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    Burnout: How can it be prevented?


    A study illustrated the concept of “20% time” in which companies allow their workers 20% of their time to pursue whatever they want to pursue. Google has adopted this concept, and Gmail actually was discovered in 20% time. It’s very renewing for the workers. In medicine, a group at the Mayo Clinic showed that if you can provide 20% of time to a physician to be engaged in meaningful professional activity, that can alleviate burnout by almost half (Arch Intern Med 2009; 169:990-5). Every individual physician will have a different meaningful activity, whether it be teaching, research, process improvement, or community service, and if each individual can find what that 20% of meaningful professional activity is. If department chairs and other mentors for our faculty can help them find that meaningful activity, that goes a long way.

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    Also, when we’re thinking of life outside of work, talking about it and not hiding it is important. Often in medicine, we try to hide the personal side and not talk about it because it’s considered a sign of weakness or lack of dedication, but I think it can be very positive to talk about it and admit we do have lives outside of work.

    On a more practical point, there are studies that show exercise can be a very important factor. If physicians follow the Department of Health and Human Services recommendations for exercise and get 75 minutes of vigorous exercise each week or 150 minutes of more sedentary exercise, they can improve quality of life and reduce dissatisfaction and burnout.


    What do you think the future holds?

    I am optimistic about the future because there is acknowledgement and discussion of burnout. We’re having several discussions on a national stage, including this year’s meeting of the Society of Academic Urologists, an organization of academic urologists, chairs, and program directors who can help to discuss this, open this up, and not treat it as a blind spot—at least on the departmental level. As we become more aware of this in our positions, we can lead from the top down and help our learners and our junior faculty with it. At this year’s AUA annual meeting, there was an international plenary panel on burnout that I participated in to discuss the problem and its international implications. To do this in such a public forum is the first positive step.

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    I do think institutions are beginning to address this issue. I’d love for our institution to do more operationally and structurally, which will require big financial investments. At least we’re beginning at institutions to have seminars and discussions about the issue. We’re starting to measure burnout at our institution as well. Until you measure it, you can’t improve it. We have a long way to go, and there are financial hurdles, but from an institution’s perspective and from a department’s perspective, preventing burnout is financially worthwhile. Faculty turnover is very expensive both for a department and an institution. A dissatisfied worker is less productive and a lot more likely to turn over.

    Next: "You can recover from burnout, but the best strategy is prevention."

    Stephen Y. Nakada, MD
    Stephen Y. Nakada, MD, a Urology Times editorial consultant, is professor and chairman of urology at the University of Wisconsin, Madison.


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