Podcasts about Maslach Burnout Inventory

In this Marketing Speak podcast, we delve into the pressing issue of burnout in the workplace with our esteemed guest, Ana Melikian. This episode explores the negative impacts of working to exhaustion and emphasizes the importance of creating optimal conditions for sustainable performance. Ana Melikian shares her own transformative journey through battling cancer and how it reshaped her approach to work and life. We discuss the differences between burnout and overwhelm, the systemic causes of burnout within organizations, and practical strategies to foster mindfulness, rest, and effective performance. Ana introduces helpful frameworks and assessments, like the P.I.E. method and the Maslach Burnout Inventory, to boost self-awareness and organizational health. You'll also hear about the power of aligning work with core values and the significance of interdependence for achieving greater outcomes. Tune in to learn how to recognize the warning signs of burnout, implement proactive changes, and harness the power of rest and reflection to thrive both personally and professionally. Don't miss this opportunity to equip yourself with valuable strategies to avoid burnout and promote a healthier, more engaged work environment. The show notes, including the transcript and checklist for this episode, are at marketingspeak.com/483.

Burnout is on the rise everywhere. Understanding and managing burnout not only benefits employees but also improves the bottom line. Today's Better Being episode focuses on the increasing dangers of burnout, warning signs that burnout is building and strategies for preventing – rather than merely coping with – the work stressors that lead to burnout. Experts in this episode: Rachel Fellowes, Chief Wellbeing Officer, Aon Christina Maslach, Professor of Psychology at the University of California, Berkeley[3:58] Classification of burnout as a stress response[11:00] The danger of viewing burnout as a disease[12:28] Three dimensions of the Maslach Burnout Inventory[14:58] Symptoms of classic burnout patterns[17:21] Six areas of mismatch that result in burnout[23:03] Effective strategies for burnout improvement[24:18] Distinguishing between coping and preventionAdditional Resources:Aon's websiteBetter Being Series: Are You Taking Care of Your Digital Wellbeing?Better Being Series Dives into Women's HealthRachel Fellowes LinkedInAon's Workplace WellbeingAon's 2022-2023 Global Wellbeing SurveyChristina Maslach Resources:UC Berkeley Psychology WebsiteUC Berkeley Research Social Psychology NetworkMaslach Burnout Inventory™ (MBI)The Burnout ChallengeLinkedInTweetables:“[Burnout] is not a pathology itself, but it's the lack of recovery afterward that really becomes the problem.” — Christina Maslach“With burnout, employees are switching from doing their very best to doing the bare minimum.” — Christina Maslach“We need to recognize burnout as a phenomenon that can happen in the workplace because of the health consequences it can have.” — Christina Maslach“We should not honor increasingly difficult jobs by just coping with it, we should get rid of some of these stressors or make them less frequent.” — Christina Maslach

Burnout is real, and coaches are not exempt. How can we effectively help others achieve growth and accomplish their goals if we are personally dealing with the symptoms of burnout? Today's guest is a passionate expert on this topic, and she's sharing helpful information and resources in this episode. Join us!Dr. Zeina Ghossoub, a Master Certified Coach, has a Ph.D. in human behavior and counseling and co-founded Vital Signs, a coaching/consulting company with a global presence in Houston and Beirut. She is passionate about addressing burnout, especially among healthcare professionals and coaches. In this episode, Dr. Ghossoub identifies the red flags of burnout, the importance of wellness and emotional intelligence, and how to address burnout. She stresses the necessity of prioritizing self-care for coaches and shares helpful tools and resources. Show Highlights:Dr. Zeina's passion for wellness for those in the caring professionsWhat is burnout?Severe burnout symptoms are similar to those of PTSD!The contributing factors to burnout for coachesFor coaches, fighting burnout begins with overall wellness and emotional intelligence.Dr. Zeina's focus on physical wellness from her perspective as a dietitian and coachRed flags of burnout symptomsWhere a coach should start in addressing burnout and seeking helpIf you have unmet expectations, a lack of control over what you're doing, and insufficient rewards, you are likely heading toward burnout.The value in evaluations and assessments in addressing burnout (Dr. Zeina recommends the Maslach Burnout Inventory)Resources:Connect with Dr. Zeina Ghossoub: Vital Signs Website, LinkedIn, Facebook, and InstagramDownload the Maslach Burnout Inventory that Dr. Zeina recommends!Work with Meg! A few spots remain for the Fall STaR Coach Show Mentor Program! It's quickly approaching; we begin in late August!Visit the STaR Coach Show YouTube Channel!Explore past episodes and other resources at www.STaRcoachshow.com. Explore the STaR Coach Community and see what's available there for you!

This week we are revealing part 2 of our talk with Dr. Meredith Krause about burnout and compassion fatigue. She talks about the Maslach Burnout Inventory. We found this free tool that you might find useful.   https://www.mindtools.com/auhx7b3/burnout-self-test This podcast may not be suitable to all listeners due to language and subject matters. Please listen with care. Send us your comments and suggestions podcast911delta@yahoo.com Facebook: https://www.facebook.com/911Delta      Instagram: https://www.instagram.com/911deltatethered4life TikTok: @911deltatethered4life

Compilation Episode 3This is a bonus longer episode; a compilation of episodes 11-16 of the podcast so you can listen to them back-to-back.3:06 Episode 11 - ConnectionWe are all bound by the connection of treating patients and working in healthcare. Why do we forget that at times? And how can we improve that connection.9:50 Episode 12 - MindfulnessIs mindfulness still a dirty word in your mind in healthcare?This episode explores what I feel it means in real life and I look at practical mindfulness techniques that you can undertake anywhere at anytime in healthcare - however busy or distracted you might be.20:27 Episode 13 - ReflectionReflection is defined as serious thought or consideration. How often do you give episodes of work 'serious thought or consideration'?Reflection can be used positively to enhance your work and improve your learning. In this episode I talk about how reflection can easily be added to your thoughts about work beyond being a forced written piece for your appraisal.31:56 Episode 14 - EducationTwo definitions of education: "The process of receiving or giving instruction" or "An enlightening experience". Some thoughts on that definition and what I feel are the key components to bear in mind as an educator: Engagement, Understanding and Remembering.PS A slip of the tongue at 12:11 when I refer to Maslach's Hierachy of Needs ... I was conflating Maslach's Burnout Inventory (https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory)and Maslow's Hierachy of Needs (https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs).43:19 Episode 15 - CharityThis episode originally aired just before Christmas and that time of year always makes me think of charity and how lucky and privileged I am to have the life I have, and how so many people rely on charities for the basics of human life of warmth, food and education.In this episode I explore the benefits to healthcare workers of working with, raising money for or donating to charities; reflecting a bit on my time with the Calendar Lads of Northumbria.51:02 Episode 16 - ChristmasAs healthcare professionals we know we are going to be working at some point over the Christmas and New Year period.In this episode I reflect back on what Christmas has meant to me working clinically over the years.I leave you with a link to a funny Christmas song which does contain some offensive lyrics, but I think it sums up nicely how to conduct yourself in this festive time: https://www.youtube.com/watch?v=JmoG4JY_T58Support the showThanks for listening,James@JMACeducation

Episode 14 - EducationTwo definitions of education: "The process of receiving or giving instruction" or "An enlightening experience". Some thoughts on that definition and what I feel are the key components to bear in mind as an educator: Engagement, Understanding and Remembering.This episode is a couple of days late as I was at the Developing Excellence in Medical Educators Conference: https://www.demec.org.uk/and the rest of the podcast is some thoughts inspired by this conference focussing on how we can improve ourselves as educators.PS A slip of the tongue at 12:11 when I refer to Maslach's Hierachy of Needs ... I was conflating Maslach's Burnout Inventory (https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory)and Maslow's Hierachy of Needs (https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs).Support the showThanks for listening,James@JMACeducation

Dr Yvonne Couch, narrates her blog written for the Dementia Researcher website. In her blog, Yvonne tackles the issue of academic burnout, drawing from her personal experiences and insights from the podcast 'No Stupid Questions'. She discusses her own misconceptions about burnout, initially viewing it as extreme exhaustion, and discovers her potential vulnerability to it through self-assessment and the Maslach Burnout Inventory. Her exploration reveals that burnout in academia often stems from institutional deficits rather than personal circumstances, highlighting the importance of organisational support and recognition in combating this growing issue among academics. Find the original text, and narration here on our website. https://www.dementiaresearcher.nihr.ac.uk/blog-frazzled-brains-academic-burnout/ -- Dr Yvonne Couch is an Alzheimer's Research UK Fellow and Associate Professor at the University of Oxford. Yvonne studies the role of extracellular vesicles and their role in changing the function of the vasculature after stroke, aiming to discover why the prevalence of dementia after stroke is three times higher than the average. It is her passion for problem solving and love of science that drives her, in advancing our knowledge of disease. Yvonne writes about her work, academic life, and careers as she takes a new road into independent research @dr_yvonne_couch -- Enjoy listening? We're always looking for new bloggers, drop us a line. http://www.dementiaresearcher.nihr.ac.uk This podcast is brought to you in association with Alzheimer's Association, Alzheimer's Research UK, Alzheimer's Society and Race Against Dementia, who we thank for their ongoing support.

As a listener of the ATA podcast show, we understand how deeply you care about the well-being of the animals you work with. However, at times, your role as a positive reinforcement trainer can feel isolating, stressful, and overwhelming. At ATA, we don't want anyone to feel this way, especially knowing how diligently our listeners strive to make a positive impact on the lives of both animal and human learners they work with. Enter Dr. Kathie Nurena, a human physician and a certified dog trainer. Kathie deeply understands how learning theory and positive reinforcement principles can benefit both animals and humans. Having graduated from Albert Einstein College of Medicine and Karen Pryor Academy, Kathie's unique background blends medicine and dog training, providing her with a truly unique perspective on the challenges faced in caring roles. In this episode, together with Kathie, you'll learn about: Trauma-Informed Care: Discover the essence of trauma-informed care and how its principles can be integrated into your role as a trainer. Patient-Centred Care and Compassion Satisfaction: Explore the significance of shifting focus from compassion fatigue to compassion satisfaction. Learn how reframing your thoughts can play a pivotal role in your professional journey, both in preventing burnout and enhancing satisfaction. Emotions, Reinforcement, and Hope: Gain insights into the Maslow scale and pro qual questionnaires, and discover how "hope" (Healthy Outcomes through Positive Experiences) can benefit you. By the end of this episode, you'll be equipped with new knowledge and ideas to help avoid feelings of overwhelm and burnout. This will boost your confidence as a trainer, enabling you to have your biggest possible positive impact on the lives of both animal and human learners you work with. Links/references; The original Adverse Childhood Experiences (ACE) questionnaire >>> https://www.ncjfcj.org/wp-content/uploads/2006/10/Finding-Your-Ace-Score.pdf Maslach Burnout Inventory >>> https://pscentre.org/wp-content/uploads/2023/04/Maslach-Burnout-Inventory-.pdf ProQol >>> https://proqol.org/proqol-measure Healthy Outcomes From Positive Experiences (HOPE) >>> https://positiveexperience.org/about-us/ Trauma informed care from CDC >>> https://www.cdc.gov/orr/infographics/6_principles_trauma_info.htm Crisis phone line in USA >>> https://988lifeline.org/ Crisis text line in USA >>> https://www.crisistextline.org/ Clicker Expo Live (Kathie & Linda present Sat Jan 27 8-10 am pacific time) >>> https://clickerexpo.clickertraining.com/clicker-expo-virtual/live-2024-conference-program/ Videos A talk by Dr Nadine Burke Harris (16 minutes) >>> https://youtu.be/95ovIJ3dsNk?si=nI_NtlOeN_0KUunv Three and a half minute video on trauma-informed care >>> https://youtu.be/fWken5DsJcw?si=pCZTrKe3Xgz9oujI

Something I NEVER thought I would have to say... I have been diagnosed with functional burnout!I found myself struggling to wake up in the morning and had a feeling of emotional exhaustion.  I was no longer feeling excited and I felt disconnected from my feelings of who I wanted to be.Through self reflection and research I found Dr. Christina Maslach, the pioneer of the Maslach Burnout Inventory.  It's the most used tool for measuring job burnout!Our sacral center, is our largest motor center.  It works like a battery, you have to put into the reserves in order to get something back.  As women, we know that our sacral replenishment does not replenish in a 24 hour period.As a Generator, my motors powered me through it (burnout).  They're not in tune with the reasoning of what is happening.  Often we can experience hormonal imbalances during burnout.  I discovered that I have extremely high estrogen even though I did not have any of the physical symptoms.Looking back I had too much mental output and I need to reboot!  Some of what I did was:Go back to my human design chart  to recognize again my life purposeWorked on a trust hypnosisAsked the universe how I can get back on trackLived in the moment and was presentThe universe told me to trust in timing and to not speed through life!If you are going through burnout PLEASE reach out to me!  I am happy to share my resources and help you get through this phase in life.Get in on the limited group program, Designed On Purpose >>>Join us now! >>>Human Design Society is now accepting founding members! Head over here to join the community at the lowest price it will ever be!Download your free Human Design body graph here.Want to book your Human Design chart reading?Head over here to pick your dateInterested in personalized coaching that's unique to YOUR design for your life or business?Book a coffee chat with me for freeI look forward to getting to know you better so please subscribe, rate, and review this episode!Connect with me on Instagram (@adrikeefe)Head over to www.AdrianaKeefe.com for your free Human Design body chart, tools, tips, and more!

In part two of this three-part series on Culture, Andy and Mon-Chaio wrangle with the question "Is there 'better culture' to aim for?" Along the way they delve into bad culture, focusing on values or on outcomes, differences between what people say and what people do, burnout, and pillars of a good tech culture. Opening quote from "A Strong Market Culture Drives Organizational Performance and Success". References: Joy at Work: https://dennisbakke.com/joy-at-work/ Espoused Theory and Theory in Use: http://www.aral.com.au/resources/argyris.html Maslach Burnout Inventory: https://www.mindgarden.com/117-maslach-burnout-inventory-mbi Understanding the burnout experience: recent research and its implications for psychiatry: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911781/ Compassion and Curiosity values: https://cdn.csu.edu.au/__data/assets/pdf_file/0008/917018/Eight-Behaviors-for-Smarter-Teams-2.pdf A Strong Market Culture Drives Organizational Performance and Success: https://www.researchgate.net/publication/227995656_A_strong_market_culture_drives_organizational_performance_and_success Squeezing the Orange Podcast "When Time is Money": https://squeezingtheorange.podbean.com/e/when-time-is-money/ GLOBE Project Cultural Dimensions: https://globeproject.com/study_2004_2007 --- Send in a voice message: https://podcasters.spotify.com/pod/show/tactics-tech-leadership/message

Burnout is still an issue for so many of our listeners. In fact burnout is so pervasive that over seventy-five percent of the workforce is currently, or has previously experienced it.  As a refresher, it feels like depletion, exhaustion, disconnection, negative emotions and reduced capacity...sound familiar?  You're not alone!    SHOW NOTES Burnout is a  real diagnosis - and defined as “chronic workplace stress that has not been successfully managed” by the World Health Organization.  This relatively new diagnosis is defined as a “syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and 3) reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”   Christina Maslach (creator of the Maslach Burnout Inventory) first identified the syndrome - and it came out of her work with healthcare workers and their families.  Here are her inventory questions:   How often are you tired and lacking energy to go to work in the morning? How often do you feel physically drained, like your batteries are dead? How often is your thinking process sluggish or your concentration impaired? How often do you feel emotionally detached from co-workers (or customers) and unable to be sensitive to their needs?   Does it sound like you?  If you are like most of us - yes, at least some teimes.   How does this happen?  When we carry too much for too long and cannot effectively process our emotions, our neurological system gets overloaded - and we are unable to effectively deal with this overload.   Who does this happen to?  Well, all of us, but those of us that are anxious or have a low self esteem or poor boundaries are thought to be more likely to suffer burnout, according to a study of Spanish nurses.  According to authors Rachel Montane and Erika Pryor, women of color also carry the emotional burden of discrimination, fear of retaliation - and of course much of the emotional labor of diversity in the workplace..   Employers contribute to burnout by unfair treatment, an unmanageable workload, unrealistic deadlines, poor communication and a lack of support.   Enter Drs. Emily and Amelia Nagoski, authors of Burnout, who just happen to be identical twins.  They have concluded, based on their research, that the key to preventing burnout is to manage the emotions you are having so that we do not become emotionally exhausted.  They encourage us to process the emotion - actually turn towards it, and feel it.  Scary!!  But we can do it.   Here are the twins' suggestions to deal with, process and get on the other side of our emotions.   Engage in physical activity Try breathing exercises Make positive connections with people you love and care about (call someone or better yet go for a walk with a friend) Laugh - a great big belly laugh Hug for 20 seconds - the full slightly uncomfortable 20 seconds Cry - they promise it will not go on forever Be Creative - paint, sing, dance, write   The key is to send our body a signal that the danger is over, we are safe.  And how do we know our emotions have been processed and we are “done?”  The twin doctors promise your body will tell you.   Be aware of your depletion clues.  Are you sleeping well and enough?  Are you engaging in activities where you do not think of work? Are you taking breaks at work?  Do you have work-life boundaries?   The solution to burnout is actually more than self-care.  It is more about managing emotions.    While burnout is prevalent, there are things we can do to recognize our vulnerability, determine whether it is happening to us and work to relieve that chronic stress through the processing of emotions.     More good reads: How to Recover From Burnout & Love Work Again According to Science   How to Eliminate Burnout and Retain Top Talent  

