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What the EHA Burnout Survey Reveals for Hematologists (with Dr. Côme Bommier) · EHA Unplugged

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  Our results also call for institutions and stakeholders to
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  take action. Really there is no one solution.
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  It's a like plenty of solution that that that have to be taken
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  together and to to change things and provoke an increase in
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  quality of life at work basically.
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  Welcome to EHA Unplugged, the official podcast channel of the
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  European Hematology Association. EHA, I'm your host, Isabella
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  Rivera, and today we have the pleasure to have with us Doctor
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  Combo Mier. Dr. Combo Mier is a clinical
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  hematologist at Opitals Only in Paris.
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  Thank you for being with us today.
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  Thank you for inviting me. Doctor Combo Mier is also an
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  associate editor for the Journal of Ethics and Medicine in Public
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  Health, Correct? And he is recognized for his
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  work on bridging clinical practice and ethical reflection.
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  So he has been involved lately in a burnout survey conducted by
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  Young AJ and the Young National Society Ambassadors.
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  This burnout survey was directed to hematologist.
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  So in this podcast, we're going to talk about how this burnout
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  survey came about. Why was it designed?
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  Why was it done? And we're going to have an
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  insight into the observations of this survey.
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  So, first of all, can you explain to us how did this
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  burnout survey begin? Burnout is not a new problem and
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  we all faced difficulties in our daily life of practitioners, of
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  physicians and but this is a problem that was not addressed
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  in hematology. So two years ago I was a young
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  National Society ambassador for France and together with the
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  Yengechi committee, we decided to speak louder about that that
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  matter. And so we decided to, to to set
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  up a webinar to raise awareness about burnout with two key
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  figures, two key personalities in the burnout research.
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  First was Tate Shannenfeld, former Mayo Clinic physician, 9
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  Stanford, who has been working on burnout for two decades, 2
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  decades at least. And Elie Azule, who is
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  intensivist in France and who has also been working in in the
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  burnout research for two decades as well, but more in the
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  intensivist part of of medicine. While Tay Chenafeld is an
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  oncologist, so he has been working a lot in oncology.
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  And, and so we, we made that webinar like a year ago.
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  And right after the webinar, we set up a, a questionnaire and
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  to, to run a survey that was conducted between September and
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  October of 22 and 24, thanks to the support of EHA and with the
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  help of Membership Matters. And so a society that was
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  associated with the EHA. And very luckily, I mean, we, we
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  were very happy to see that in less than a week they were on
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  already like 1000 respondents taking the survey.
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  And so we'll let the survey run a little more, a few weeks more.
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  And at the end of the day, we ended up with a little less that
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  than 2000 people responding to survey.
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  And the the the results are striking and.
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  Were there any particular circumstances or incidents that
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  made you get interested in burnout?
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  We all face challenges in the daily practice.
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  We all the healthcare systems are in tension.
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  It's not only in France, it's like in all Europe, even in the
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  US and generally from Europe, we all, I used to have that feeling
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  that, oh, in the US they have a different healthcare system.
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  So, well, it might be less fair when you're in the system.
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  It might be a bit better in terms of quality of life at
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  work. But then I realized that it was
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  not the case. They had other issues.
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  And the burnout is rife also in the US.
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  And based on the studies conducted in oncology by Tate
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  Tenefelds and his colleagues, 45% of the respondents of the
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  oncologists showed symptoms of eye burnout.
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  So this is something very important.
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  What are those symptoms? That was my next question.
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  How do you recognize burnout and also how were they asked us in
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  the survey? Did you ask us burnout in the
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  survey? So burnout, as it says, you feel
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  burned out. So it's consuming you from the
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  inside and as you might, I guess we cannot like see every
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  respondents on the psychological interview and assess the the
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  exact level of burnout in each in each person.
