How I Practice Now

Michael J. Bloch, MD, on Physician Burnout During the COVID-19 Pandemic

In this video, Michael J. Bloch, MD, discusses physician burnout during the COVID-19 pandemic, including doing more for patients with fewer resources in the office, planning for the future, and promoting well-being. 

Michael J. Bloch, MD, is an associate professor at the University of Nevada School of Medicine, the medical director of vascular care at the Renown Institute for Heart and Vascular Health, and the President of Blue Spruce Medical Consultants, PLLC in Reno, Nevada.



Michael J. Bloch, MDHello, my name's Dr. Michael Bloch. I'm a vascular medicine physician here in Northern Nevada. I want to just have a brief few moments to talk to you about an issue that's become important in my life, which is the issue of physician and other provider burnout. Now, I'm certainly no expert in the academic literature around physician and provider burnout, but I've certainly experienced in my own career and would like to just offer any insights that I've had and how I've dealt with some of these issues, in hopes that maybe they will be applicable to some of your practices. I think there's things that we can do, both big and small, to avoid physician burnout. But the first thing we have to do is recognize that it's a real thing. For me, the frustrations that lead to feelings of burnout, are not really the long hours. They're not the complaints that that patients have about their medical conditions.

For me, it's really the constantly being asked to do more in the office with less and really being the forward facing face, the patient facing face of a medical industrial complex that often doesn't work for patients. And those are the things that just really frustrate me and also things that I feel like I can't do very much about. And so, I really try to really more focus on things that I can affect. And as I say, I think those, I've tried to take efforts, both big and small, to try to keep myself focused on keeping my career on a good path and being energized and present for patients and for my staff as well. And I think the first and biggest thing really, is to treat the practice of medicine as a career, rather than just a job. That's really something that I focused on throughout my career, is really trying to think about this as it affects me, not necessarily my employer or somebody I've been working with.

And that's one of the reasons, actually, that I'm an independent contractor, rather than an employee. I think trying to keep that freedom and think about a plan of what you want to do in the next couple of years, what you want to do five years after that, 10 years after that, and really concentrate on what's important to you. And one of the things that's really been important to me in that regard, is making sure that my daily or weekly schedule is somewhat flexible. So I know if I just see patients all day, every day, all week, I'm going to get burned out. So I've tried to be very varied in my career. I have an administrative role in running our center. I supervise a number of different nurse practitioners and clinical pharmacists and other providers. I do some teaching, I do some research. And so I only end up seeing patients about half of the week, which I think allows me to be less burned out, more present and a better partner for those patients.

I've also really tried to keep my schedule the way it works for me. And that includes starting a couple of days a little bit later. One of the things that I've definitely found is, I need to exercise in the mornings and particularly exercising in times of natural light. So I live here in Northern Nevada. It's a beautiful area. So having a couple of mornings that I start late and stay late, so I can get some exercise in outside, get some access to the great outdoors, is something that's been super, super important to me. I've also tried to take at least a half day, a week more recently and work out of my home office, where you can see I am, which is generally just a more peaceful place than my regular office. Once again, has access to natural light, have my pets and my creature comforts around. And I've found ways that I can be efficient here in my home office, just like I am in my regular office.

I think some little things, as well, that I've tried to do, when patients are frustrated with our system and our hospital system, I don't feel like I have to apologize for that. I often will share the same frustrations I have as a patient and get my office manager or a representative of the hospital or medical system to talk to those patients, and speak to them about their concerns. I've also tried to put a small hole in each of my patient schedules, which is 10 or 20 minutes in my template, where I can take a little time in the middle of the afternoon or the morning for myself. I know it sounds a little bit crazy, but I do a lot of yoga and meditation and breath work. And so I try, especially when I'm feeling burnt out, to go into my office once every morning or afternoon, turn out the lights, set my alarm on my phone for three minutes and just do some deep breathing and some meditation, just to kind of reset me for the rest of the day.

It's only two or three minute investment, but it really does seem to affect my ability to stay present and focused and just generally happier when I'm at the office. I think one other thing that I've just found really recently, is that I noticed that in the time of the COVID pandemic, I've been so afraid of contracting COVID again and potentially exposing patients, that I haven't taken time to travel. I haven't taken as much time to socialize with friends. And then I really found that that was making me more burned out. So I just got back from a trip from Aspen, skiing with some old friends from undergrad. That was great. I tested two days in a row before going back to the office. So I feel very safe, in that regard. But I think earlier in the pandemic, I was just canceling vacations, canceling vacations with my family, canceling other events and scheduling myself more in the office.

So I think even if you're not going to go away, making sure that you're taking those personal days, making sure you're taking days that are not at the office, even if it doesn't mean that you're going to be traveling elsewhere, but making sure that you're taking some time for yourself, at least that's been helpful for me. And really the final thing is, just kind of recognizing the good that we do in our jobs, in our careers and just taking a certain satisfaction from that, even in the last couple of years, with the magnitude of the death and disability from COVID that we've seen, cardiovascular disease remains the number one cause of death and disability in this country. And just being present, going to the office every day helps to stem the tide of that cardiovascular disease progression and expansion in our country. And I think we have to take great pride in that. We're all trying to work towards the same thing.

Yes, it can be frustrating. Patients can be frustrating. Our office staff can be frustrating. Hospital administration can be frustrating. Working with insurance companies and formularies can be frustrating, but generally we're trying to do the right thing. And I spend a lot of time, really, thinking about that and being very intentional in how I can have the best outcomes for my patients and for the populations that we take care of. So those are just some of the things that I think about when I start to get burned out. I hope, maybe, that could be helpful for some of you. I'd be curious if there's any other ideas, we can certainly start a dialogue here, about other ways that providers have addressed the issue of physician and other provider burnout. So, thank you very much for your time.