Dr. Christina Maslach is on a mission to redefine how we tackle burnout at work. For over 35 years, Dr. Maslach has researched the far reaching costs of burnout on society. Her commitment to this work led the World Health Organization to recognize burnout as an occupational phenomenon in 2019, raising the stakes for organizations worldwide. Today, Dr. Maslach is paving the way for meaningful workplace interventions that help people avoid burnout and be their best at work.Dr. Christina Maslach is the pioneer of research on the definition, predictors, and measurement of job burnout. She is a researcher, author, former administrator, and distinguished professor emerita of psychology at UC Berkeley. Dr. Maslach is also the creator of the Maslach Burnout Inventory, the leading measure of burnout in the workplace validated by over three decades of research. In this episode, Dart and Christina discuss:- Dr. Maslach's latest book, The Burnout Challenge- The impact of employee burnout on business success- Chronic job stressors and what to do about them- The effect of burnout on employee engagement and retention- Compassion fatigue at work- Components of the Maslach Burnout Inventory (MBI)- The six causes of burnout - And other topics…Dr. Christina Maslach is a researcher, author, former administrator, and distinguished professor emerita of psychology at the University of California, Berkeley. She is the creator of the Maslach Burnout Inventory, the leading measure of burnout in the workplace validated by over 35 years of research. She is also the author of numerous award-winning articles and books, including The Cost of Caring, The Truth About Burnout, and The Burnout Challenge. Christian received her B.A. from Harvard University and her Ph.D. from Stanford University. She was named by Business Insider as one of the top 100 people transforming business in 2021. With over three decades of experience, she is the pioneer of research on the definition, predictors, and measurement of job burnout. Dr. Maslach's expertise led the World Health Organization to recognize burnout as an occupational phenomenon in 2019. Resources Mentioned:The Burnout Challenge, by Christina Maslach and Michael Leiter: https://www.amazon.com/Burnout-Challenge-Managing-Peoples-Relationships/dp/B0BLXX1T1W The Cost of Caring, by Christina Maslach: https://www.amazon.com/Burnout-Cost-Caring-Christina-Maslach/dp/1883536359 

Welcome to an episode with Christina Maslach, PhD, a professor of psychology (Emerita) and a researcher at the Healthy Workplaces Center at the University of California, Berkeley.  In this episode, we discuss the causes of burnout and the factors contributing to it, and how leaders and organizations can address this issue to provide a sustainable and healthy working environment for their employees.  Christina Maslach, PhD, received her BA from Harvard and her PhD from Stanford. She is best known as the pioneering researcher on job burnout, producing the standard assessment tool (the Maslach Burnout Inventory, MBI), books, and journal articles. She has received numerous awards for her work, including both academic (the 2020 award for scientific writing from the National Academy of Sciences) and public (named in 2021 as one of the top 100 people transforming business, by Business Insider). In addition, she is an award-winning teacher and was Professor of the Year in 1997. As an administrator, she was Vice Provost for Undergraduate Education and Instructional Technology, and the Chair of the faculty Academic Senate (twice) at UC-Berkeley. She was the president of the Western Psychological Association when it celebrated its 100th anniversary in 2020. She is now interviewing women faculty who arrived at Berkeley in the 1970s, after the historic low point for women in the 1960s. Get Christina's new book here: The Burnout Challenge: Managing People's Relationships with Their Jobs. Christina Maslach and Michael P. Leiter Enjoying this episode? Get access to sample advanced training episodes here: www.firmsconsulting.com/promo

Helping me in this episode is the remarkable Christina Maslach. You will not find anyone more knowledgeable on burnout than her.If you don't believe me, her work is the basis for the 2019 World Health Organization (WHO) decision to include burnout as an occupational phenomenon.Christina started her psychology research career in the early 1970s, and her work led to the co-creation of the Maslach Burnout Inventory. This is a measure of professional burnout that is still being used today.She is currently a Professor of Psychology at the University of California, Berkeley, where she's taught for nearly 50 years. She is no ordinary teacher because, in 1997, she was named USA Professor of the Year.She is the co-author of a new book called, The Burnout Challenge: Managing People's Relationships with Their Jobs.Arianna Huffington stated, “The Burnout Challenge offers tips and tools to evaluate problems and implement solutions…Vital reading for today's and tomorrow's leaders.”00:16 to 01:59 - Intro11:32 to 12:26 - How we learn from each other to make better choices24:01 to 25:15 - Looking at the job and the person and what makes us do well.********************Make sure to follow the show, so you don't miss upcoming episodes!********************Guy Kawasaki is on a mission to make you remarkable. His Remarkable People podcast features interviews with remarkable people such as Jane Goodall, Neil deGrasse Tyson, Marc Benioff, Woz, Kristi Yamaguchi, and Bob Cialdini. Every episode will make you more remarkable.With his decades of experience in Silicon Valley as a Venture Capitalist and advisor to the top entrepreneurs in the world, Guy's questions come from a place of curiosity and passion for technology, start-ups, entrepreneurship, and marketing. If you love society and culture, documentaries, and business podcasts, take a second to follow Remarkable People.Listeners of the Remarkable People podcast will learn from some of the most successful people in the world with practical tips and inspiring stories that will help you be more remarkable.Episodes of Remarkable People organized by topic: https://bit.ly/rptopologyListen to Remarkable People here:https://podcasts.apple.com/us/podcast/guy-kawasakis-remarkable-people/id1483081827Text to get notified of new episodes: https://joinsubtext.com/guyLike this show? Please leave us a review -- even one sentence helps! Consider including your Twitter handle so we can thank you personally!Thank you for your support; it helps the show!

Welcome to Strategy Skills episode 330, an episode with Christina Maslach, PhD, a professor of psychology (Emerita) and a researcher at the Healthy Workplaces Center at the University of California, Berkeley.  In this episode, we discuss the causes of burnout and the factors contributing to it, and how leaders and organizations can address this issue to provide a sustainable and healthy working environment for their employees.  Christina Maslach, PhD, received her BA from Harvard and her PhD from Stanford. She is best known as the pioneering researcher on job burnout, producing the standard assessment tool (the Maslach Burnout Inventory, MBI), books, and journal articles. She has received numerous awards for her work, including both academic (the 2020 award for scientific writing from the National Academy of Sciences) and public (named in 2021 as one of the top 100 people transforming business, by Business Insider). In addition, she is an award-winning teacher and was Professor of the Year in 1997. As an administrator, she was Vice Provost for Undergraduate Education and Instructional Technology, and the Chair of the faculty Academic Senate (twice) at UC-Berkeley. She was the president of the Western Psychological Association when it celebrated its 100th anniversary in 2020. She is now interviewing women faculty who arrived at Berkeley in the 1970s, after the historic low point for women in the 1960s. Get Christina's new book here: The Burnout Challenge: Managing People's Relationships with Their Jobs. Christina Maslach and Michael P. Leiter Enjoying this episode? Get access to sample advanced training episodes here: www.firmsconsulting.com/promo  

Leading burnout expert Dr. Christina Maslach shares the fundamental causes of burnout and what individuals and organizations can do to fix them. — YOU'LL LEARN — 1) Why burnout isn't just an individual problem 2) The 6 key areas of job mismatch that cause burnout 3) What to do when you're burnt out Subscribe or visit AwesomeAtYourJob.com/ep832 for clickable versions of the links below. — ABOUT CHRISTINA — Dr. Christina Maslach is Professor of Psychology, Emerita, at the University of California, Berkeley, and the co-creator of the Maslach Burnout Inventory, the most widely used instrument for measuring job burnout, and has written numerous articles and books, including The Truth About Burnout. In 2020 she received the Scientific Reviewing award from the National Academy of Sciences for her writing on burnout. In 2021, she was named by Business Insider as one of the top 100 people transforming business. She also consults on the identification of sources of burnout and potential interventions. • Book: The Burnout Challenge: Managing People's Relationships with Their Jobs • Website: Christina Maslach, UC Berkeley — RESOURCES MENTIONED IN THE SHOW — • Book: A Burnt-Out Case by Graham GreeneSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