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  So we use a validated questionnaire that is called the
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  mass slash burnout index and that is that relies on three
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  components. The first one is emotional
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  exhaustion. The second one is
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  depersonalization cynicism, and the third one is personal
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  accomplishment. And so if you have a high
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  emotional exhaustion or, and, or I depersonalization score, you
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  present symptoms of burnout, high, high severe burnout.
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  And aside there is the personal accomplishment component.
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  And, and so it's a different score and it's, it is it
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  assesses if you have a low personal accomplishment in your
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  work. And So what are the consequences
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  or risks of burnout? There are personal consequences,
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  but there are also consequences for your colleagues and for the
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  institution, for the patients, obviously.
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  So something that's is not well known is that burnout is a is an
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  epidemic. It's like COVID because it's if
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  you have one or two or three colleagues that are burnout in
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  your department, you're more likely to declare burnout
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  yourself. OK.
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  But then of course, it's not only that aspect, because if
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  your colleagues are in burnout, it means that there might be
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  systemic factors explaining or to triggering that burnout.
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  So there are many factors in the in the service that are
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  convicted. We're not able to draw straight
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  causality between the factors and the burnout, but we drew
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  association of statistical inference and based on all the
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  data that is already published in the literature, there are
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  factors that are recurrent. I mean, if you don't read that
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  literature, you will think that it's very personal, that people
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  are not well organized. They feel they feel overwhelmed
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  by the task they are assigned. Maybe they are too young, not
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  much, not not mature enough. But what the literature says is
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  that overall the burnout risk is 80% associated with systemic
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  factors, 20% associated with personal factors.
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  But of course people want to correct the personal factors
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  because this is on what they can act and play.
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  And so we always speak about resilience and people try to
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  have a better work life balance to, to to better cope with the
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  situation. But what we also underline with
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  our survey, but which correlates with what was already observed
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  in the literature is that the systemic factor of really,
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  really important importance of management of support of hours
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  of course workload are very, very important and really drag
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  the the the the the physician towards burnout or not.
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  Can you tell us what have you observed in this survey?
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  So yeah, the, the the main results that are like very
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  striking. I wasn't expecting that really.
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  So the burnout definition is high emotional exhaustion and or
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  ID personalization. And so you have 43% of the
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  respondents that add high emotional exhaustion and 1/3 a
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  third who add ID personalization.
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  Oh and so when you aggregate these results, 50 persons of the
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  respondents declare having symptoms of burnout or as we all
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  working, right, people are working, are seeing patient
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  everyday and half of them are in burnout.
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  And moreover, in addition, like 2 third of the respondents have
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  a low personal accomplishment. So they engage into these long
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  medical studies. They wanted to help others.
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  They decided to become hematologists.
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  You know, most of them are cure cancer.
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  They are facing death on a daily basis.
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  They, they really want to help the patient they're seeing every
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  day and they are not accomplishing what they do.
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  They and off of them are like very tired and or
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  depersonalized, which is scaring at some point.
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  Our results also call for institutions and stakeholders to
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  take action. Really, there is no one
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  solution. It's a like plenty of solution
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  that that that have to be taken together and to to change things
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  and provoke an increase in quality of life at work.
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  Basically, so far it's very observational, but hopefully in
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  the future it will be a little more political in terms of
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  discussion within the institution with EH to start and
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  with the National societies and with the hospital locally to
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  change the the work conditions and to make it livable for the
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  physicians. So it's just really great that
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  you're raising awareness about this problem.
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  So what advice would you give? Is there something that you have
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  learned in this journey that could help?
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  So this is a very personal question and as I'm not
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  psychologist, I don't know if I'm if my advice is a good one.
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  But what I can say from the observation I've done conducting
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  the survey is that being young, being female, being a woman,
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  being not having a senior position or not having an
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  academic position or a a tenured position is associated with
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  higher burnout rates. So we're living in a very high
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  pressure field with the confrontation of death on a
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  daily, daily basis, lot of lots of responsibilities, lots of
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  demands from the patients, from the institutions as well.
