IR physician wellness toolkit

Evidence

Burnout is prevalent among interventional radiologists, as it is across many medical specialties. While the factors contributing to burnout may vary across practice settings and individuals, IR physicians face many of the same professional pressures that contribute to burnout throughout medicine.

Causes and risk factors specific to IR

• Workload and long hours: IR physicians face intense workloads and often work more than 60 hours per week. Physicians who work >80 hours/week are 7 times more likely to experience burnout (3).

• On-call burden and unpredictable cases: IR involves numerous emergent procedures, requiring constant readiness for urgent cases at any time. Night shifts and unpredictable on-call schedules lead to sleep disruption, contributing significantly to burnout (6).

• Exposure to radiation: Chronic radiation exposure is a unique stressor in IR, contributing not only to physical health concerns but also to anxiety about long-term health risks, which exacerbates stress (9).

• Physical strain: Prolonged standing, heavy lifting, and wearing lead aprons during procedures contribute to musculoskeletal pain and fatigue, which are reported as significant causes of stress and burnout (7).

• Lack of support: Many IRs report insufficient support from clinical staff and lack of mentorship, leading to professional isolation and a lack of guidance for managing complex cases and career challenges (14).

• Cultural and gender factors: Female IRs face higher burnout rates due to gender-related challenges, such as lack of mentorship, gender bias, and disproportionate family responsibilities (11).

• Lack of control over workload: Physicians who have limited control over their patient load, work schedule, and team composition are more likely to experience burnout. The inability to make autonomous decisions regarding scheduling and clinical responsibilities contributes significantly to stress and exhaustion (16).

• Excessive administrative burdens: The overwhelming volume of administrative tasks, including extensive electronic health record (EHR) documentation, constant emails, and numerous unnecessary meetings, significantly contributes to burnout. These burdens, particularly in IR, create stress and take time away from clinical duties. The constant pressure to manage these tasks without sufficient support or resources intensifies burnout in IR (12).

• Identity of IR: Interventional radiologists often face difficulty in establishing a clear professional identity compared to other specialties. Challenges such as lack of name recognition and insufficient acknowledgment of their skills and abilities can undermine their professional self-esteem, ultimately contributing to burnout.

• Respect from other specialties: The perception that IR is sometimes viewed as a secondary, procedural-based specialty rather than an equal in the medical hierarchy can result in a lack of professional recognition and support from colleagues in other specialties.

Drivers of burnout

The wellbeing of healthcare providers is the cornerstone of high-quality, compassionate care of patients. To this end, in collaboration with the organization or its leadership, we (all SIR members!) should strive for the ideal workplace which can eliminate physician burnout and create engaged professionals, eventually leading to “esprit de corps” (15).

The alternative state to the burned-out individual is an engaged, fulfilled, and resilient individual who is connected to and supported by similarly engaged colleagues with a shared purpose to achieve a patient-centered mission. (In other words, a person with “esprit de corps”.)

The researchers at Mayo Clinic have described 6 characteristics of a health care system, when working optimally, which creates engaged professionals with meaning and purpose in work (column 1). When these do not function optimally, they become drivers of burnout (column 2).