About ChristinaChristina Maslach, PhD, is a Professor of Psychology (Emerita) and a researcher at the Healthy Workplaces Center at the University of California, Berkeley.  She received her A.B. from Harvard, and her Ph.D. from Stanford.  She is best known as the pioneering researcher on job burnout, producing the standard assessment tool (the Maslach Burnout Inventory, MBI), books, and award-winning articles.  The impact of her work is reflected by the official recognition of burnout, as an occupational phenomenon with health consequences, by the World Health Organization in 2019.  In 2020, she received the award for Scientific Reviewing, for her writing on burnout, from the National Academy of Sciences.  Among her other honors are: Fellow of the American Association for the Advancement of Science (1991 -- "For groundbreaking work on the application of social psychology to contemporary problems"), Professor of the Year (1997), and the 2017 Application of Personality and Social Psychology Award (for her research career on job burnout).  Links: The Truth About Burnout: https://www.amazon.com/Truth-About-Burnout-Organizations-Personal/dp/1118692136 TranscriptAnnouncer: Hello, and welcome to Screaming in the Cloud with your host, Chief Cloud Economist at The Duckbill Group, Corey Quinn. This weekly show features conversations with people doing interesting work in the world of cloud, thoughtful commentary on the state of the technical world, and ridiculous titles for which Corey refuses to apologize. This is Screaming in the Cloud.Corey: If you asked me to rank which cloud provider has the best developer experience, I'd be hard-pressed to choose a platform that isn't Google Cloud. Their developer experience is unparalleled and, in the early stages of building something great, that translates directly into velocity. Try it yourself with the Google for Startups Cloud Program over at cloud.google.com/startup. It'll give you up to $100k a year for each of the first two years in Google Cloud credits for companies that range from bootstrapped all the way on up to Series A. Go build something, and then tell me about it. My thanks to Google Cloud for sponsoring this ridiculous podcast.Corey: This episode is brought to us by our friends at Pinecone. They believe that all anyone really wants is to be understood, and that includes your users. AI models combined with the Pinecone vector database let your applications understand and act on what your users want… without making them spell it out. Make your search application find results by meaning instead of just keywords, your personalization system make picks based on relevance instead of just tags, and your security applications match threats by resemblance instead of just regular expressions. Pinecone provides the cloud infrastructure that makes this easy, fast, and scalable. Thanks to my friends at Pinecone for sponsoring this episode. Visit Pinecone.io to understand more.Corey: Welcome to Screaming in the Cloud. I'm Corey Quinn. One subject that I haven't covered in much depth on this show has been a repeated request from the audience, and that is to talk a bit about burnout. So, when I asked the audience who I should talk to about burnout, there were really two categories of responses. The first was, “Pick me. I hate my job, and I'd love to talk about that.” And the other was, “You should speak to Professor Maslach.” Christina Maslach is a Professor of Psychology at Berkeley. She's a teacher and a researcher, particularly in the area of burnout. Professor, welcome to the show.Dr. Maslach: Well, thank you for inviting me.Corey: So, I'm going to assume from the outset that the reason that people suggest that I speak to you about burnout is because you've devoted a significant portion of your career to studying the phenomenon, and not just because you hate your job and are ready to go do something else. Is that directionally correct?Dr. Maslach: That is directionally correct, yes. I first stumbled upon the phenomenon back in the 1970s—which is, you know, 45, almost 50 years ago now—and have been fascinated with trying to understand what is going on.Corey: So, let's start at the very beginning because I'm not sure in, I guess, the layperson context that I use the term that I fully understand it. What is burnout?Dr. Maslach: Well, burnout as we have been studying it over many years, it's a stress phenomenon, okay, it's a response to stressors, but it's not just the exhaustion of stress. That's one component of it, but it actually has two other components that go along with it. One is this very negative, cynical, hostile attitude toward the job and the other people in it, you know, “Take this job and shove it,” kind of feeling. And usually, people don't begin their job like that, but that's where they go if they become more burned out.Corey: I believe you may have just inadvertently called out a decent proportion of the tech sector.Dr. Maslach: [laugh].Corey: Or at least, that might just be my internal cynicism rising to the foreground.Dr. Maslach: No, it's not. Actually, I have heard from a number of tech people over the past decades about just this kind of issue. And so I think it's particularly relevant. The third component that we see going along with this, it usually comes in a little bit later, but I've heard a lot about this from tech people as well, and that is that you begin to develop a very negative sense of your own self, and competence, and where you're going, and what you're able to do. So, the stress response of exhaustion, the negative cynicism towards the job, the negative evaluation of yourself, that's the trifecta of burnout.Corey: You've spent a lot of your early research at least focusing on, I guess, occupations that you could almost refer to as industrial, in some respects: working with heavy equipment, working with a variety of different professionals in very stressful situations. It feels weird, on some level, to say, “Oh, yeah, my job is very stressful. In that vein, I have to sit in front of a computer all day, and sometimes I have to hop on a meeting with people.” And it feels, on some level, like that even saying, “I'm experiencing burnout,” in my role is a bit of an overreach.Dr. Maslach: Yeah, that's an interesting point because, in fact, yes, when we think about OSHA, you know, and occupational risks and hazards, we do think about the chemicals, and the big equipment, and the hazards, so having more psychological and social risk factors, is something that probably a lot of people don't resonate to immediately and think, well, if you're strong, and if you're resilient, and whatever, you can—anybody can handle that, and that's really a test almost of your ability to do your work. But what we're finding is that it has its own hazards, psychological and social as well. And so, burnout is something that we've seen in a lot of more people-oriented professions, from the beginning. Healthcare has had this for a long time. Various kinds of social services, teaching, all of these other things. So, it's actually not a sign of weakness as some people might think.Corey: Right. And that's part of the challenge and, honestly, one of the reasons that I've stayed away from having in-depth discussions about the topic of burnout on the show previously is it feels that—rightly or wrongly, and I appreciate your feedback on this one either way—it feels like it's approaching the limits of what could be classified as mental health. And I can give terrible advice on how computers work—in fact, I do on a regular basis; it's kind of my thing—and that's usually not going to have any lasting impact on people who don't see through the humor part of that. But when we start talking about mental health, I'm cautious because it feels like an inadvertent story or advice that works for some but not all, has the potential to do a tremendous bit of damage, and I'm very cautious about that. Is burnout a mental health issue? Is it a medical issue that is recognized? Where does it start, okay does it stop on that spectrum?Dr. Maslach: It is not a medical issue—and the World Health Organization, which just came out with a statement about this in 2019 on burnout, they're recognizing it as an occupational risk factor—made it very clear that this is not a medical thing. It is not a medical disease, it doesn't have a certain set of medical diagnoses, although people tend to sometimes go there. Can it have physical health outcomes? In other words, if you're burning out and you're not sleeping well, and you're not eating well, and not taking care of yourself, do you begin to impair your physical health down the road? Yes.Could it also have mental health outcomes, that you begin to feel depressed, and anxious, and not knowing what to do, and afraid of the future? Yes, it could have those outcomes as well. So, it certainly is kind of like—I can put it this way, like a stepping stone in a path to potential negative health: physical health, or mental health issues. And I think that's one of the reasons why it is so important. But unfortunately, a lot of people still view it as somebody who's burned out isn't tough enough, strong enough, they're wimpy, they're not good enough, they're not a hundred percent.And so the stigma that is often attached to burnout, people not only indulge it, but they feel it directed towards them, and often they will try to hide the kinds of experiences they're having because they worry that they are going to be judged negatively, thrown under the bus, you know, let go from the job, whatever, if they talk about what's actually happening with them.Corey: What do you see, as you look around, I guess, the wide varieties of careers that are susceptible to burnout—which I have a sneaking suspicion based upon what you've said rounds to all of them—what do you think is the most misunderstood, or misunderstood aspects of burnout?Dr. Maslach: I think what's most misunderstood is that people assume that it is a problem of the individual person. And if somebody is burned out, then they've got to just take care of themselves, or take a break, or eat better, or get more sleep, all of those kinds of things which cope with stressors. What's not as well understood or focused on is the fact that this is a response to other stressors, and these stressors are often in the workplace—this is where I've been studying it—but in essentially in the larger social, physical environment that people are functioning in. They're not burning out all by themselves.There's a reason why they are feeling the kind of exhaustion, developing that cynicism, beginning to doubt themselves, that we see with burnout. So there, if you ever want to talk about preventing burnout, you really have to be focusing on what are the various kinds of things that seem to be causing the problem, and how do we modify those? Coping with stressors is a good thing, but it doesn't change the stressors. And so we really have to look at that, as well as what people can bring about, you know, taking care of themselves or trying to do the job better or differently.Corey: I feel like it's impossible to have a conversation like this without acknowledging the background of the past year that many of us have spent basically isolated, working from home. And for some folks, okay, they were working from home before, but it feels different now. At least that's the position I find myself in. Other folks are used to going into an office and now they're either isolated—and research shows that it has been worse, statistically, for single people versus married people, but married people are also trapped at home with their spouse, which sounds half-joking but it is very real. At some point, distance is useful.And it feels like everyone is sort of a bit at their wit's end. It feels like things are closer to being frayed, there's a constant sense that there's this, I guess, pervasive dread for the past year. Are you seeing that that has a potential to affect how burnout is being expressed or perceived?Dr. Maslach: I think it has, and one of the things that we clearly see is that people are using the word burnout, more and more and more and more. It's almost becoming the word du jour, and using it to describe, things are going wrong and it's not good. And it may be overstretching the use of burnout, but I think the reason of the popularity of the term is that it has this kind of very vivid imagery of things going up in smoke, and can't handle it, and flames licking at your heels, and all this sort of stuff so that they can do that. I even got a comment from a colleague in France just a few days ago, where they're talking about, “Is burnout the malady of the century?” you know, kind of thing. And it's being used a lot; it's sometimes maybe overused, but I think it's also striking a chord with people as a sign that things are going badly, and I don't know how to deal with it in some way.Corey: It also feels, on some level, for those of us who are trapped inside, it kind of almost feels like it's a tremendous expression of privilege because who am I to have a problem with this? Oh, I have to go inside and order a lot of takeout and spend time with my family. And I look at how folks who are nowhere near as privileged have to go and be essential workers and show up in increasingly dangerous positions. And it almost feels like burnout isn't something that I'm entitled to, if that makes sense.Dr. Maslach: [laugh]. Yeah. It's an interesting description of that because I think there are ways in which people are looking at their experience and dealing with it, and like many things in life, I find that all of these things are a bit of a double-edged sword; there's positive and there's negative aspects to them. And so when I've talked with some people about now having to work from home rather than working in their office, they're also bringing up, “Well, hey, I've noticed that the interviews I'm doing with potential clients are actually going a little better”—you know, this is from a law office—“And trying to figure out how—are we doing it differently so that people can actually relate to each other as human beings instead of the suit and tie in the big office? What's going on in terms of how we're doing the work that there may be actually a benefit here?”For others. It's been, “Oh, my gosh. I don't have to commute, but endless meetings and people are thinking I'm not doing my job, and I don't know how to get in touch, and how do we work together effectively?” And so there's other things that are much more difficult, in some sense. I think another thing that you have to keep in mind that it's not just about how you're doing your work, perhaps differently, or you're under different circumstances, but people, so many people have lost their jobs, and are worried that they may lose their jobs.That we're actually finding that people are going into overdrive and working harder and more hours as a way of trying to protect from being the next one who won't have any income at all. So, there's a lot of other dynamics that are going on as a result of the pandemic, I think, that we need to be aware of.Corey: One thing that I'd like to point out is that you are a Professor Emerita of Psychology at Berkeley, which means you presumably wound up formulating this based upon significant bodies of peer-reviewed research, as opposed to just coming up with a thesis, stating it as if it were fact, and then writing an entire series of books on it. I mean, that path, I believe, is called being a venture capitalist, but I may be mistaken on that front. How do you effectively study something like burnout? It feels like it is so subjective and situation-specific, but it has to have a normalization aspect to it.Dr. Maslach: Uh, yeah, that's a good point. I think, in fact, the first time I ever wrote about some of the stuff that I was learning about burnout back in the mid '70s—I think it was '75, '76 maybe—and it was in a magazine, it wasn't in a journal. It wasn't peer-reviewed because not even peer-reviewed journals would review this; they thought it was pop psychology, and eh. So, I would get, in those days, snail mail by the sackfuls from people saying, “Oh, my God. I didn't know anybody else felt like this. Let me tell you my story.”You know, kind of thing. And so that was really, after doing a lot of interviews with people, following them on the job when possible to, sort of, see how things were going, and then writing about the basic themes that were coming out of this, it turned out that there were a lot of people who responded and said, “I know that. I've been there. I'm experiencing it.” Even though each of them were sort of thinking, “I'm the only one. What's wrong with me? Everybody else seems fine.”And so part of the research in trying to get it out in whatever form you can is trying to share it because that gives you feedback from a wide variety of people, not only the peers reviewing the quality of the research, but the people who are actually trying to figure out how to deal effectively with this problem. So it's, how do I and my colleagues actually have a bigger, broader conversation with people from which we learn a lot, and then try and say, okay, and here's everything we've heard, and let's throw it back out and share it and see what people think.Corey: You have written several books on the topic, if I'm not mistaken. And one thing that surprises me is how much what you talk about in those books seems to almost transcend time. I believe your first was published in 1982—Dr. Maslach: Right.Corey: —if I'm not mistaken—Dr. Maslach: Yes.Corey: —and it's an awful lot of what it talks about still feels very much like it could be written today. Is this just part of the quintessential human experience? Or has nothing new changed in the last 200 years since the Industrial Revolution? How is it progressing, if at all, and what does the future look like?Dr. Maslach: Great questions and I don't have a good answer for you. But we have sort of struggled with this because if you look at older literature, if you even go back centuries, if you even go back in parts of the Bible or something, you're seeing phrases and descriptions sometime that says sounds a lot like burnout, although we're not using that term. So, it's not something that I think just somehow got invented; it wasn't invented in the '70s or anything like that. But trying to trace back those roots and get a better sense of what are we capturing here is fascinating, and I think we're still working on it.People have asked, well, where did the term ‘burnout' as opposed to other kinds of terms come from? And it's been around for a while, again, before the '70s or something. I mean, we have Graham Greene writing the novel A Burnt-Out Case, back in the early '60s. My dad was an engineer, rarefied gas dynamics, so he was involved with the space program and engineers talk about burnout all the time: ball bearings burn out, rocket boosters burn out. And when they started developing Silicon Valley, all those little startups and enterprises, they advertised as burnout shops. And that was, you know, '60s, into the '70s, et cetera, et cetera. So, the more modern roots, I think probably have some ties to that use of the term before I and other researchers even got started with it.Corey: This episode is sponsored in part by our friends at Uptycs, because they believe that many of you are looking to bolster your security posture with CNAPP and XDR solutions. They offer both cloud and endpoint security in a single UI and data model. Listeners can get Uptycs for up to 1,000 assets through the end of 2023 (that is next year) for $1. But this offer is only available for a limited time on UptycsSecretMenu.com. That's U-P-T-Y-C-S Secret Menu dot com.Corey: This is one of those questions that is incredibly self-serving, and I refuse to apologize for it. How can I tell whether I'm suffering from burnout, versus I'm just a jerk with an absolutely terrible attitude? And that is not as facetious a question as it probably sounds like.Dr. Maslach: [laugh]. Yeah. Well, part of the problem for me—or the challenge for me—is to understand what it is people need to know about themselves. Can I take a diagnostic test which tells me if I am burned out or if I'm something else?Sort of the more important question is, what is feeling right and what is not feeling so good—or even wrong—about my experience? And usually, you can't figure that all out by yourself and you need to get other input from other people. And it could be a counselor or therapist, or it could be friends or colleagues who you have to be able to get to a point where we can talk about it, and hear each other, and get some feedback without putdowns, just sort of say, “Yeah, have you ever thought about the fact that when you get this kind of a task, you usually just go crazy for a while and not really settle down and figure out what you really need to do as opposed to what you think you have to do?” Part of this, are you bringing yourself in terms of the stress response, but what is it that you're not doing—or that you're doing not well—to figure out solutions, to get help or advice or better input from others. So, it takes time, but it really does take a lot of that kind of social feedback.So, when I said—if I can stay with it a little bit more—when I first was writing and publishing about and all these people were writing back saying, “I thought I was the only one,” that phenomenon of putting on a happy face and not letting anybody else see that you're going through some difficult challenges, or feeling bad, or depressed, or whatever is something we call pluralistic ignorance; means we don't have good knowledge about what is normal, or what is being shared, or how other people are because we're all pretending to put on the happy face, to pretend and make sure that everybody thinks we're okay and is not going to come after us. But if we all do that, then we all, together, are creating a different social reality that people perceive rather than actually what is happening behind that mask.Corey: It feels, on some level, like this is an aspect of the social media problem, where we're comparing our actual lives and all the bloopers that we see to other people's highlight reels because few people wind up talking very publicly about their failures.Dr. Maslach: Oh, yeah. Yeah. And often for good reason because they know they will be attacked and dumped. And there could be some serious consequences, and you just say, “I'm going to figure out what I'm going to do on my own.”But one of the things that when I work with people, and I'm asking them, “What do you think would help? What sort of things that don't happen could happen?” And so forth, one of the things that goes to the top of the list is having somebody else; a safe relationship, a safe place where we can talk, where we can unburden, where you're not going to spill the beans to everybody else, and you're getting advice, or you're getting a pat on the back, or a shoulder to cry on, and that you're there for them for the same kind of reason. So, it's a different form of what we think of as social network. It used to be that a network like that meant that you had other people, whether family, friends, neighbors, colleagues, whoever, that you knew, you could go to; a mentor, an advisor, a trusted ally, and that you would perform that role for them and other people, as well.And what has happened, I think, to add to the emphasis on burnout these days, is that those social connections, those trusts, between people has really been shredding, and, you know—or cut off or broken apart. And so people are feeling isolated, even if they're surrounded by a lot of other people, don't want to raise their hand, don't want to say, “Can we talk over coffee? I'm really having a bad day. I need some help to figure out this problem.” And so one of those most valuable resources that human beings need—which is other people—is, if we're working in environments where that gets pulled apart, and shredded, and it's lacking, that's a real risk factor for burnout.Corey: What are the things that contribute to burnout? It doesn't feel, based upon what you've said so far, that it's one particular thing. There has to be points of commonality between all of this, I have to imagine.Dr. Maslach: Yeah.Corey: Is it possible to predict that, oh, this is a scenario in which either I or people who are in this role are likely to become burned out faster?Dr. Maslach: Mm-hm. Yeah. Good question and I don't know if we have a final answer, but at this point, in terms of all the research that's been done, not just on burnout, but on much larger issues of health, and wellbeing, and stress, and coping, and all the rest of it, there are clearly six areas in which the fit between people and their job environment are critical. And if the fit is—or the match, or the balance—is better, they are going to be at less risk for burnout, they're more likely to be engaged with work.But if some real bad fits, or mismatches, occur in one or more of these areas, that raises the risk factor for burnout. So, if I can just mention those six quickly. And these are not in any particular order because I find that people assume the first one is the worst or the best, and it's not. Any rate, one of them has to do with that social environment I was just talking about; think of it as the workplace community. All the people whose paths you cross at various points—you know, coworkers, the people you supervise, your bosses, et cetera—so those social relationships, that culture, do you have a supportive environment which really helps people thrive? Can you trust people, there's respect, and all that kind of thing going on? Or is it really what people are now describing as a socially toxic work environment?A second area has to do with reward. And it turns out not so much salary and benefits, it's more about social recognition and the intrinsic reward you get from doing a good job. So, if you work hard, do some special things, and nothing positive happens—nobody even pats you on the back, nobody says, “Gee, why don't you try this new project? I think you're really good at it,” anything that acknowledges what you've done—it's a very difficult environment to work in. People who are more at risk of burnout, when I asked them, “What is a good day for you? A good day. A really good day.” And the answer is often, “Nothing bad happens.” But it's not the presence of good stuff happening, like people glad that you did such good work or something like that.Third area has to do with values—and this is one that also often gets ignored, but sometimes this is the critical bottom line—that you're doing work that you think is meaningful, where you're working has integrity, and you're in line with that as opposed to value conflicts where you're doing things that you think are wrong: “I want to help people, I want to help cure patients, and here, I'm actually only supposed to be trying to help the hospital get more money.” When they have that kind of value conflict, this is often where they have to say, “I don't want to sell my soul and I'm leaving.”The fourth area is one of fairness. And this is really about that whatever the policies, the principles, et cetera, they're administered fairly. So, when things are going badly here—the mismatch—this is where discrimination lives, this is where glass ceilings are going on, that people are not being treated fairly in terms of the work they do, how they're promoted, or all of those kinds of things. So, that interpersonal respect, and, sort of, social justice is missing.The next two areas—the fifth and six—are probably the two that had been the most well-known for a long time. One has to do with workload and how manageable it is. Given the demands that you have, do you have sufficient resources, like time, and tools, and whatever other kind of teams support you need to get the job done. And control is about the amount of autonomy and the opportunities you have to perhaps improvise, or innovate, or correct, or figure out how to do the job better in some way. So, when people are having mismatches in work overload; a lack of control; you cannot improvise; where you have unfairness; where there is values that are just incompatible with what you believe is right, a sort of moral issue; where you're not getting any kind of positive feedback, even when it's deserved, for the kind of work you're doing; and when you're working in a socially toxic relationship where you can't trust people, you don't know who to turn to, people are having unresolved conflicts all the time. Those six areas are, those are the markers really of risk factors for burnout.Corey: I know that I'm looking back through my own career history listening to you recount those and thinking, “Oh, maybe I wasn't just a terrible employee in every one of those situations.”Dr. Maslach: Exactly.Corey: I'm sure a lot of it did come from me, I want to be very clear here. But there's also that aspect of this that might not just be a ‘me' problem.Dr. Maslach: Yeah. That's a good way of putting it. It's really in some sense, it's more of a ‘we' problem than a ‘me' problem. Because again, you're not working in isolation, and the reciprocal relationship you have with other people, and other policies, and other things that are happening in whatever workplace that is, is creating a kind of larger environment in which you and many others are functioning.And we've seen instances where people begin to make changes in that environment—how do we do this differently? How can we do this better, let's try it out for a while and see if this can work—and using those six areas, the value is not just, “Oh, it's really in bad shape. We have huge unfairness issues.” But then it says, “It would be better if we could figure out a way to get rid of that fairness problem, or to make a modification so that we have a more fair process on that.” So, they're like guideposts as well.As people start thinking through these six areas, you can sort of say, “What's working well, in terms of workload, what's working badly? Where do we run into problems on control? How do we improve the social relationships between colleagues who have to work together on a team?” They're not just markers of what's gone wrong, but they can—if you flip it around and look at it, let's look at the other end—okay is a path that we could get better? Make it right?Corey: If people want to learn more about burnout in general, and you're working in it specifically, where can they go to find your work and learn more about what you have to say?Dr. Maslach: Obviously, there's been a lot of articles, and now lots of things on the web, and in past books that I've written. And as you said, in many ways, they are still pretty relevant. The Truth About Burnout came out, oh gosh, '97. So, that's 25 years ago and it's still work.But my colleague, Michael Leiter from Canada, and I have just written up a new manuscript for a new book in which we really are trying to focus on sharing everything we have learned about, you know, what burnout has taught us, and put that into a format of a book that will allow people to really take what we've learned and figure out how does this apply? How can this be customized to our situation? So, I'm hoping that that will be coming out within the next year.Corey: And you are, of course, welcome back to discuss your book when it releases.Dr. Maslach: I would be honored if you would have me back. That would be a wonderful treat.Corey: Absolutely. But in return, I do expect a pre-release copy of the manuscript, so I have something intelligent to talk about.Dr. Maslach: [laugh]. Of course, of course.Corey: Thank you so much for your time. I really appreciate it.Dr. Maslach: Well, thank you for having me. I appreciate the opportunity to share this, especially during these times.Corey: Indeed. Professor Christina Maslach, Professor Emeritus of Psychology at Berkeley, I'm Cloud Economist Corey Quinn, and this is Screaming in the Cloud. If you've enjoyed this podcast, please leave a five-star review on your podcast platform of choice, whereas if you've hated this podcast, please leave a five-star review on your podcast platform of choice along with an insulting comment telling me why you're burned out on this show.Corey: If your AWS bill keeps rising and your blood pressure is doing the same, then you need The Duckbill Group. We help companies fix their AWS bill by making it smaller and less horrifying. The Duckbill Group works for you, not AWS. We tailor recommendations to your business and we get to the point. Visit duckbillgroup.com to get started.Announcer: This has been a HumblePod production. Stay humble.

Christina Maslach: The Burnout Challenge Christina Maslach is the pioneer of research on job burnout, producing the standard assessment tool called the Maslach Burnout Inventory, award-winning articles, and several books, beginning with Burnout: The Cost of Caring, in 1982. Her research achievements over the past five decades have led to multiple awards from the National Academy of Sciences, Western Psychological Association, Society for Personality and Social Psychology, and many others. Christina has received awards for her outstanding teaching, including USA Professor of the Year in 1997. She has been a Professor of Psychology at the University of California, Berkeley since 1971. Christina is now a core researcher at the Healthy Workplaces Center, at Berkeley, and the author along with Michael Leiter of The Burnout Challenge: Managing People's Relationships With Their Jobs*. In this conversation, Christina and I address the reality that burnout is often perceived as an issue with just the individual. We explore how leaders can begin to look at the larger picture: context, culture, and management, in order to address burnout more proactively. We discuss key mindsets that will help and a few tactics that almost every leader can use to get started. Key Points The canary in the coal mine is an indicator of a problem, not the source of it. Our tendency is to focus on the person (the figure) and to miss all the context and environment factors (the ground). Burnout is first and foremost a management issue. “Fixing” the person should not be the focus — instead, get curious about where there is a mismatch. Instead of focusing on what's wrong with the person, shift to what may be wrong in the relationship between the person and situation. Ensure you have a plan for communicated survey results. If you'd done surveys previously, share those results and also the actions the organization had taken before engaging in more surveys. Resources Mentioned The Burnout Challenge: Managing People's Relationships With Their Jobs* by Christina Maslach and Michael Leiter Interview Notes Download my interview notes in PDF format (free membership required). Related Episodes Gallup Findings on the Changing Nature of Work, with Jim Harter (episode 409) How to Reduce Burnout, with Jennifer Moss (episode 561) How to Compare Yourself to Others, with Mollie West Duffy (episode 582) Discover More Activate your free membership for full access to the entire library of interviews since 2011, searchable by topic.

