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This fall, UNC Health Care was designated among 22 healthcare organizations to receive the American Medical Association (AMA)’s first Joy in Medicine Recognition, which acknowledges healthcare organizations that have committed to improving physician satisfaction and reducing burnout.

Alice Chuang, MD, MEd, professor of obstetrics and gynecology and the UNC School of Medicine’s Assistant Dean of Student Affairs, is the leader of UNC OB-GYN’s Joy in Medicine initiative. Chuang has traveled the state and nation to lecture on issues of burnout, and she recently spoke at a panel highlighting her efforts in the department for the 2019 joint meeting of the Council on Resident Education in Obstetrics and Gynecology (CREOG) and Association of Professors of Gynecology and Obstetrics (APGO).

How have you been involved with the School of Medicine’s efforts in reducing burnout?

I have been working on the Finding Joy initiative in the Department of Obstetrics and Gynecology for a couple of years. I am also deeply interested in helping our learners and trainees understand the importance of managing stress, reducing burnout (as a preventative measure) and, more importantly, reconnecting with the true gift of being able to care for patients.

What kinds of burnout have you seen on the rise in recent years?

The Maslach Burnout Inventory originally defined occupational burnout as emotional exhaustion, depersonalization or dehumanization and decreased sense of accomplishment.  There are many newer, updated paradigms that characterize burnout.

I think the most common thing I have seen is the burnout which stems from our electronic medical records (EMR) system. It feels like so much more effort is required for the administrative tasks related to patient care – with less time to spend face to face with patients.

What are the risks to trainees (and their patients/families) of burnout?

The consequences of burnout are decreased work satisfaction leading to job transition, career transition or even early retirement. Severe burnout can lead to depression.  Burnout decreases focus and can increase mistakes, which has implications for our patients.

What have been your own experiences with burnout, and what helped you the most?

I remember a time early in my career (after a difficult lawsuit and big transition) being so unhappy. The lawsuit made me distrust patients, and the transition was just challenging. I could not find meaning in being a doctor. I definitely could not find joy, and I was unable to be an authentic role model for my students. I wanted to leave medicine and find something that was more predictable and mundane.  I knew I needed coaching, counseling . . . something.  Those sessions helped me reconnect with the reasons I chose a career in medicine and education.

How does ‘Finding Joy’ help with combating burnout?

Finding Joy is an international initiative that includes personal and institutional responsibility for decreasing burnout and increasing joy.

If I just go about my business, I won’t find joy. Joy is a practice, a habit that is built, a way of viewing the world, regardless of the circumstance. It includes mindfulness, connection / reconnection to humanistic principles of medicine, curiosity and wonder, and many other practices. Joy is choosing to believe in the goodness of people and the assurance that things will work out.  At an institutional level, our committee is working to find ways as a department to creatively address the issues which steal our joy at work.

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