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  And so I think the, the hardest years, of course, between 25 and
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  maybe 40 years of age, we cannot accept the idea of the tunnel
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  that we all have to go through. And finally light comes, you
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  know, we have to open that tunnel and make it different for
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  all the younger physicians. The, the, this survey is only
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  like a A1 time survey. It's not a longitudinal
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  assessment of the burnout. We're not able to say whether
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  people grow out of burnout when they grow older or if they leave
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  the specialty. The advice is that's, I mean,
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  there's no advice that you have to take care of yourself.
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  I mean, we all have one life, We're looking after the other's
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  life, but we also have one life and, and they are every year
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  suicides among physicians that happen and among young
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  physicians mostly. So this is something very
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  serious and concerning. And so we have to take care of
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  ourselves for sure, and we have to find a meaning in what we do.
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  One of the key driver for resilience in occupational
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  health is having a meaning in what you do when you see patient
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  and when you treat them, you find a meaning in that because
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  you have an input in their lives.
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  And when you at the end of the year, you will, you will
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  remember what you've done through the year and you will
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  say, OK, I've been very helpful for this person and this person
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  and that patient came to thank me and gave me a little present.
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  So it means that I'm useful. I was useful to him or to her
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  and and which makes sense to my commitment.
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  OK, but pay attention to keep this sense of meaning because if
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  you lose it, it means that you might be in burnout and you're
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  in danger. So we so keep that in mind.
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  We all can be very exhausted and fatigued by the intense rhythm
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  pace that we have no daily life. But if you have a very strong
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  meaning in what you do and if you keep your empathy, if you're
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  able to act humanly with humanity, with the patient and
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  with your colleagues, if you still have the impression to act
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  positively towards them, then you're preserved a little bit
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  from burnout and you, you'll be safer.
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  But if you don't find that meaning anymore, and if you feel
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  more careless to the others towards the others, then it
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  means that you might you might pay attention.
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  If a member of our audience wanted to participate in these
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  efforts of raising awareness and then like, you know, also for
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  institutions, is it possible? How would they get involved?
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  I think everyone can be involved.
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  We are then initiate an initiative and I hope that's yet
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  she will foster research in the field by maybe supporting A
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  longitudinal assessment and assessing maybe targeted
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  intervention, maybe EHAV, national societies and the local
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  institution. We all have to develop targeted
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  intervention mainly towards young people and women because
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  they are more prone to develop burnout because of systemic
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  factors. OK, the gender disparity is
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  something very important. It's not only in as we got to
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  burn out, it's very systemic issue.
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  But as we get to burn out, it has to be addressed as well.
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  For example, the flexibility of the schedule at work, the
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  career, the career for women, you know, because due to
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  pregnancies, it might stop and start again, stop and start
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  again. And it's more difficult for them
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  to, to, to get access to senior academic positions initially
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  because they are not 100% of the year at work you see.
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  And so I mean, there are many intervention that can be done.
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  You don't have to work in the intensive unit, intensive care
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  unit like through the year. You might for example in acute
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  meal leukemia or aggressive lymphoma unit, you might work
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  two months and then switch to the outpatient clinic and then
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  come back to the intensive unit. Because if you are only
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  confronting the hardest cases and the hardest human situations
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  throughout the year, it can really consumes you.
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  So if you want our audience to remember just one thing from
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  this podcast, what would be your the most important thing?
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  It's not easy. If there was one thing to
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  remember, it's not only the first line physicians that are
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  exposed to burnout. The senior are so exposed to
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  burnout. The laboratory workers are also
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  exposed to burnout. The researchers also exposed to
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  burnout. So this is a a problem that is
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  rife in the profession and we, we should, we should really take
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  action collectively to make that change.
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  So thank you very much, Doctor, for being with us today and
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  thank you for all of you for listening.
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  And stay tuned for more episodes.