What causes burnout? So often, conversations around burnout center on the effect — the burnout itself — rather than the cause. It is only when the conversation focuses on the chronic job stressors at the root of burnout, can organizations begin to tackle the problem.  Because at its root, burnout is an indication of a misalignment between people and their jobs. By identifying where these misalignments occur, organizations can make adjustments which improve employees' relationships with their jobs. In this episode of Get Reworked, Christina Maslach, pioneer of research on workplace burnout, creator of the Maslach Burnout Inventory standard assessment tool and author of "The Burnout Challenge," shares the key factors that influence whether we have positive or negative relationships with our jobs. Christina has studied the relationships people have with their work and what organizations can do to improve those relationships for over four decades. Listen: Get Reworked Full Episode List "If we're going to do anything about why burnout occurs, as opposed to focusing on who is getting it, we need to focus on what's causing it, we need to prevent the impact of those stressors, reduce them, or have them be better managed, so that they don't occur as often all of these kinds of things," said Christina. Highlights of the conversation include: Why burnout and stress aren't synonymous. Why vacations and self-care are only short-term solutions. How burnout is more than an individual issue. The importance of networks and community in alleviating burnout. The six areas where organizations can focus to improve alignment between people and their jobs. Plus, host Siobhan Fagan talks with Christina about hustle culture, the upsides and the downsides of a daily commute and chardonnay burnout. Listen in for more. Have a suggestion, comment or topic for a future episode? Send it to editors@reworked.co.

“I'm burned out” is a familiar phrase in higher ed these days. This episode explores: What burnout is and is not. One scholar's personal experience with burnout. How higher ed's culture and the “expectation escalation” encourage burnout. Academic capitalism and its relationship to faculty burnout. The missing voices from the conversation on burnout. Imposter syndrome and how it plays out for women, especially, in the academy. Our guest is: Dr. Rebecca Pope-Ruark, Director of the Office of Faculty Professional Development at the Georgia Institute of Technology. She is the author of Unraveling Faculty Burnout: Pathways to Reckoning and Renewal (Johns Hopkins University Press, 2022) and Agile Faculty: Practical Strategies for Managing Research, Service, and Teaching (The University of Chicago Press, 2017) as well as the coeditor of Redesigning Liberal Education: Innovative Design for a Twenty-First-Century Undergraduate Education (Johns Hopkins University Press, 2020). Our host is: Dr. Dana M. Malone, co-producer and co-host of The Academic Life channel. Dana is energized by facilitating meaningful conversations and educational experiences for folks across the academy and beyond. Dana is the author of From Single to Serious: Relationships, Gender, and Sexuality on American Evangelical Campuses, (Rutgers University Press). Listeners to this episode may also be interested in: This Chronicle of Higher Education article on how to cope with Covid-19 burnout. This Inside Higher Ed article on beating pandemic burnout. The Maslach Burnout Inventory for Educators (MBI-ES). This Academic Life conversation on community building and how we show up. This Academic Life conversation on being well in academia. This Academic Life conversation on finding your people and making meaningful connections. Welcome to The Academic Life! You are smart and capable, but you aren't an island, and neither are we. We reach across our mentor network to bring you podcasts on everything from how to finish that project to how to take care of your beautiful mind. Here on the Academic Life channel, we embrace a broad definition of what it means to be an academic and to lead an academic life. We view education as a transformative human endeavor and are inspired by today's knowledge-producers working inside and outside the academy. Wish we'd bring on an expert about something? DMs us on Twitter: @AcademicLifeNBN. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

“I'm burned out” is a familiar phrase in higher ed these days. This episode explores: What burnout is and is not. One scholar's personal experience with burnout. How higher ed's culture and the “expectation escalation” encourage burnout. Academic capitalism and its relationship to faculty burnout. The missing voices from the conversation on burnout. Imposter syndrome and how it plays out for women, especially, in the academy. Our guest is: Dr. Rebecca Pope-Ruark, Director of the Office of Faculty Professional Development at the Georgia Institute of Technology. She is the author of Unraveling Faculty Burnout: Pathways to Reckoning and Renewal (Johns Hopkins University Press, 2022) and Agile Faculty: Practical Strategies for Managing Research, Service, and Teaching (The University of Chicago Press, 2017) as well as the coeditor of Redesigning Liberal Education: Innovative Design for a Twenty-First-Century Undergraduate Education (Johns Hopkins University Press, 2020). Our host is: Dr. Dana M. Malone, co-producer and co-host of The Academic Life channel. Dana is energized by facilitating meaningful conversations and educational experiences for folks across the academy and beyond. Dana is the author of From Single to Serious: Relationships, Gender, and Sexuality on American Evangelical Campuses, (Rutgers University Press). Listeners to this episode may also be interested in: This Chronicle of Higher Education article on how to cope with Covid-19 burnout. This Inside Higher Ed article on beating pandemic burnout. The Maslach Burnout Inventory for Educators (MBI-ES). This Academic Life conversation on community building and how we show up. This Academic Life conversation on being well in academia. This Academic Life conversation on finding your people and making meaningful connections. Welcome to The Academic Life! You are smart and capable, but you aren't an island, and neither are we. We reach across our mentor network to bring you podcasts on everything from how to finish that project to how to take care of your beautiful mind. Here on the Academic Life channel, we embrace a broad definition of what it means to be an academic and to lead an academic life. We view education as a transformative human endeavor and are inspired by today's knowledge-producers working inside and outside the academy. Wish we'd bring on an expert about something? DMs us on Twitter: @AcademicLifeNBN. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/academic-life

“I'm burned out” is a familiar phrase in higher ed these days. This episode explores: What burnout is and is not. One scholar's personal experience with burnout. How higher ed's culture and the “expectation escalation” encourage burnout. Academic capitalism and its relationship to faculty burnout. The missing voices from the conversation on burnout. Imposter syndrome and how it plays out for women, especially, in the academy. Our guest is: Dr. Rebecca Pope-Ruark, Director of the Office of Faculty Professional Development at the Georgia Institute of Technology. She is the author of Unraveling Faculty Burnout: Pathways to Reckoning and Renewal (Johns Hopkins University Press, 2022) and Agile Faculty: Practical Strategies for Managing Research, Service, and Teaching (The University of Chicago Press, 2017) as well as the coeditor of Redesigning Liberal Education: Innovative Design for a Twenty-First-Century Undergraduate Education (Johns Hopkins University Press, 2020). Our host is: Dr. Dana M. Malone, co-producer and co-host of The Academic Life channel. Dana is energized by facilitating meaningful conversations and educational experiences for folks across the academy and beyond. Dana is the author of From Single to Serious: Relationships, Gender, and Sexuality on American Evangelical Campuses, (Rutgers University Press). Listeners to this episode may also be interested in: This Chronicle of Higher Education article on how to cope with Covid-19 burnout. This Inside Higher Ed article on beating pandemic burnout. The Maslach Burnout Inventory for Educators (MBI-ES). This Academic Life conversation on community building and how we show up. This Academic Life conversation on being well in academia. This Academic Life conversation on finding your people and making meaningful connections. Welcome to The Academic Life! You are smart and capable, but you aren't an island, and neither are we. We reach across our mentor network to bring you podcasts on everything from how to finish that project to how to take care of your beautiful mind. Here on the Academic Life channel, we embrace a broad definition of what it means to be an academic and to lead an academic life. We view education as a transformative human endeavor and are inspired by today's knowledge-producers working inside and outside the academy. Wish we'd bring on an expert about something? DMs us on Twitter: @AcademicLifeNBN. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/education

“I'm burned out” is a familiar phrase in higher ed these days. This episode explores: What burnout is and is not. One scholar's personal experience with burnout. How higher ed's culture and the “expectation escalation” encourage burnout. Academic capitalism and its relationship to faculty burnout. The missing voices from the conversation on burnout. Imposter syndrome and how it plays out for women, especially, in the academy. Our guest is: Dr. Rebecca Pope-Ruark, Director of the Office of Faculty Professional Development at the Georgia Institute of Technology. She is the author of Unraveling Faculty Burnout: Pathways to Reckoning and Renewal (Johns Hopkins University Press, 2022) and Agile Faculty: Practical Strategies for Managing Research, Service, and Teaching (The University of Chicago Press, 2017) as well as the coeditor of Redesigning Liberal Education: Innovative Design for a Twenty-First-Century Undergraduate Education (Johns Hopkins University Press, 2020). Our host is: Dr. Dana M. Malone, co-producer and co-host of The Academic Life channel. Dana is energized by facilitating meaningful conversations and educational experiences for folks across the academy and beyond. Dana is the author of From Single to Serious: Relationships, Gender, and Sexuality on American Evangelical Campuses, (Rutgers University Press). Listeners to this episode may also be interested in: This Chronicle of Higher Education article on how to cope with Covid-19 burnout. This Inside Higher Ed article on beating pandemic burnout. The Maslach Burnout Inventory for Educators (MBI-ES). This Academic Life conversation on community building and how we show up. This Academic Life conversation on being well in academia. This Academic Life conversation on finding your people and making meaningful connections. Welcome to The Academic Life! You are smart and capable, but you aren't an island, and neither are we. We reach across our mentor network to bring you podcasts on everything from how to finish that project to how to take care of your beautiful mind. Here on the Academic Life channel, we embrace a broad definition of what it means to be an academic and to lead an academic life. We view education as a transformative human endeavor and are inspired by today's knowledge-producers working inside and outside the academy. Wish we'd bring on an expert about something? DMs us on Twitter: @AcademicLifeNBN. Learn more about your ad choices. Visit megaphone.fm/adchoices

The Behavioral View panel welcomes Dr. Becca Tagg, owner of Del Mar Behavioral Services, to discuss burnout through a lens of community care (as opposed to self-care). In this episode, we define stress and burnout and emphasize the differences between them. We identify risk factors for burnout, including behaviors of the individual, leadership, and the cultural context of the organization. We wrap up with tangible things leaders can do to create a community care model within.  To earn CEUs for listening, click here, log in or sign up, pay the CEU fee, + take the attendance verification to generate your certificate! Don't forget to subscribe and follow and leave us a rating and review Show Notes: References Houmanfar, R. & Johnson, R. (2004.  Organizational implications of gossip and rumor, Journal of Organizational Behavior Management, 23:2-3, 117-138, DOI: 10.1300/J075v23n02_07 Jaffe, S. (2021). Work won't love you back: How devotion to our jobs keeps us exploited, exhausted, and alone. New York: Bold Type Books. Parry-Cruwys, R. (Host). (2020, June 17). Staff Turnover w/ Dr. Byron Wine. (No. 139). [Audio podcast episode]. In ABA On Track. https://www.abainsidetrack.com/home/2020/6/17/episode-129-staff-turnover.  Plantiveau, Camille & Dounavi, Katerina & Virués-Ortega, Javier. (2018). High Levels of Burnout among Early-Career Board-Certified Behavior Analysts with Low Collegial Support. European Journal of Behavior Analysis. 19, 195-207. 10.1080/15021149.2018.1438339. Wine, B., Osborne, M. R., & Newcomb, E. T. (2020). On Turnover in Human Services. Behavior analysis in practice, 13(2), 492–501. https://doi.org/10.1007/s40617-019-00399-6 World Health Organization. (2016). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines (10th ed.). Geneva: World Health Organization. World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/ Resources BACB Certificant Data:  https://www.bacb.com/bacb-certificant-data/ The Business of Behavior website and podcast: https://thebusinessofbehavior.com/ Del Mar Behavioral Health https://delmarbehavioralhealth.com/ Maslach Burnout Inventory: https://www.mindgarden.com/314-mbi-human-services-survey

Feel exhausted, cynical, and utterly ineffective at work? There's a cure for what ails you.  --- Jonathan Malesic had always dreamed of being a college professor. The reality, however, didn't match up to his expectations. It got to the point where he found it difficult to drag himself out of bed to teach a class. Nothing seemed to help: therapy, medication, even extended leave.  So he quit.  Obviously, that's not the solution for everyone. But in his new book The End of Burnout: Why work drains us and how to build better lives, Malesic reflects on his own experience as well as our “burnout culture” that primes us for exhaustion.  In this interview on Life & Faith, Malesic describes that culture as a toxic combination of deteriorating working conditions – think stagnant wages, the gig economy, the decline of union membership – as well as our overinvestment in work as a source of meaning and purpose (“do what you love”). Then there's the “badge of honour” in being a “work martyr” – someone so committed to work they're prepared to sacrifice themselves to the cause.  To plot a path out of burnout, Malesic turns to unlikely sources – like the ora et labora (prayer and work) rhythms of Benedictine monks at Christ in the Desert Monastery in New Mexico. There, the monks tame the “demon of work” by subordinating it to their higher callings. If you've ever felt demoralised about your job, this is an interview that will name your spiritual ills and convince you that there is more to life than work. -- Explore: Buy Jonathan Malesic's book The End of Burnout: Why work drains us and how to build better lives Follow him on Twitter Sign up for his newsletter Interested in the Maslach Burnout Inventory? Find more info here.

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Burnout: What is it and how to Treat it. , published by Elizabeth on theeffective altruism forum. Introduction Lately there has been considerable concern among effective altruists about burnout. People are worried about themselves or others being less productive or just plain miserable. The goal of this report is to bring people up to speed on the scientific research about burnout and, when possible, make recommendations about alleviation and prevention. Unfortunately, the scientific literature has few specific recommendations to make, so I would like to use this as an opportunity to foster discussion about what has worked and not worked for people personally. Look for those comments below. The goal is for this to be useful to individual workers in treating their own burnout, and to organizational decision makers in preventing burnout organization-wide. [Studies are actually mixed on if burnout reduces productivity, with some even showing burnout associated with higher productivity. My interpretation here is that high standards for yourself lead to both high performance and burnout.] Tl;dr Social support == Good. Sleep == Good. Ambiguity == Bad. Vacations == Meh. What is Burnout? The official definition of burnout is “physical or mental collapse caused by overwork or stress”. That kind of implies that a person can't work when burnt out, but that's not my experience- ceasing work when you're burnt out is a privilege. But working when you're burnt out is miserable, and makes burnout worse, so even if circumstances improve you're in a hole. Burnout was originally conceived of in the caring professions (e.g. nursing and social work), which are emotionally demanding in several different ways. This has by and large not been born out scientifically; other professions burn out just as hard, with perhaps slightly different patterns on the Maslach Burnout Inventory, the most popular measure of burnout. Based mostly on personal observation I strongly suspect there are multiple types of burnout, which can co-occur, and which current instruments are not sensitive enough to differentiate. Of particular interest to this crowd is the difference between burnout caused by hating your job or not having the resources it demands, vs. loving your job too much and being sucked into giving more than you should. I suspect that the latter is more heavily represented among effective altruists than in the literature. The Maslach Burnout Inventory (used in >90% of studies) divides burnout into three parts: exhaustion, cynicism, and (perceived) personal efficacy. The MBI has been shown to be internally consistent and cross-culturally valid. On the other hand, it has mixed results in distinguishing burnout from traditional depression or anxiety, and I could find no studies demonstrating any predictive value of the inventory — the closest was two studies showing MBI predicted an increase in thoughts of suicide and dropping out of school among med students. In contrast, the Copenhagen Burnout Inventory has one whole study showing a that a high score predicts future sickness absence, sleep problems, and use of painkillers. The CBI measures only exhaustion, and separately tracks personal burnout, work burnout, and client burnout. I would have liked to give preference to studies using the CBI because it has more empirical validation, but there simply weren't enough to rely on, so most of the studies referred to in this post use the MBI. By far the most popular model of burnout in the literature is “Job Demands - Resources”, or “JD-R”, which posits that high job demands lead to exhaustion, and low resources lead to cynicism and feelings of low personal efficacy. “Demands” and “Resources” are defined fairly broadly here. Demands includes things like “coping with conflicting goals” and resources includes ...

