MAR 2014

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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But then he had an epiphany. "Why don't I get someone else who could do the prescriptions, that can do the chart- ing," he reasoned. "Let me see the patients." He left the group, opened his own private practice, and employed a support staff that he paid out of his own salary. "That changed my life, that absolutely changed my life," he says. Dr. Crutchfi eld is a prime example of a physician whose critical decision to shift gears helped prevent more serious problems, like burnout, down the road. Although it is not often discussed, burnout among aesthetic medical professionals is alarmingly commonplace. A recent study, published in the December 2013 edition of the Annals of Plastic Surgery, in which a self-administered survey was sent to 708 U.S.-based plastic surgeons, found that nearly one-third of plastic surgeons have signs of pro- fessional burnout. Physicians are more prone to burnout than any other professionals, and yet there are few tools available to help them understand what leads to burnout, how to prevent it, and how to cope with it. RECOGNIZING THE SYMPTOMS According to the 2012 book High Octane Women: How Superachievers Can Avoid Burnout by Sherrie Bourg Carter, burnout is defi ned by a state of chronic stress and frustra- tion that leads to: • physical and emotional exhaustion; • feelings of cynicism and detachment; and • a sense of ineffectiveness and lack of accomplishment. An immediate distinction must be made between stress and burnout. "Stress is usually due to temporary situations, which over time, will resolve," explains Carolyn Jacob, MD, founder and medical director of Chicago Cosmetic Surgery and Dermatology in Chicago. Burnout, on the other hand, is a sign of "something much more ominous," says Elizabeth Tanzi, MD, co- director of Laser Surgery at the Washington Institute of Dermatologic Laser Surgery in Washington, DC. Both Dr. Tanzi and Dr. Jacob run successful, busy practices, and have experience in combatting stress. "Burnout means that you don't fi nd any joy in what you're doing on a day-to- day basis," explains Dr. Tanzi. "That's a really big problem." Burnout occurs when unmanaged daily stress accu- mulates to a level where the physician feels emotionally disconnected from his or her work and personal life, experiences chronic fatigue and illness, loss of appetite, increased anxiety and irritability, anger and isolation, or be- gins to abuse substances. If left unmonitored, burnout can have a catastrophic impact on not only the professional and personal life of the physician, but on the family and patients of the physician as well. The family of professor Neil Cox, MD, knows this all too well. Dr. Cox was an acclaimed British dermatolo- gist with a loving wife and two children. The recipient of several national awards, he was highly regarded for his research. But in September of 2010, Dr. Cox took a drive down a remote country road in the town of Cumbria, UK, where he lived, parked his car and took his own life. What came to light in the wake of the tragedy was that Dr. Cox was suffering from severe burnout. "He was totally spent by the time he came home," his wife told The Daily Mail. "He would sit exhausted on the sofa with a glass of wine, eat his supper and go to bed at 9:30pm most nights." Coupled with health problems, Dr. Cox's work pressures became unmanageable, and he lost his ability to cope. While Dr. Cox's case is a worst case scenario, the good news is that there are several daily habits and business practices that can help prevent burnout. If a physician is experiencing the symptoms of burnout, there are also tools available to help treat them, successfully. PREVENTING BURNOUT Since burnout is essentially the accumulation of unman- aged stress, the most important form of prevention is the daily banishing of stressors. Physicians need to be aware of what is causing them stress and then "zap it," as Dr. Crutchfi eld puts it. There are several ways to do this. Hire a Support Staff. For high-functioning physicians, having the right team is critical in staving off fatigue, keeping them excited about their profession, and allowing time to unplug. "In your business, do only that which only you can do; if there's something that can be done by some- one else, delegate it," says Dr. Crutchfi eld, who currently employs two personal assistants, in addition to his staff of nurses. The assistants help him with everything from keep- ing track of his appointments to picking up dry cleaning and getting his car washed. It may seem like an extravagance, but for Dr. Crutchfi eld that kind of help is indispensible. "It frees up so much time and allows me to do the really COMBATING BURNOUT 56 MARCH 2014 | Med Esthetics Burnout occurs when unmanaged daily stress accumulates to a level where the physician feels emotionally disconnected from his work and personal life. B u r n o u t / A d I n d e x M E D 3 1 4 . i n d d 5 6 Burnout/Ad Index MED314.indd 56 2 / 1 1 / 1 4 3 : 5 8 P M 2/11/14 3:58 PM

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