctors for today’s stressful health-care environment. Learning compassion, empathy and resilience that speak to the human service challenges of the job have helped many rediscover the meaning of medicine and why they became a doctor in the first place.
Since 2014, Emory has offered cognitively based compassion training (CBCT) courses free of charge for staff, faculty and students at the medical school. Each course runs for 10 weeks, meets once a week in person and also includes at-home exercises. Enrolment has grown every year, with a total of 171 faculty/staff members and 239 medical students having completed the course.
“Medical students are this really unique population that suffers from incredibly high rates of depression, suicidal ideation and burnout,” said study author Jennifer Mascaro, an anthropologist at Emory. “Not surprisingly, they also seem to suffer a decrease in empathy and compassion during training. It’s hard to feel compassion when you’re just trying to keep your head above water.”
CBCT draws from traditions of Tibetan Buddhism mind training that have been secularized with a focus on compassion and wellbeing. The course begins with meditative exercises that emphasize self-compassion, then asks students to expand these emotions to their loved ones, strangers and finally difficult people. Each class combines didactic teaching and guided meditation.