Burnout feels like depletion, exhaustion, disconnection, negative emotions and reduced capacity...sound familiar?  You're not alone! In fact burnout is so pervasive that over seventy-five percent of the workforce is currently, or has previously experienced it.     SHOW NOTES Burnout is a  real diagnosis - and defined as “chronic workplace stress that has not been successfully managed” by the World Health Organization.  This relatively new diagnosis is defined as a “syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and 3) reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”   Christina Maslach (creator of the Maslach Burnout Inventory) first identified the syndrome - and it came out of her work with healthcare workers and their families.  Here are her inventory questions:   How often are you tired and lacking energy to go to work in the morning? How often do you feel physically drained, like your batteries are dead? How often is your thinking process sluggish or your concentration impaired? How often do you feel emotionally detached from co-workers (or customers) and unable to be sensitive to their needs?   Does it sound like you?  If you are like most of us - yes, at least some teimes.   How does this happen?  When we carry too much for too long and cannot effectively process our emotions, our neurological system gets overloaded - and we are unable to effectively deal with this overload.   Who does this happen to?  Well, all of us, but those of us that are anxious or have a low self esteem or poor boundaries are thought to be more likely to suffer burnout, according to a study of Spanish nurses.  According to authors Rachel Montane and Erika Pryor, women of color also carry the emotional burden of discrimination, fear of retaliation - and of course much of the emotional labor of diversity in the workplace..   Employers contribute to burnout by unfair treatment, an unmanageable workload, unrealistic deadlines, poor communication and a lack of support.   Enter Drs. Emily and Amelia Nagoski, authors of Burnout, who just happen to be identical twins.  They have concluded, based on their research, that the key to preventing burnout is to manage the emotions you are having so that we do not become emotionally exhausted.  They encourage us to process the emotion - actually turn towards it, and feel it.  Scary!!  But we can do it.   Here are the twins' suggestions to deal with, process and get on the other side of our emotions.   Engage in physical activity Try breathing exercises Make positive connections with people you love and care about (call someone or better yet go for a walk with a friend) Laugh - a great big belly laugh Hug for 20 seconds - the full slightly uncomfortable 20 seconds Cry - they promise it will not go on forever Be Creative - paint, sing, dance, write   The key is to send our body a signal that the danger is over, we are safe.  And how do we know our emotions have been processed and we are “done?”  The twin doctors promise your body will tell you.   Be aware of your depletion clues.  Are you sleeping well and enough?  Are you engaging in activities where you do not think of work? Are you taking breaks at work?  Do you have work-life boundaries?   The solution to burnout is actually more than self-care.  It is more about managing emotions.    While burnout is prevalent, there are things we can do to recognize our vulnerability, determine whether it is happening to us and work to relieve that chronic stress through the processing of emotions.     More good reads: How to Recover From Burnout & Love Work Again According to Science   How to Eliminate Burnout and Retain Top Talent

With workloads spinning out of control and workers not always getting the support they need, it's no wonder “burnout” has become a buzzword. Enter Christina Maslach, PhD, a professor of psychology at the University of California, Berkeley, and a pioneer in the field of burnout research. In this episode, she explains just what burnout means — and what it doesn't. She reveals some hard truths about what “mental health days” can do — and what they can't. But most importantly, she offers a way forward, laying out six paths to a healthy workplace. Drawing on Dr Maslach's decades of research, we can all learn to change our work environments for the better. Mind-Body LinksWe weren't kidding when we called her “burnout royalty.” See Dr Maslach's full credentials, accomplishments and awards.  Geek out with host Jaclyn Byrer on the research methods behind the full Maslach Burnout Inventory. Feeling stressed or frustrated? Check out this article to learn how exercise can help.

About Christina Christina Maslach, PhD, is a Professor of Psychology (Emerita) and a researcher at the Healthy Workplaces Center at the University of California, Berkeley.  She received her A.B. from Harvard, and her Ph.D. from Stanford.  She is best known as the pioneering researcher on job burnout, producing the standard assessment tool (the Maslach Burnout Inventory, MBI), books, and award-winning articles.  The impact of her work is reflected by the official recognition of burnout, as an occupational phenomenon with health consequences, by the World Health Organization in 2019.  In 2020, she received the award for Scientific Reviewing, for her writing on burnout, from the National Academy of Sciences.  Among her other honors are: Fellow of the American Association for the Advancement of Science (1991 -- "For groundbreaking work on the application of social psychology to contemporary problems"), Professor of the Year (1997), and the 2017 Application of Personality and Social Psychology Award (for her research career on job burnout).  Links: The Truth About Burnout: https://www.amazon.com/Truth-About-Burnout-Organizations-Personal/dp/1118692136 TranscriptAnnouncer: Hello, and welcome to Screaming in the Cloud with your host, Chief Cloud Economist at The Duckbill Group, Corey Quinn. This weekly show features conversations with people doing interesting work in the world of cloud, thoughtful commentary on the state of the technical world, and ridiculous titles for which Corey refuses to apologize. This is Screaming in the Cloud.Corey: This episode is sponsored in part by Thinkst. This is going to take a minute to explain, so bear with me. I linked against an early version of their tool, canarytokens.org in the very early days of my newsletter, and what it does is relatively simple and straightforward. It winds up embedding credentials, files, that sort of thing in various parts of your environment, wherever you want to; it gives you fake AWS API credentials, for example. And the only thing that these things do is alert you whenever someone attempts to use those things. It's an awesome approach. I've used something similar for years. Check them out. But wait, there's more. They also have an enterprise option that you should be very much aware of canary.tools. You can take a look at this, but what it does is it provides an enterprise approach to drive these things throughout your entire environment. You can get a physical device that hangs out on your network and impersonates whatever you want to. When it gets Nmap scanned, or someone attempts to log into it, or access files on it, you get instant alerts. It's awesome. If you don't do something like this, you're likely to find out that you've gotten breached, the hard way. Take a look at this. It's one of those few things that I look at and say, “Wow, that is an amazing idea. I love it.” That's canarytokens.org and canary.tools. The first one is free. The second one is enterprise-y. Take a look. I'm a big fan of this. More from them in the coming weeks.Corey: This episode is sponsored in part by our friends at Lumigo. If you've built anything from serverless, you know that if there's one thing that can be said universally about these applications, it's that it turns every outage into a murder mystery. Lumigo helps make sense of all of the various functions that wind up tying together to build applications. It offers one-click distributed tracing so you can effortlessly find and fix issues in your serverless and microservices environment. You've created more problems for yourself; make one of them go away. To learn more, visit lumigo.io.Corey: Welcome to Screaming in the Cloud. I'm Corey Quinn. One subject that I haven't covered in much depth on this show has been a repeated request from the audience, and that is to talk a bit about burnout. So, when I asked the audience who I should talk to about burnout, there were really two categories of responses. The first was, “Pick me. I hate my job, and I'd love to talk about that.” And the other was, “You should speak to Professor Maslach.” Christina Maslach is a Professor of Psychology at Berkeley. She's a teacher and a researcher, particularly in the area of burnout. Professor, welcome to the show.Dr. Maslach: Well, thank you for inviting me.Corey: So, I'm going to assume from the outset that the reason that people suggest that I speak to you about burnout is because you've devoted a significant portion of your career to studying the phenomenon, and not just because you hate your job and are ready to go do something else. Is that directionally correct?Dr. Maslach: That is directionally correct, yes. I first stumbled upon the phenomenon back in the 1970s—which is, you know, 45, almost 50 years ago now—and have been fascinated with trying to understand what is going on.Corey: So, let's start at the very beginning because I'm not sure in, I guess, the layperson context that I use the term that I fully understand it. What is burnout?Dr. Maslach: Well, burnout as we have been studying it over many years, it's a stress phenomenon, okay, it's a response to stressors, but it's not just the exhaustion of stress. That's one component of it, but it actually has two other components that go along with it. One is this very negative, cynical, hostile attitude toward the job and the other people in it, you know, “Take this job and shove it,” kind of feeling. And usually, people don't begin their job like that, but that's where they go if they become more burned out.Corey: I believe you may have just inadvertently called out a decent proportion of the tech sector.Dr. Maslach: [laugh].Corey: Or at least, that might just be my internal cynicism rising to the foreground.Dr. Maslach: No, it's not. Actually, I have heard from a number of tech people over the past decades about just this kind of issue. And so I think it's particularly relevant. The third component that we see going along with this, it usually comes in a little bit later, but I've heard a lot about this from tech people as well, and that is that you begin to develop a very negative sense of your own self, and competence, and where you're going, and what you're able to do. So, the stress response of exhaustion, the negative cynicism towards the job, the negative evaluation of yourself, that's the trifecta of burnout.Corey: You've spent a lot of your early research at least focusing on, I guess, occupations that you could almost refer to as industrial, in some respects: working with heavy equipment, working with a variety of different professionals in very stressful situations. It feels weird, on some level, to say, “Oh, yeah, my job is very stressful. In that vein, I have to sit in front of a computer all day, and sometimes I have to hop on a meeting with people.” And it feels, on some level, like that even saying, “I'm experiencing burnout,” in my role is a bit of an overreach.Dr. Maslach: Yeah, that's an interesting point because, in fact, yes, when we think about OSHA, you know, and occupational risks and hazards, we do think about the chemicals, and the big equipment, and the hazards, so having more psychological and social risk factors, is something that probably a lot of people don't resonate to immediately and think, well, if you're strong, and if you're resilient, and whatever, you can—anybody can handle that, and that's really a test almost of your ability to do your work. But what we're finding is that it has its own hazards, psychological and social as well. And so, burnout is something that we've seen in a lot of more people-oriented professions, from the beginning. Healthcare has had this for a long time. Various kinds of social services, teaching, all of these other things. So, it's actually not a sign of weakness as some people might think.Corey: Right. And that's part of the challenge and, honestly, one of the reasons that I've stayed away from having in-depth discussions about the topic of burnout on the show previously is it feels that—rightly or wrongly, and I appreciate your feedback on this one either way—it feels like it's approaching the limits of what could be classified as mental health. And I can give terrible advice on how computers work—in fact, I do on a regular basis; it's kind of my thing—and that's usually not going to have any lasting impact on people who don't see through the humor part of that. But when we start talking about mental health, I'm cautious because it feels like an inadvertent story or advice that works for some but not all, has the potential to do a tremendous bit of damage, and I'm very cautious about that. Is burnout a mental health issue? Is it a medical issue that is recognized? Where does it start, okay does it stop on that spectrum?Dr. Maslach: It is not a medical issue—and the World Health Organization, which just came out with a statement about this in 2019 on burnout, they're recognizing it as an occupational risk factor—made it very clear that this is not a medical thing. It is not a medical disease, it doesn't have a certain set of medical diagnoses, although people tend to sometimes go there. Can it have physical health outcomes? In other words, if you're burning out and you're not sleeping well, and you're not eating well, and not taking care of yourself, do you begin to impair your physical health down the road? Yes.Could it also have mental health outcomes, that you begin to feel depressed, and anxious, and not knowing what to do, and afraid of the future? Yes, it could have those outcomes as well. So, it certainly is kind of like—I can put it this way, like a stepping stone in a path to potential negative health: physical health, or mental health issues. And I think that's one of the reasons why it is so important. But unfortunately, a lot of people still view it as somebody who's burned out isn't tough enough, strong enough, they're wimpy, they're not good enough, they're not a hundred percent.And so the stigma that is often attached to burnout, people not only indulge it, but they feel it directed towards them, and often they will try to hide the kinds of experiences they're having because they worry that they are going to be judged negatively, thrown under the bus, you know, let go from the job, whatever, if they talk about what's actually happening with them.Corey: What do you see, as you look around, I guess, the wide varieties of careers that are susceptible to burnout—which I have a sneaking suspicion based upon what you've said rounds to all of them—what do you think is the most misunderstood, or misunderstood aspects of burnout?Dr. Maslach: I think what's most misunderstood is that people assume that it is a problem of the individual person. And if somebody is burned out, then they've got to just take care of themselves, or take a break, or eat better, or get more sleep, all of those kinds of things which cope with stressors. What's not as well understood or focused on is the fact that this is a response to other stressors, and these stressors are often in the workplace—this is where I've been studying it—but in essentially in the larger social, physical environment that people are functioning in. They're not burning out all by themselves.There's a reason why they are feeling the kind of exhaustion, developing that cynicism, beginning to doubt themselves, that we see with burnout. So there, if you ever want to talk about preventing burnout, you really have to be focusing on what are the various kinds of things that seem to be causing the problem, and how do we modify those? Coping with stressors is a good thing, but it doesn't change the stressors. And so we really have to look at that, as well as what people can bring about, you know, taking care of themselves or trying to do the job better or differently.Corey: I feel like it's impossible to have a conversation like this without acknowledging the background of the past year that many of us have spent basically isolated, working from home. And for some folks, okay, they were working from home before, but it feels different now. At least that's the position I find myself in. Other folks are used to going into an office and now they're either isolated—and research shows that it has been worse, statistically, for single people versus married people, but married people are also trapped at home with their spouse, which sounds half-joking but it is very real. At some point, distance is useful.And it feels like everyone is sort of a bit at their wit's end. It feels like things are closer to being frayed, there's a constant sense that there's this, I guess, pervasive dread for the past year. Are you seeing that that has a potential to affect how burnout is being expressed or perceived?Dr. Maslach: I think it has, and one of the things that we clearly see is that people are using the word burnout, more and more and more and more. It's almost becoming the word du jour, and using it to describe, things are going wrong and it's not good. And it may be overstretching the use of burnout, but I think the reason of the popularity of the term is that it has this kind of very vivid imagery of things going up in smoke, and can't handle it, and flames licking at your heels, and all this sort of stuff so that they can do that. I even got a comment from a colleague in France just a few days ago, where they're talking about, “Is burnout the malady of the century?” you know, kind of thing. And it's being used a lot; it's sometimes maybe overused, but I think it's also striking a chord with people as a sign that things are going badly, and I don't know how to deal with it in some way.Corey: It also feels, on some level, for those of us who are trapped inside, it kind of almost feels like it's a tremendous expression of privilege because who am I to have a problem with this? Oh, I have to go inside and order a lot of takeout and spend time with my family. And I look at how folks who are nowhere near as privileged have to go and be essential workers and show up in increasingly dangerous positions. And it almost feels like burnout isn't something that I'm entitled to, if that makes sense.Dr. Maslach: [laugh]. Yeah. It's an interesting description of that because I think there are ways in which people are looking at their experience and dealing with it, and like many things in life, I find that all of these things are a bit of a double-edged sword; there's positive and there's negative aspects to them. And so when I've talked with some people about now having to work from home rather than working in their office, they're also bringing up, “Well, hey, I've noticed that the interviews I'm doing with potential clients are actually going a little better”—you know, this is from a law office—“And trying to figure out how—are we doing it differently so that people can actually relate to each other as human beings instead of the suit and tie in the big office? What's going on in terms of how we're doing the work that there may be actually a benefit here?”For others. It's been, “Oh, my gosh. I don't have to commute, but endless meetings and people are thinking I'm not doing my job, and I don't know how to get in touch, and how do we work together effectively?” And so there's other things that are much more difficult, in some sense. I think another thing that you have to keep in mind that it's not just about how you're doing your work, perhaps differently, or you're under different circumstances, but people, so many people have lost their jobs, and are worried that they may lose their jobs.That we're actually finding that people are going into overdrive and working harder and more hours as a way of trying to protect from being the next one who won't have any income at all. So, there's a lot of other dynamics that are going on as a result of the pandemic, I think, that we need to be aware of.Corey: One thing that I'd like to point out is that you are a Professor Emerita of Psychology at Berkeley, which means you presumably wound up formulating this based upon significant bodies of peer-reviewed research, as opposed to just coming up with a thesis, stating it as if it were fact, and then writing an entire series of books on it. I mean, that path, I believe, is called being a venture capitalist, but I may be mistaken on that front. How do you effectively study something like burnout? It feels like it is so subjective and situation-specific, but it has to have a normalization aspect to it.Dr. Maslach: Uh, yeah, that's a good point. I think, in fact, the first time I ever wrote about some of the stuff that I was learning about burnout back in the mid '70s—I think it was '75, '76 maybe—and it was in a magazine, it wasn't in a journal. It wasn't peer-reviewed because not even peer-reviewed journals would review this; they thought it was pop psychology, and eh. So, I would get, in those days, snail mail by the sackfuls from people saying, “Oh, my God. I didn't know anybody else felt like this. Let me tell you my story.”You know, kind of thing. And so that was really, after doing a lot of interviews with people, following them on the job when possible to, sort of, see how things were going, and then writing about the basic themes that were coming out of this, it turned out that there were a lot of people who responded and said, “I know that. I've been there. I'm experiencing it.” Even though each of them were sort of thinking, “I'm the only one. What's wrong with me? Everybody else seems fine.”And so part of the research in trying to get it out in whatever form you can is trying to share it because that gives you feedback from a wide variety of people, not only the peers reviewing the quality of the research, but the people who are actually trying to figure out how to deal effectively with this problem. So it's, how do I and my colleagues actually have a bigger, broader conversation with people from which we learn a lot, and then try and say, okay, and here's everything we've heard, and let's throw it back out and share it and see what people think.Corey: You have written several books on the topic, if I'm not mistaken. And one thing that surprises me is how much what you talk about in those books seems to almost transcend time. I believe your first was published in 1982—Dr. Maslach: Right.Corey: —if I'm not mistaken—Dr. Maslach: Yes.Corey: —and it's an awful lot of what it talks about still feels very much like it could be written today. Is this just part of the quintessential human experience? Or has nothing new changed in the last 200 years since the Industrial Revolution? How is it progressing, if at all, and what does the future look like?Dr. Maslach: Great questions and I don't have a good answer for you. But we have sort of struggled with this because if you look at older literature, if you even go back centuries, if you even go back in parts of the Bible or something, you're seeing phrases and descriptions sometime that says sounds a lot like burnout, although we're not using that term. So, it's not something that I think just somehow got invented; it wasn't invented in the '70s or anything like that. But trying to trace back those roots and get a better sense of what are we capturing here is fascinating, and I think we're still working on it.People have asked, well, where did the term ‘burnout' as opposed to other kinds of terms come from? And it's been around for a while, again, before the '70s or something. I mean, we have Graham Greene writing the novel A Burnt-Out Case, back in the early '60s. My dad was an engineer, rarefied gas dynamics, so he was involved with the space program and engineers talk about burnout all the time: ball bearings burn out, rocket boosters burn out. And when they started developing Silicon Valley, all those little startups and enterprises, they advertised as burnout shops. And that was, you know, '60s, into the '70s, et cetera, et cetera. So, the more modern roots, I think probably have some ties to that use of the term before I and other researchers even got started with it.Corey: This episode is sponsored by ExtraHop. ExtraHop provides threat detection and response for the Enterprise (not the starship). On-prem security doesn't translate well to cloud or multi-cloud environments, and that's not even counting IoT. ExtraHop automatically discovers everything inside the perimeter, including your cloud workloads and IoT devices, detects these threats up to 35 percent faster, and helps you act immediately. Ask for a free trial of detection and response for AWS today at extrahop.com/trial.Corey: This is one of those questions that is incredibly self-serving, and I refuse to apologize for it. How can I tell whether I'm suffering from burnout, versus I'm just a jerk with an absolutely terrible attitude? And that is not as facetious a question as it probably sounds like.Dr. Maslach: [laugh]. Yeah. Well, part of the problem for me—or the challenge for me—is to understand what it is people need to know about themselves. Can I take a diagnostic test which tells me if I am burned out or if I'm something else?Sort of the more important question is, what is feeling right and what is not feeling so good—or even wrong—about my experience? And usually, you can't figure that all out by yourself and you need to get other input from other people. And it could be a counselor or therapist, or it could be friends or colleagues who you have to be able to get to a point where we can talk about it, and hear each other, and get some feedback without putdowns, just sort of say, “Yeah, have you ever thought about the fact that when you get this kind of a task, you usually just go crazy for a while and not really settle down and figure out what you really need to do as opposed to what you think you have to do?” Part of this, are you bringing yourself in terms of the stress response, but what is it that you're not doing—or that you're doing not well—to figure out solutions, to get help or advice or better input from others. So, it takes time, but it really does take a lot of that kind of social feedback.So, when I said—if I can stay with it a little bit more—when I first was writing and publishing about and all these people were writing back saying, “I thought I was the only one,” that phenomenon of putting on a happy face and not letting anybody else see that you're going through some difficult challenges, or feeling bad, or depressed, or whatever is something we call pluralistic ignorance; means we don't have good knowledge about what is normal, or what is being shared, or how other people are because we're all pretending to put on the happy face, to pretend and make sure that everybody thinks we're okay and is not going to come after us. But if we all do that, then we all, together, are creating a different social reality that people perceive rather than actually what is happening behind that mask.Corey: It feels, on some level, like this is an aspect of the social media problem, where we're comparing our actual lives and all the bloopers that we see to other people's highlight reels because few people wind up talking very publicly about their failures.Dr. Maslach: Oh, yeah. Yeah. And often for good reason because they know they will be attacked and dumped. And there could be some serious consequences, and you just say, “I'm going to figure out what I'm going to do on my own.”But one of the things that when I work with people, and I'm asking them, “What do you think would help? What sort of things that don't happen could happen?” And so forth, one of the things that goes to the top of the list is having somebody else; a safe relationship, a safe place where we can talk, where we can unburden, where you're not going to spill the beans to everybody else, and you're getting advice, or you're getting a pat on the back, or a shoulder to cry on, and that you're there for them for the same kind of reason. So, it's a different form of what we think of as social network. It used to be that a network like that meant that you had other people, whether family, friends, neighbors, colleagues, whoever, that you knew, you could go to; a mentor, an advisor, a trusted ally, and that you would perform that role for them and other people, as well.And what has happened, I think, to add to the emphasis on burnout these days, is that those social connections, those trusts, between people has really been shredding, and, you know—or cut off or broken apart. And so people are feeling isolated, even if they're surrounded by a lot of other people, don't want to raise their hand, don't want to say, “Can we talk over coffee? I'm really having a bad day. I need some help to figure out this problem.” And so one of those most valuable resources that human beings need—which is other people—is, if we're working in environments where that gets pulled apart, and shredded, and it's lacking, that's a real risk factor for burnout.Corey: What are the things that contribute to burnout? It doesn't feel, based upon what you've said so far, that it's one particular thing. There has to be points of commonality between all of this, I have to imagine.Dr. Maslach: Yeah.Corey: Is it possible to predict that, oh, this is a scenario in which either I or people who are in this role are likely to become burned out faster?Dr. Maslach: Mm-hm. Yeah. Good question and I don't know if we have a final answer, but at this point, in terms of all the research that's been done, not just on burnout, but on much larger issues of health, and wellbeing, and stress, and coping, and all the rest of it, there are clearly six areas in which the fit between people and their job environment are critical. And if the fit is—or the match, or the balance—is better, they are going to be at less risk for burnout, they're more likely to be engaged with work.But if some real bad fits, or mismatches, occur in one or more of these areas, that raises the risk factor for burnout. So, if I can just mention those six quickly. And these are not in any particular order because I find that people assume the first one is the worst or the best, and it's not. Any rate, one of them has to do with that social environment I was just talking about; think of it as the workplace community. All the people whose paths you cross at various points—you know, coworkers, the people you supervise, your bosses, et cetera—so those social relationships, that culture, do you have a supportive environment which really helps people thrive? Can you trust people, there's respect, and all that kind of thing going on? Or is it really what people are now describing as a socially toxic work environment?A second area has to do with reward. And it turns out not so much salary and benefits, it's more about social recognition and the intrinsic reward you get from doing a good job. So, if you work hard, do some special things, and nothing positive happens—nobody even pats you on the back, nobody says, “Gee, why don't you try this new project? I think you're really good at it,” anything that acknowledges what you've done—it's a very difficult environment to work in. People who are more at risk of burnout, when I asked them, “What is a good day for you? A good day. A really good day.” And the answer is often, “Nothing bad happens.” But it's not the presence of good stuff happening, like people glad that you did such good work or something like that.Third area has to do with values—and this is one that also often gets ignored, but sometimes this is the critical bottom line—that you're doing work that you think is meaningful, where you're working has integrity, and you're in line with that as opposed to value conflicts and where you're doing things that you think are wrong: “I want to help people, I want to help cure patients, and here, I'm actually only supposed to be trying to help the hospital get more money.” When they have that kind of value conflict, this is often where they have to say, “I don't want to sell my soul and I'm leaving.”The fourth area is one of fairness. And this is really about that whatever the policies, the principles, et cetera, they're administered fairly. So, when things are going badly here—the mismatch—this is where discrimination lives, this is where glass ceilings are going on, that people are not being treated fairly in terms of the work they do, how they're promoted, or all of those kinds of things. So, that interpersonal respect, and, sort of, social justice is missing.The next two areas—the fifth and six—are probably the two that had been the most well-known for a long time. One has to do with workload and how manageable it is. Given the demands that you have, do you have sufficient resources, like time, and tools, and whatever other kind of teams support you need to get the job done. And control is about the amount of autonomy and the opportunities you have to perhaps improvise, or innovate, or correct, or figure out how to do the job better in some way. So, when people are having mismatches in work overload; a lack of control; you cannot improvise; where you have unfairness; where there is values that are just incompatible with what you believe is right, a sort of moral issue; where you're not getting any kind of positive feedback, even when it's deserved, for the kind of work you're doing; and when you're working in a socially toxic relationship where you can't trust people, you don't know who to turn to, people are having unresolved conflicts all the time. Those six areas are, those are the markers really of risk factors for burnout.Corey: I know that I'm looking back through my own career history listening to you recount those and thinking, “Oh, maybe I wasn't just a terrible employee in every one of those situations.”Dr. Maslach: Exactly.Corey: I'm sure a lot of it did come from me, I want to be very clear here. But there's also that aspect of this that might not just be a ‘me' problem.Dr. Maslach: Yeah. That's a good way of putting it. It's really in some sense, it's more of a ‘we' problem than a ‘me' problem. Because again, you're not working in isolation, and the reciprocal relationship you have with other people, and other policies, and other things that are happening in whatever workplace that is, is creating a kind of larger environment in which you and many others are functioning.And we've seen instances where people begin to make changes in that environment—how do we do this differently? How can we do this better, let's try it out for a while and see if this can work—and using those six areas, the value is not just, “Oh, it's really in bad shape. We have huge unfairness issues.” But then it says, “It would be better if we could figure out a way to get rid of that fairness problem, or to make a modification so that we have a more fair process on that.” So, they're like guideposts as well.As people start thinking through these six areas, you can sort of say, “What's working well, in terms of workload, what's working badly? Where do we run into problems on control? How do we improve the social relationships between colleagues who have to work together on a team?” They're not just markers of what's gone wrong, but they can—if you flip it around and look at it, let's look at the other end—okay is a path that we could get better? Make it right?Corey: If people want to learn more about burnout in general, and you're working in it specifically, where can they go to find your work and learn more about what you have to say?Dr. Maslach: Obviously, there's been a lot of articles, and now lots of things on the web, and in past books that I've written. And as you said, in many ways, they are still pretty relevant. The Truth About Burnout came out, oh gosh, '97. So, that's 25 years ago and it's still work.But my colleague, Michael Leiter from Canada, and I have just written up a new manuscript for a new book in which we really are trying to focus on sharing everything we have learned about, you know, what burnout has taught us, and put that into a format of a book that will allow people to really take what we've learned and figure out how does this apply? How can this be customized to our situation? So, I'm hoping that that will be coming out within the next year.Corey: And you are, of course, welcome back to discuss your book when it releases.Dr. Maslach: I would be honored if you would have me back. That would be a wonderful treat.Corey: Absolutely. But in return, I do expect a pre-release copy of the manuscript, so I have something intelligent to talk about.Dr. Maslach: [laugh]. Of course, of course.Corey: Thank you so much for your time. I really appreciate it.Dr. Maslach: Well, thank you for having me. I appreciate the opportunity to share this, especially during these times.Corey: Indeed. Professor Christina Maslach, Professor Emeritus of Psychology at Berkeley, I'm Cloud Economist Corey Quinn, and this is Screaming in the Cloud. If you've enjoyed this podcast, please leave a five-star review on your podcast platform of choice, whereas if you've hated this podcast, please leave a five-star review on your podcast platform of choice along with an insulting comment telling me why you're burned out on this show.Corey: If your AWS bill keeps rising and your blood pressure is doing the same, then you need The Duckbill Group. We help companies fix their AWS bill by making it smaller and less horrifying. The Duckbill Group works for you, not AWS. We tailor recommendations to your business and we get to the point. Visit duckbillgroup.com to get started.Announcer: This has been a HumblePod production. Stay humble.

