Supporting Physician Families: A Crucial Frontier in Combating Burnout

The issue of physician burnout continues to be a hot topic of conversation within the medical community, particularly following the COVID-19 crisis. The concept of physician burnout is familiar to most health care providers as well as lay people, and most have experienced burnout personally or vicariously through colleagues. Studies have proposed a myriad of reasons why physicians experience burnout.

However, one crucial aspect remains less discussed within medical circles: the profound impact of burnout on physician families. Within the intimate spheres of physician-spouse communities, the decline in mental health among spouses has been an ongoing yet understated and largely unexplored topic.

In the recent study, “When Perceived Physician Burnout Leads to Family Burnout: How Secondary Emotional Trauma Impacts Physician Spouses”, Grimmer and Jacquin (2023) identified a connection between burnout experienced by physicians and the psychological distress felt by their spouse. The objective of this study was to assess the correlation between perceived physician burnout and the wellbeing of the spouse, specifically by examining their emotional health in terms of anxiety, depression, and secondary trauma.

In other words, the authors aimed to determine whether spouses experienced heightened anxiety, depression, or secondary trauma due to their physician partner’s workplace stress and fatigue. A total of 207 physician patterns participated in the study. The majority of physician spouses endorsed experiencing psychological distress themselves at some point during their physician pattern’s medical training or career. The results showed that physician spouses who perceived higher levels of burnout in the physician partner experienced more symptoms of anxiety, depression, and secondary trauma themselves, compared to spouses who perceived less burnout in their physician partner.

When asked about their personal emotional wellness, a significant portion of respondents (69.8%) exhibited scores indicative of moderate to severe anxiety levels. Over 10% of participants self-reported experiencing clinically severe anxiety. Furthermore, nearly 70% of respondents manifested symptoms associated with depression, with approximately 31.2% scoring within the moderate to severe range. Secondary trauma was disclosed by 62% of participants, among whom nearly 20% reported high to severe levels of secondary trauma.

In a world where over half of physicians report symptoms of burnout, it is becoming increasingly evident that the ramifications of burnout extend beyond the individual practitioner, with new evidence showing their families are often directly affected.

The transition to a life in medicine comes with rigorous demands and can be stressful. It is not a journey just for the practitioner but for their entire family. Some of the challenges that physician spouses encounter during training include their partners’ long and variable working hours, multiple relocations (medical school, rotations/clerkships, internships, residency, and fellowship often take place in different cities/states) putting their own career goals on hold, managing student debt, and taking on primary household/parenting duties. In addition, many spouses worry about their partner’s physical safety and health in the workplace.

As stated by Grimmer and Jacquin (2023), “The experiences that are shared between couples have a resonating effect, where those experiences, for better or worse, impact the couple both as individuals and as partners. Because the coupled physician is an individual, a partner, and also a provider, it stands to reason that any impact on the self or the partnership also has and impact on the provider, and vice-versa.” Thus, by ignoring the well-being of physician families, the cycle of physician burnout is inadvertently perpetuated, amplifying its detrimental effects on both the individual practitioner and their primary support system.

It is essential to incorporate physician spouses and families into the discussions aimed at mitigating physician burnout. While individual wellness strategies and resilience training have their place, they are not comprehensive solutions.

A family systems approach is imperative, an approach that recognizes the interconnectedness of they physician’s well-being with that of their family. One must acknowledge the bidirectional effect of psychological distress between the physician and their spouse/family.

Early intervention may be important for long term success. Research consistently indicates that signs of burnout and psychological stress emerge early in medical training, despite medical students exhibiting better psychological well-being upon enrollment compared to peers of similar age in college.

A nationwide multi-institutional investigation revealed that 35-45% of medical students reported significant emotional exhaustion, 26-38% experienced pronounced depersonalization, and 45-56% displayed symptoms suggestive of burnout and mental fatigue compared to peers of the same age who were not pursuing medical education. It follows that medical students’ spouses are likely similarly affected, but this population has not been specifically studied. Therefore, programs geared towards fighting physician burnout should begin early in medical training and involve students as well as their families.

Perhaps a dialogue regarding mental health should begin during pre-medical education, informing prospective physicians and their families of the challenges that medical education and a career in medicine pose. This may help them to navigate the hurdles they  may encounter along the way.

Embedding mental health awareness and support structures within the framework of medical training lays the foundation for a more robust and resilient health care workforce. While physicians stand as the cornerstone of our health care system, they also exist as individuals within familial, communal, and relational contexts. To effectively address burnout and secure the enduring welfare of our health care providers, we must expand our focus to encompass the entire family unit within our strategies.

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