Physicians pushing back on burnout

This issue covers such topics as making systemic changes to fight physician burnout, planning for end-of-life care, and addressing e-cigarettes with patients.

Physician burnout is well known as a major problem, with competing priorities, growing administrative tasks, and less time caring for patients as causes. But physicians are fighting back against these systemic factors through national, regional, local, and individual efforts. ACP, as one example, has developed a network of Wellness Champions around the country who have been leading sessions on diagnosis and prevention and offering physicians tools on addressing the risk for burnout in their own practices. One of the goals is to empower physicians to assess their practice environments, pinpoint what exactly isn't working, and determine the best ways to fix it. Work flow overhauls are often key, according to experts.

All patients need advance care planning, though they might not always think so. Older patients may be reluctant to discuss end-of-life care because they don't want to think about how much or how little time they have left, while younger patients may think it's unnecessary because they have all the time in the world. Internists, who have ongoing relationships with their patients, are usually well placed to tackle these discussions. Our story in this issue offers tips on the best opportunities to bring up the subject, how to handle resistance, and how to address the role of culture and religion in patients' decision making.

Information abounds on various methods of smoking cessation, from “cold turkey” to medications, but very few data are available as yet on the harms, or benefits, of e-cigarettes. Physicians may find that more of their patients who smoke are using e-cigarettes in addition to or instead of traditional cigarettes, but there's no way to tell if that's a good thing or a bad thing, and no consensus on the best medical advice to give in this situation beyond, of course, “Stop smoking.” Our story takes a closer look at this issue, summarizes the current state of the science, and offers advice on what to say to patients who are turning to e-cigarettes in an effort to cut down on or stop “traditional” smoking.

Finally, earlier this year, Steven E. Weinberger, MD, MACP, stepped down from his role as the College's EVP/CEO after serving 6 years at the helm. Though Dr. Weinberger will remain at the College until next September as associate EVP and CEO emeritus, we took this chance to give him an “<a href=““>exit interview” of sorts with Staff Writer Mollie Durkin, covering such topics as MACRA, gun control, and MOC.

Do you discuss end-of-life care with every patient? How do you combat burnout? Let us know.


Jennifer Kearney-Strouse
Executive Editor, ACP Internist