The psychiatrists of Shrinking Burnout, Dr. Wu and Dr. Radhakrishnan, discuss the controversy about clinician burnout (1:40), burnout's overlapping symptoms with clinician distress (3:03), depression (4:56), and moral injury (9:59), and the stigma of seeking mental health as a clinician (17:38).    Topics discussed in this episode:  (1:40): The lack of consensus on the burnout definition (2:28): The Maslach Burnout Inventory definition of burnout  (3:03): Clinician distress  (4:56): The reduced stigma of calling it clinician burnout rather than depression  (6:28): Systemic issues contributing to burnout (7:36): Why we decided to make the Shrinking Burnout Podcast. The benefit of decreasing stigma  (9:59): Moral injury  (11:00): The limitations of current burnout research  (13:48): Future directions of addressing clinician burnout, the need to redefine the burnout construct  (15:22): Burnout and Covid-19 (16:40):The need to assess clinician willingness to utilize burnout resources  (17:38): The stigma of seeking mental health as a clinician  (18:40): Dr. Wu's opinion on burnout terminology and the under-utilization of clinician's seeking mental health resources

Physician Burnout: Definition, Controversies and Etiology The last episode waded into the murky waters of graduate business education. Anyone listening to that podcast should have emerged with serious doubts about whether an MBA is a desirable credential for healthcare, much less for healthcare leadership. This Licensed to Lead Podcast is the first of four episodes zeroing in on physician burnout. What is it? Why is it? And how is it that the word “burnout” has become radioactive? This episode defines the terms, takes a look at the assessments used to determine the presence of burnout, and fleshes out the controversies and the causes. Part 1: What is burnout? How is it measured? Research tells us that on day one of medical school, medical students have lower rates of burnout and depression than a matched cohort. The impending medical students are more mentally healthy and stable than their counterparts. Research also tells us that once in medical school, students develop very high rates of depression and burnout. So they go in more mentally stable than their peers, and they get sick. The “canary in the mine” analogy is apt. And everyone who’s anyone in the world of burnout agrees: The World Health Organization, Berkeley professor emeritus Christina Maslach (of the eponymous Maslach Burnout Inventory), even Pamela Wible, MD (author of “Burnout is Bullshit!”) agree that burnout is an occupationally induced syndrome. It is caused by the workplace. It’s not the doctor’s lack of resilience or predisposition to mental illness or Patchouli oil deficiency that creates a 50% burnout rate. Doctors don’t start out with it. A damaging work environment ushered in by unenlightened, unskilled, or uncaring leaders is the source. How is burnout measured? In 1981, Christina Maslach and Susan Jackson developed the Maslach Burnout Inventory (MBI). The standard 22-item questionnaire has three domains: 1. Exhaustion, typically emotional exhaustion 2. Cynicism (or depersonalization), a loss of caring about work, colleagues and patients 3. Inefficacy, feelings of incompetence There are multiple versions of the MBI which have been adapted for various groups as well as truncated versions which correlate well with the original MBI. Part 2: What’s so controversial about burnout? The word “burnout” has become radioactive. It has been co-opted by resilience consultants and administrators who prefer to “fix” doctors rather than crawl into that coalmine to eliminate the toxicity. This is a masterful sleight of hand by those who control the direction, the dollars and the microphones in our healthcare institutions. Another area of controversy is whether the “burnout” accurately captures the issue. Drs. Wendy Dean and Simon Talbot believe the term “moral injury” is a more accurate description of what happens to doctors in toxic institutions. They describe this as the trauma done to physicians who succumb to the influence of a pernicious system that doesn't share the professional values of physicians—a pernicious system that constructs barriers to doing the right thing. Pamela Wible, MD says we should dump the term burnout because what’s really going on is a systematic violation of human rights. That argument is particularly relevant to medical students and residents who are vulnerable to abuse of power by those with influence over their career options. PART 3: Physician Burnout Data and More The causes are not a mystery. The RAND/AMA survey of 2013 spelled it out—physicians are dissatisfied by: -being thwarted in their attempts to provide high quality care -the electronic health record which is dysfunctional and drives an inordinate amount of meaningless work for physicians -In addition to the above, other sources list the following elements: -high workload with long work hours and time pressure but no recovery time -chaotic work environments -lack of control over work -values dissonance which prioritizes corporate profits over care of patients A disconcerting component of all the burnout research is the serial documentation of relentlessly high physician burnout without a focus on the ultimate source of the problem: leadership. In the next episode: a summary of the harm done to physicians, patients and practices, and the enormous financial impact. Then a no-holds-barred discussion of the real issues, which are created by leadership invested in the status quo. A note from the Licensed to Lead podcast host Patty Fahy, MD: Thank you for reading and listening. Visit FahyConsulting.com to learn more about how we work with physicians and other leaders to create healthy work cultures. Also—join future podcast conversations by sending me an email or leaving me a voice message. I would love to hear YOUR voice! Show Notes The Business of Health Care Depends on Exploiting Doctors and Nurses by Danielle Ofri, MD, PhD

The number 42 has a huge meaning for baseball fans. Jackie Robinson wore 42, Mariano Rivera wore 42 and now one of the greatest in DevOps, John Willis wears the On-Call Nightmares podcast episode #42! Learn from John's past, his present and his future at Red Hat. We got together at the 2019 DevOps Enterprise Summit in Las Vegas to chat about all things DevOps and a lil Yankees baseball (not much). By far one of the most important episodes of the podcast yet. John Willis has worked in the IT management industry for more than 35 years. Currently he is part of Red Hat's Global Transformation Office which will be focused on accelerating our customers digital visions while bringing holistic change across their technological AND social systems. He was formerly Director of Ecosystem Development at Docker. Prior to Docker, Willis was the VP of Solutions for Socketplane (sold to Docker) and Enstratius (sold to Dell). Prior to to Socketplane and Enstratius, Willis was the VP of Training and Services at Opscode, where he formalized the training, evangelism, and professional services functions at the firm. Willis also founded Gulf Breeze Software, an award-winning IBM business partner, which specializes in deploying Tivoli technology for the enterprise. Willis has authored six IBM Redbooks on enterprise systems management and was the founder and chief architect at Chain Bridge Systems. https://twitter.com/botchagalupe Beyond the Phoenix Project - Audiobook https://itrevolution.com/book/beyond-phoenix-project-audiobook/ Maslach Burnout Inventory - https://www.mindgarden.com/117-maslach-burnout-inventory

Ich habe für Dich einen Stress- und Burnouttest entwickelt. Du kannst ihn gleich hier im Podcast für Dich in Gedanken mitmachen. Nimm dir die Zeit und checke anhand wissenschaftlich fundierter Fragen Dein Stress- und Burnoutlevel. Ich drücke Dir die Daumen, daß bei ganz vielen Fragen ein klares "selten" bis "nie" vorkommt. Hör rein! Natürlich kannst du anschliessend den Test in Ruhe online nachholen. Da erhältst du sofort die Auswertung und den Indikator, wo du gerade stehst mit Hinweisen, Tips und Hacks zur Verbesserung Deiner Situation.

Steve Hayes returns to discuss all things ACT, RFT, and his new book, A Liberated Mind: How to Pivot to What Really Matters. We begin the show with a quick tutorial of sorts on Relational Frame Theory, as well as it’s relationship with Acceptance and Commitment Therapy. We then spend quite a bit of time discussing the use of ACT in the context of preventing and responding to staff burnout. We also discuss managing “difficult people,” optimizing staff performance, and other aspects of management and supervision. Along the way, we frequently reference A Liberated Mind. To be candid, to say that this book is a big deal is a bit of an understatement. As Steve explains, A Liberated Mind is being published by one of the largest publishing houses in the world, which means that our science will have an opportunity to be disseminated in a way that we haven’t seen before. In addition to the book, we discussed a few other resources, including: The Prosocial.world website. The Maslach Burnout Inventory. Bond & Bunce (2000). Bond & Hayes (2002). Steve's website, where you can get his free ACT Mini-Course. Get Out of Your Mind and Into Your Life. This episode is brought to you by the following: Behavior University. Behavior University provides university-quality continuing education for everyday practitioners. To learn more about their CE offerings, please visit behavioruniversity.com/observations. The First Annual Tate Behavioral Conference taking place on October 25th in Springfield, Massachusetts, featuring presentations by Megan Miller, Ryan O'Donnell, Yours Truly, and Kim Berens. It will also include a live recording of the Behavioral Observations Podcast with my interview with Kim Berens. Here are a few other important details: 6 BACB CE credits (including 1.5 Ethics CEs) Doors open for registration and coffee at 8:00 am Speakers begin at 9 am and end at 5 pm Lunch included Oh, and save 15% off of your registration by using the promo code, "Matt" GoLotus. Go Lotus is an intuitive and easy to use, practice management system. It handles every aspect of practice management from data collection, to scheduling and billing, and more. It is so simple your entire team can be up and running in less than an hour. Listeners who use the promo code MATT, the first 100 people will receive 90 days of our data trackers completely free. And by signing up, you’ll then receive an additional discount of 25% off the first 12 months. For more info, head over to golotus.com/register.

Burnout is pervasive in academic medicine. We administered the Maslach Burnout Inventory and an Infectious Diseases (ID) job description survey to our ID faculty. Respondents’ burnout (>50%) and job satisfaction (>90%) were each high. Although burnout may be balanced by job satisfaction, the relationship between the 2 deserves further study. Nori P et al. Is Burnout Infectious? Understanding Drivers of Burnout and Job Satisfaction Among Academic Infectious Diseases Physicians. Open Forum Infect Dis. 2019 Apr; 6(4): ofz092. Published online 2019 Feb 23. doi: 10.1093/ofid/ofz092. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Access the full-text article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483804/

Show Notes By Jacqueline Posada, MD, 4th-year resident in the department of psychiatry & behavioral sciences at George Washington University, Washington.   Masterclass guest Richard Balon, MD: professor of psychiatry and training director at Wayne State University, Detroit. In March, Dr. Balon spoke at the American Academy of Clinical Psychiatrists 2019 annual meeting in Chicago, sponsored by Global Academy for Medical Education (GAME). GAME and the MDedge Psychcast are owned by the same company.   Physician burnout and effective interventions The scales (for example, the Maslach Burnout Inventory) do not necessarily represent the full extent of burnout: If physicians work 12 hours but find fulfillment in work, they will be tired but not necessarily burned out. However, if physicians work 12 hours a day feeling frustrated by the systemic problems, then burnout can ensue. Common contributors to provider burnout: Excessive workload: Pressures of working with an electronic medical record, extensive time spent on documentation; lack of work satisfaction and job control; lack of respect for the work; student loan burden. “Moral injury”: The emotional burden, which occurs when physicians cannot deliver ideal care/treatment to patients, especially when limited by resources (such as insurance or poverty), or other systemic health care issues. Work environment and organizational culture: These factors also contribute to physician burnout. Burnout is a problem for health care organizations as a whole Two main ways to address burnout: Physician-directed interventions (focused on individuals) and organization-directed interventions. Organization-directed burnout prevention strategies include: Reducing workload; reducing time spent on documentation, such as decreasing time spent in front of EMRs; cultivating effective teamwork; fostering a sense of job control. Organizations prefer individual-focused interventions over systemic changes. Examples include mindfulness teaching, yoga, cognitive-behavioral therapy techniques, education about burnout, and education. Individual-focused interventions are great, but they are not realistic for changing the culture that contributes to burnout. Interventions for burnout In a systematic review and meta-analysis in JAMA Internal Medicine, Maria Panagioti, PhD, and colleagues found that: Burnout interventions focused on individual physicians have small, significant effect on physician burnout. Organizational-directed approaches result in greater treatment effects, especially when interventions focus on promoting healthy individual-organization relationships. The impact of individual interventions can be improved when supported by organizational interventions. Interventions targeted at more experienced physicians within primary care settings show greater treatment effect than interventions targeted at less experienced physicians within secondary treatment settings. Approaches identified by staff, as outlined in a New England Journal of Medicine article, can lead to meaningful change. A Hawaiian health care system queried individuals (physicians, mid-levels, and nursing staff) to identify parts of EMR documentation that are poorly designed and unnecessary, and lead to unintended burdens contributing to burnout. This type of survey improves efficiency of a system and shows that the health care organization cares about preventing clinician burnout. References Panagioti M et al. “Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis.” JAMA Intern Med. 2017 Feb 1;777(2):195-205. Ashton M.  “Getting rid of stupid stuff.” N Engl J Med. 2018 Nov. 8;379(10):1789-91.      

Burnout is a commonly discussed topic these days, but what exactly is burnout and is it really a “millennial condition” as the popular press suggests it is? In this episode, we explain what it means to experience burnout at work and discuss some of the workplace challenges that often lead to burning out. We also provide some suggestions that may help you, or others, cope with burnout. We cap off with some discussion about burnout as a cultural phenomenon and if burnout can be viewed as a form of adaptation to the kind of work we do. Timestamps: 1:10: What is burnout? 2:46: What causes burnout at work? 4:54: Examples of stressors (autonomy, role ambiguity, role conflict) 7:34: Even more stressors - emotional dissonance and work-life conflict 9:48: Preventing and coping with burnout 12:00: Helping others cope with burnout as a manager or peer 14:02: Do we live in a burnout culture? 19:26: Does burnout protect us from emotional demands at work? 22:35: This is not Homework: Burnout self-assessment Mentioned This Episode: Buzzfeed article on burnout This is Not Homework – Are you showing signs of burnout? Take this shortened version of the Maslach Burnout Inventory to find out (Disclaimer: This in no way constitutes a medical diagnosis) mindyourworkpodcast@gmail.com – Email us your ideas here! MindYourWorkIO – Send us a tweet! Mindyourwork.io – Find us here! Credits: Our intro and outro music is “Ingenuity” by Lee Rosevere, licensed under Creative Commons (CC BY-NC 3.0). You can find more of Lee’s music at https://leerosevere.bandcamp.com/. https://leerosevere.bandcamp.com/. Our transition music for this episode is "Looking Back” also by Lee; licensed under Creative Commons (CC BY-NC 3.0). Logo Artwork by Antonella Espinoza. Find her at @ellaspin on Twitter!

The State of the Science While there is a lot of evidence related to physician burnout (e.g. the prevalence, rates, and consequences of), this is not the case in the nursing literature. Not that there are no articles related to nursing burnout. Trust me, there are many. But the issue relates more to the fact that the science does not tell us one story. In fact, the numbers are all over the place! Don’t believe me? Head over to PubMed or your favorite scholarly search engine and type in the term “nurse burnout prevalence” and see what you find. In one of my recent keynote talks, here are the studies I have on my prevalence slide: Oncology Nurses 21.5 % (Clinical Journal of Oncology Nursing, 2010) Nurses in England 42% (BMC Nursing, 2011) ICU Nurses in Portugal 31% (BMC Anesthesiology, 2013) NICU Nurses 25.9% (BMJ Quality & Safety, 2014) Nurses in Mainland China 34.9% (Nursing & Health Sciences, 2015) Emergency Nurses 26% (International Journal of Nursing Studies, 2015) Nursing Homes in France 40% (Journal of Clinical Nursing, 2017) And then there is this recent systematic review on the prevalence of burnout which outlines that burnout does exist in various roles of healthcare professionals. But again, this is just one subset (palliative care). So yes. Nurse burnout statistics are all over the place, however maybe one thing that the literature can agree upon is that it does exist. Evidence Requires Measurable Outcome Data The nursing studies that are published related to nurse burnout have limitations such as low sample sizes and weak study designs. If we do not have the literature to support nurse burnout, then we will not get the support from decision makers in power. Poor studies- do data. Without the outcome measures, there are little interventions that can be put into place. Healthcare decision makers need to see the data. They are all about the numbers. Whether we like it or not, healthcare has become likened to a business. Without money, new interventions that can help alleviate nurse burnout, will not be adopted. I do think that we can agree that nurse burnout does exist. Again, if you go to your favorite search engine and type in the term, you will receive lots of articles related to the topic of burnout in nursing. What I also think is that we do not need any more of these smaller, specialty specific studies. The ones where the team uses the Maslach Burnout Inventory to measure burnout in nurses pre- and post- some intervention. We get it. Nurses are burned out. In all jobs, all locations, and all over the world! Meaningful Research Across Practice Settings While I cannot start to give advice or suggestions related to specific study design (that is not the point of this blog or the Nursing from Within™ work), I do want to put a charge out there to anyone reading who is involved in world of scholarly work to look at nursing burnout. We need robust evidence that nurse burnout is linked to patient safety and outcomes. Yes, process measures such as these are harder to measure and difficult to link in a one-to-one causation. For example, it is difficult to say that nurse burnout and burnout alone is what causes patients to fall (as an example), however we need study designs that do their best to look at burnout and the impact it has on patient safety and quality. Nurse and researcher, Linda Aiken, PhD, FAAN, FRCN, RN, has published extensively on nurse and patient outcomes related to job dissatisfaction and burnout. In fact, in a 2012 article in the American Journal of Infection Control, study findings reported that “In a multivariate model controlling for patient severity and nurse and hospital characteristics, only nurse burnout remained significantly associated with urinary tract infection (0.82; P = .03) and surgical site infection (1.56; P < .01) infection.” So, it can be done. And needs to be done more often, linking nurse burnout statistics to outcomes that healthcare administrators are interested in. Then, taken a step further. Burnout is real. It exists and impacts nurses and patients we care about. Once we realize this, then we can start to measure the impact that we can have on nursing burnout. But again, we need to focus on implementation projects that study the barriers and facilitators to why interventions impact and relieve nurse burnout across the spectrum. Work is to be done, but there is hope. Nurses across the world are doing great things to move the nurse burnout needle. Will you be one of them? Get your copy of Stop Nurse Burnout: https://elizabethscala.com/stop-nurse-burnout.  Check out the blog post that accompanies this episode here: elizabethscala.com/nurse-burnout-statistics-measure-and-evaluation/

Burnout has reached epidemic proportions among healthcare professionals and is especially high among those who care for patients with chronic pain and chronic painful conditions such as migraine and fibromyalgia. This course will review the definition and prevalence of burnout, review the risk factors for healthcare professionals, have participants take the Maslach Burnout Inventory, and review what the results may imply both professionally and personally. Then the course will review strategies for reducing stress, enhancing resilience, and improving quality of life. As well as improving satisfaction for healthcare professionals, these resilience enhancing strategies and healthy lifestyle practices also have benefits for patients.

Dr. Paddy Barrett is a trained Interventional Cardiologist. He is also the host and creator of The Doctor Paradox, a podcast committed to addressing the issues of burnout in healthcare and understanding how to make it better. He has worked internationally--practicing in Ireland, Sydney, New York, and San Diego. His work has been featured in TimeHealth, Business Week, the New York Academy of Sciences, the New England Journal of Medicine, and many other media outlets and journals. This interview with Dr. Barrett discusses the many aspects of finding joy and satisfaction of a career in medicine, and ultimately, the importance of taking back control of your life. Please enjoy this very wise next guest: Dr. Paddy Barrett. Website: http://thedoctorparadox.com/  iTunes: https://itunes.apple.com/us/podcast/the-doctor-paradox/id1043836086 Top Points My personal take: listen to the entire conversation. It is filled with great wisdom to be utilized actively in your life today.  The roots of physician burnout is not in the physicians themselves, it is primarily in the environment in which they work. The issue is that the ecosystem that exists has changed very dramatically over the past couple of decades and this environment in which people work, is what's driving these issues of discontent and dissatisfaction within the physician community. What matters most, and this is a key thing, in setting up an ecosystem in that people feel they are cared for and heard. People will work incredibly hard (physicians are not strangers to hard work). But, if you have an environment where they are not appreciated and cared for, it doesn't matter how hard working they are, they will be dissatisfied with their work. Yet, in the setting of long hours, if people feel heard, appreciated, and cared for, they will enjoy their work. If you are working somewhere and you feel burned out, look at your organization's mission statement. Read the first line, and if you throw your eyes up and say that's kind of nonsense, you have a personal value conflict with the way that you believe the organization delivers care, the way you believe people should be treated. And this is the problem. Ultimately, and this is one of the distinctions when you look at the actual happiness scores whether having children make you happier or not, compared to people who don't have children... if you survey people at the time and ask them are they particularly happy, a lot of the time they are not, they are in the middle of some crazy situation, they are stressed, and just want free time. But when you ask them in an overall sense, are you happy that you had children? Are you happy in life and the way things are? They are happy. Understand the distinction between the weather and the climate. The weather will always change, that is part of life. You need to try to pitch to where your climate is, and whether you are generally happy with the world. Change your attitude or change your geography: Sometimes it just requires you change your geography: either who you spend your time with, where you spend your time, or how you spend your time. But sometimes you can't, if you are in a medical school and you simply can't leave...you need then to look at how you change your attitude and how you respond to the world... As you move through your training to your own independence, it is up to you to define what are the components of your job, the parts of your work you want to do most of, and you do that. Because, then you can craft your life and your work that you truly had envisioned it to be. One of the most fundamental things I like to reiterate to myself or would try to reiterate to a younger me is: "it's going to be okay," and things will just be okay. Because, it's a matter of how you view it. I think that would be the most important thing for me. Understand that you can take back that control of the direction of what you are doing, and to dictate that you will have a satisfying and engaged career. To understand there are certain things you cannot change, and if you cannot change them, you cannot worry about them. But understand that you are the one who is in control, and you can have items to give yourself the toolkit to achieve it. And much more... Transcription Introduction -Paddy Barrett, Interventional Cardiologist and Clinician Scholar at Scripts Translational Science Institute in San Diego, California The Doctor Paradox Podcast -Two major tenets for the podcast -One is understanding - the increasing and worrying trend of burnout and mental health issues associated with working in healthcare today. -Secondly - How will we make that better? -That has really been a journey for me, I have learned an immense amount. -Additionally we cover interesting and novel medical careers, things that people may not have considered. -You hear people's stories, and they may come from different places, but everyone's core journey is effectively the same and has gone through challenging or difficult times. What commonalities have you found through your research and learning through your interviews with physicians? - When you are in early career - you see older physicians and attending, and think everyone is doing fantastic. -A lot of people went through challenging time during medical school training, internship, residency, attending, and retirement periods. It's incredible common, but not talked about. -People tend not to disclose this [challenge/pain], and because of that there is somewhat of a perception that this does not exist amongst their peers and colleagues. -It's a feeling and a journey that people are going through individually, and when we hear about physician burnout and depression... it tends not to match up to what you see largely in personal experience. -You will see pockets of it, but these figures quoted of 50% don't seem to match up. There is obviously statistical nuance...but it's important that we have these conversations and understand what the true causes for it are and it's only when we understand the problem better can we look at addressing it. In reference to burnout: How does one expose themselves or allow that vulnerability and create dialogue within the community? -I think it's an issue of having a more global conversation and an individual conversation -When you speak with your friends and colleagues frankly, you will find you can have these conversations. -One of the more challenging parts of this is the fact that how physicians reflect on themselves or how students reflect on themselves if they feel they are going through a period they are challenged. They feel there is a very significant stigma. -Physicians also have a feeling of being invulnerable, that we don't get the diseases our patients get, and we tend to avoid disclosing it. In terms of, how we might be judged by our peers. But in close conversations and mentors, you will find that this is something that has touched almost everybody in their training. -The understanding of the problem is key here, because, what you will see and have seen is a huge growth in articles about physician burnout. Additionally, how we are as a group will likely be a performance indicator. There have been many honorable moves in institutions to "cure" physician burnout. But what that does is really speaks to our core principles of finding pathology and to treat that pathology. -And this is what I've found in the literature, It's not something you treat as an individual. So when a hospital goes to put in place a physician wellness program, what they put in place is often resisted by the physician group and it is ineffective. The reason for that is because the roots of physician burnout is not in the physicians themselves, it is primarily in the environment in which they work. So if you try and treat and cure the physicians, you really achieve very little. While I think these are really critical components, they are only useful if layered on top of an understanding of the problem. -The issue is that the ecosystem that exists has changed very dramatically over the past couple of decades and this environment in which people work, is what's driving these issues of discontent and dissatisfaction within the physician community. -So trying to address it by sending them to a mindfulness class or resiliency training is simply not going to work. It's about the true root-cause analysis and understanding the problem, then you can work towards a solution. Some healthcare systems want to address the problem, but if you have a solution which implies the problem is with the individual, and the individual doesn't get any better (and why would they because that's not the actual way to address it), you find that the ownness of responsibility is on the person. And when that doesn't work, they say well we tried, but this is a problem with the individual. But when you look at it from the other way around, and see it is the ecosystem in which they operate, so it's people in a high-risk environment, then the responsibility is on the people who actually provide the environmental structures. -And that gets a lot trickier because now we are looking at institutional organizational change, that cultural shift amongst institutions and how people interact with each other and how they interact with their roles in general. That's much trickier, but now the responsibility is shifted more on the organization. Have you conceived or seen a healthy or happy environment that doesn't provide this sense of burnout that we have seen? -I think of you are going to see elements of it everywhere, however it doesn't have to be ubiquitous -I've worked on three different continents, you will see it exist in various forms, in various different healthcare systems. -The key component for me is that if you simply accept that there will be challenges and difficult organizational structures... we have to part of the solution and once you feel you can at least attempt to influence change, it makes a huge difference (in terms of your psychological approach to it). -What matters most, and this is a key thing, in setting up an ecosystem in that people feel they are cared for and heard. People will work incredibly hard (physicians are not strangers to hard work). But, if you have an environment where they are not appreciated and cared for, it doesn't matter how hard working they are, they will be dissatisfied with their work. Yet, in the setting of long hours, if people feel heard, appreciated, and cared for, they will enjoy their work. How do we implement appreciation on a system level, and how do we on a personal level take ownership in a mission like that? (Please Read… I would have bolded the whole thing) -This is fundamentally down to leadership and when people think of leadership, they tend to think of people sitting in some elevated structure away from the clinical floors, and not seeing patients. -In reality if you are working in healthcare, if you are CEO of a hospital, if you are the head of a department, if you are a fellow, a resident, a medical student, you are playing some leadership role... because someone looks up to you in guidance in what you do, and that's important. -It's not about a very extensive complex solution, it's about sitting down with the people whom you are responsible for, and asking them and paying a genuine interest in what they are doing, asking them if they are okay, and maybe how we can work better. With that as a cultural ethos in place, the solutions will naturally find their way. -There is no one size fits-all to this problem, because the individual drivers of dissatisfaction, vary from place to place and person-to-person. -We can see vastly different rates of burnout in physician specialties, but we understand implicitly that different specialties operate in different ways, and have different personalities, that would attract them. There is something to do with the environment we work and the dynamics of that environment, and the fact they are different between specialties and areas, that are driving more dissatisfaction amongst those. But we all know of a particular person in the past, who was a leader and a mentor who allowed you to do the work you wanted to do, to be closer to the physician that you had wanted yourself to be, and you didn't mind working incredibly hard. Because that was your purpose, that was where you find agency in what you do. -That is the key is finding a cultural ethos change - understandably there are core features that are somewhat out of our control as physicians in health care groups and organizations. When you have top-down regulation of certain things you need to do with the EMR. The issues with the EMR aren't that we have to tick boxes or fill in forms, it's the fact that it takes us away from doing the thing that we feel what it means for us to be a doctor. There will always be issues with the EMR, but it's about trying to work together and minimize those, and there will never be a perfect solution. Each individual in an organization has to do a root-cause analysis of what is driving the dissatisfaction within their organization. The job of medicine versus the art of medicine -This is something that really has been described in philosophy... -it was very much a revelation to me, that we tend to put it in one category in terms of "this is what we do". It is not one thing, it's two things: it's the art of medicine and the work of medicine. -The art of medicine is the thing that truly drives you, it's the passion you have for those times when it's just fantastic to be a physician, and to intersect with patients at a time that is so critical in their lives and it is such a privileged opportunity to have that -The work of medicine, is a lot of the stuff around that. It's the call, it's the EMR, it's the board certifications, and maintenance of certification. -Ultimately we truly love the art of medicine and continue to do so, but we dislike a lot of the elements and the work of medicine. But when we start to feel a disdain for this, we put the two of them together and we have this dislike or disdain for the art of medicine, and we feel huge guilt around that. -And we can't understand why we feel guilty for disliking something that we hold so dear. And it creates huge conflict because we don't understand. -But when you begin to parse out the problem of recognizing that the art of medicine is always there and something that you truly love, and nobody can touch that, but the elements that exist around your job, where you work, how you work, the type of specialty that you are in, the people you work with, the call rotation that you, these are elements of your job that are modifiable. And, when you start out of your training, you have less scope and less flexibility, but as you move through your training to your own independence, it is up to you to define what are the components of your job, the parts of your work you want to do most of, and you do that. Because, then you can craft your life and your work that you truly had envisioned it to be. -So when you look at your job as a whole then, there are elements that you truly love, and elements that you don't love, but the aggregate is worth it. You learn to craft your ideal job, and it's a constant process. On finding Control in Adversity -I think that a general philosophy in life, is you will always face adversity. If you look at the Buddhist fundamentals of where people derive suffering is in this expectation mismatch. If you always expect things to be good, you will find you encounter painful times in your life, and therefore you have an expectation mismatch. Because of that, there is suffering. Pain is mandatory, and suffering is optional. -This reminds me of the two-arrow theory discussed by the Dalai Llama: the first arrow is pain which is unavoidable. The second arrow is our reaction to the pain which we do control. -This has been reiterated in literature, and if you read, Man's Search for Meaning, he's basically paraphrasing Niche in this, he describes that we control very little in our lives except how we respond to the situation. So that is fundamentally always up to your control. Shakespeare writes that in the tempest, so far as he says that nothing is right or wrong, only thinketh make it so. So you have the control in how you respond to situations, and we always have that no matter what situation we are in. How do you define happiness? -Everybody describes happiness as something you find, but that's not really possible. Happiness is something you create, you build, and work towards. -It is fundamentally a byproduct of the way you live your life. People describe this as a sense of finding meaning in life and that implies that there is meaning to be found. -You need to look at it another way in that you bring meaning out of the world in what you do. You bring happiness out of the world in what you do. -When people describe happiness, there's how we are in the moment (in terms of your immediate moment to moment, and day to day happiness), then there is your contemplation of how you feel you are in general. -Ultimately, and this is one of the distinctions when you look at the actual happiness scores whether having children make you happier or not, compared to people who don't have children... if you survey people at the time and ask them are they particularly happy, a lot of the time they are not, they are in the middle of some crazy situation, they are stressed, and just want free time. But when you ask them in an overall sense, are you happy that you had children? Are you happy in life and the way things are? They are happy. -So it is to understand the distinction between the weather and the climate. The weather will always change, that is part of life. You need to try to pitch to where your climate is, and whether you are generally happy with the world. -That is fundamentally up to you, because to find happiness, means that you must luckily stumble upon it (or it will select you). -But when you take ownership, that you can work towards finding happiness, that you can really put a plan in place, that you can find a toolkit... the onus is on you, therefore you can take control of that. -It's about perspective and it's a byproduct in the way you live your life. The need for control -Taylor: I think a common theme we spoke about earlier is this sense or need to find ownership or control... -And that's one of the key drivers of dissatisfaction in general and burnout. Which by means is not exclusive to physicians. When you look at the classic survey instruments used to describe burnout, the most commonly used is the Maslach Burnout Inventory. And that's what you will often see quoted in studies or a variant of it. -But all that does, is that it tells you if someone is burned out or is at high risk for becoming burned out or not. So effectively, it gives you a temperature, it gives you a binary "yes" or "no". -But it says nothing really as to what the root cause of the drivers are. -This is important, because without understanding the root cause, it's effectively just looking at a temperature of a patient, and not understanding the pathology of where that may be coming from (whether it is indeed sepsis or which organ it is coming from). -When you look at the survey instruments for finding the causes, the most commonly used is again defined by Christina Maslach, and it's the area of life survey. When you look at the rank order of these - excess work hours, or excess demands on the capacity that you have... that tends to be perceived as the number one driver, but, invariably it's actually at the bottom. The reason it is perceived as the number one driver, is because the excess work hours are probably the number one issue when you are feeling burned out, so it's the most obviously manifest symptom. -The two biggest drivers are: lack of control. The lack of control of how you deliver care. The lack of control in how you live your life. The lack of control of where you perceive your future  and your career to be heading and this fear you are being railroaded into a life that you are terrified to have, and that you have no control over this direction. -The second is, and it is equally important: is this concept of value-conflicts. What that means is you have a major conflict personally with the institution or organization and their own philosophies and beliefs. My acid test for this is, if you are working somewhere and you feel burned out, look at your organization's mission statement. Read the first line, and if you throw your eyes up and say that's kind of nonsense, you have a personal value conflict with the way that you believe the organization delivers care, the way you believe people should be treated. And this is the problem... is that if you are in a system, whereby you feel patients are being treated unfairly, or are being utilized to generate overuse for example or do certain things that, you believe are not the best for the patient, or that they deserve better... that creates huge value conflict. -These are the deepest drivers of what actually causes discontent. -The flip-side to that is, when we look at what is the most manifest, or visible symptom, an issue around working hours... and clearly working hours has tolerances if someone is working 120 hours a week, no one is going to tolerate that. But if you then solely and exclusively address that and reduce working hours you don't actually tackle the true fundamentally drivers, which are likely autonomy and control and around value-conflicts. -So you have reduced the time exposure to the adverse stimulus, but you haven't taken away the stimulus. -If you don't fundamentally understand if those are the true drivers for you, you can never orchestrate or put in place, a role or a job, that will then be able to make you feel satisfied and engaged in your job as a physician. Taylor: And this loss of control and loss of value-congruency, this is applicable in all fields. -And burnout as I stated, is not exclusive to physicians, burnout was originally described by a German gentleman, and it was described by those caring for drug addiction. It's most commonly seen in anyone in a role who cares for another. It can be seen in fields where anyone is dealing with other human beings. So that's effectively almost all jobs. -So we go in to our job having certain expectations, in terms of, we go into our lives as physicians wanting to do well for our patients, and sometimes we feel limited in our ability to do that, and that creates huge conflict. But burnout is seen across the spectrum, between physicians, teachers, lawyers, firefighters, police officers. It is something that is very ubiquitous. What are your thoughts on the climate of fear in creating and expressing your own voice, within the field of healthcare? -I think that's having a confidence in your own belief structures that are sound and reasonable. -I think it's about using the right platform, at the right time, with the right voice. -I think there is a way to have rational discourse and talk about sensitive topics, and I think what is often lacking in the world today, is the idea that we would have a rational discourse over a topic that is maybe not agreed on by two parties. -It is only by having that discourse and having rational discourse that a reasonable solution can be found. -I think one of the most valuable things is to try to understand where someone else is coming from, truly understand that, and you will recognize their fears. Often, where you are coming from is driven from fears, anxieties, and insecurities... and it is being met by the other side also. I think when we recognize those elements, then progress can be made. -But don't be afraid to voice your opinion, but think carefully about what you are saying, and how you are saying it. And the root of the motivation of saying that, if it's born out of fear, and why that is. -And understand that if someone retorts, to understand that is born out of fear also. -But I would certainly encourage everybody to develop their own thoughts independently, read broadly, have an idea and an opinion about the world, not to be opinionated but understand why things are happening and the way things are set up. To basically accept nothing at face value and understand the rationales for the structure of things. -I think it is so important to have your voice in the world, and if you don't have your voice... if you simply standback and say nothing, and when the world collapses around you, and things don't go the way you would have liked... you really are not in a position to complain. -One of the things I like to say to myself and to others who are in a position that they don't like is: you can change your attitude or you can change your geography... or both. -but if you don't do any of those processes or put those in place, and if after 6 months you are still complaining, you forfeit the right to complain. -Because sometimes it just requires you change your geography: either who you spend your time with, where you spend your time, or how you spend your time. -But sometimes you can't, if you are in a medical school and you simply can't leave...you need then to look at how you change your attitude and how you respond to the world... you need to look at building that toolkit, in terms of your psychological ability to operate in that world and understand that maybe changing your geography is something you can't do right now, and you can put a plan in place to have a structured down the road (maybe one year, two years), whatever. -But if in 6 months, you haven't found a new approach to the problem, you are essentially suffering for yourself, and you have done nothing to help yourself. Favorite Resources -For me, I think there is a currently an obsession with the new... the problems we face are as old as human behavior. -So the books I'm currently reading are older and older books. For me, it's about philosophy and understanding, and having a framework to view the world, and how to operate within it. -I think one of the most valuable resources that everybody should use, is watch there is probably hundred short videos by The school of life by Alain De Botton, videos on philosophy and how we look at the world. Although that is a new item, he is talking about very old ideas. -In terms of a book, I think for anybody who is struggling with a dilemma, and a dilemma is something that doesn't have an immediate and obvious solution. And we talk about touching the two horns of a dilemma, in so far as that if you touch one you are moving further away from the other, and I think everybody is struggling with that... the book for me that has been the most important is a book by Stephen Cope called the The great work of your life. And it's effectively a modern day interpretation of an old Vedic text called the Bhagavad Gita, which is the story of Arjuna and Krishna on the battlefield. -It's about how to deal with a situation whereby if you think you are going to choose something, that you feel you will pay a penalty in some other way, and vice versa. It's about how to rationalize that in your mind and ultimately all of that is driven by fear. -So I think that the understanding of the core tenets of philosophy, The School of Life, anything in the stoic philosophy particularly Marcus Aurelius or Seneca, just unbelievable in terms of how to look at the world, and also Stephen Cope's book. If you could speak to a younger Paddy, let's say ten years ago, what would you say to yourself? -I wouldn't change anything, I think where I am now is a result of all the good and bad things that have happened to me. -I think the character and people we become are forged by our life's journeys. I don't think I would like to say anything particular because it would change potentially who I am now. -One of the most fundamental things I like to reiterate to myself or would try to reiterate to a younger me is: "it's going to be okay," and things will just be okay. Because, it's a matter of how you view it. I think that would be the most important thing for me. What would like to say to medical community at large, something you would like us to conclude with -I think my main message is that, although I have podcast that very much talks about physician burnout, is that... it was motivated by the idea that you can have a very fulfilling and satisfying career as a physician. That people do have incredibly satisfying careers as physicians, even within this environment and that opportunity is always there for you. That is why you have taken all the exams and put in all of this hard work. The reality is, to secure that you have to take control over your personal world, in terms of how you look at the world, and how you structure it. Understand that you can take back that control of the direction of what you are doing, and to dictate that you will have a satisfying and engaged career. To understand there are certain things you cannot change, and if you cannot change them, you cannot worry about them. But understand that you are the one who is in control, and you can have those items to give yourself the toolkit to achieve them.

Summary: Fifty four percent of physicians report at least one symptom of burnout. On this episode Dr. Philip Kroth an Internist and Chief of Clinical Informatics from the University of New Mexico schools us on how electronic health records (EHR) relate to burnout and tips to promote physician wellness. Miss this episode and you might get burned...out. I refuse to apologize for that pun. Enjoy!   Clinical Pearls: *Check out the article by Shanafelt below to view breakdown of burnout by specialty. *24/7 access to EHRs is a double-edged sword. You have to protect your own time. *Turn off email alerts. *Limit your screen time when off the clock. Kids are only allowed 1 hour per day! *Take the EHR training and become a MASTER. *Keep in mind these four domains related to burnout and try to mitigate your risk. Health information technology and documentation burden Stress versus control and support. You need to balance the “seesaw” Health policy and regulation (e.g. ACOs, MACRA) Physician culture of endurance (e.g. giving yourself an IV when sick instead of going home) Disclosures: None reported. Links from the Show: 1. Article by Shanafelt finding burnout in 54 percent of physicians. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014 Shanafelt, Tait D. et al. Mayo Clinic Proceedings , Volume 90 , Issue 12 , 1600 - 1613 2. Turnover of primary care doctors cost about $250,000 in 1991! Buchbinder, SB et al. Estimates of Costs of Primary Care Physician Turnover. Am J Manag Care. 1999 Nov;5(11):1431-8. 3. Maslach Burnout Inventory http://www.mindgarden.com/117-maslach-burnout-inventory 4. Volkswagen stops sending emails in the evening. http://www.bbc.com/news/technology-16314901