American Academy of Pediatrics Releases Updated Guidance on Physician Wellness

Pediatricians are not immune to burnout, especially during the added pressures of caring for others during the pandemic

Itasca, IL--Pediatricians faced new pressures at work and home during the COVID-19 pandemic, highlighting an already existing problem within the medical community: Rising rates of physician burnout.

The American Academy of Pediatrics describes efforts to confront and remedy significant stressors within the profession in an updated clinical report, “Physician Health and Wellness,” published in the November 2022 Pediatrics (published online Monday, Oct. 24). Prevalence of burnout increased for all pediatric disciplines from 2011 to 2014, according to the report. During that time, general pediatricians experienced a more than 10% increase in burnout, from 35.3% to 46.3%.

“Pediatricians find life-affirming satisfaction in helping children. The challenge is ensuring that physicians protect their own health and wellbeing too,” said Hilary H. McClafferty, MD, FAAP, lead author of the report, written by the Section on Integrative Medicine. “The weight of caring for children who are chronically ill, disabled, maltreated, neglected, or otherwise medically vulnerable can take a toll over time.
This can lead to overlapping symptoms of compassion fatigue, secondary traumatic stress, vicarious traumatization, moral distress, countertransference, and ultimately burnout- all of which are discussed in the report.

“We also recognize that women make up the majority of pediatricians today,” Dr. McClafferty said. “This is important because women physicians historically report a higher prevalence of burnout than their male counterparts. Our field has an opportunity to lead change in this area.”

Recognized drivers of burnout involve both organizational and individual factors. Research is active on the impact of the intersection of race, ethnicity, gender, and burnout; protective factors; and components of wellness. The COVID-19 pandemic also highlighted gaps in how health care systems and governmental institutions interact, along with a lack of effective crisis-management protocols and communication.

The American Academy of Pediatrics observes that protective factors include positive social support, cultivation of personal awareness and resilience measures, and treatment for unaddressed mental and physical medical conditions. The report states that regular practice of structured debriefing with the medical team after difficult patient encounters or poor outcomes is especially important.

Other recommendations for physicians on how to increase wellness include:

• Consistent attention to healthy lifestyle fundamentals such as nutrition, physical activity, sleep, and stress management.
• Plan and take regular time off and vacation time
• Develop a hobby outside of one’s regular medical practice,
• Cultivate a gratitude practice.
• Consciously build and maintain a supportive social/family network.
• Create a personal mission statement on what brings the physician joy, why the physician chose the field and how they will thrive.
• Explore and practice mind-body approaches such as mindfulness in medicine.
  The AAP calls for finding new and creative ways to combat physician burnout and fatigue, which for some was exacerbated by the politicization of the public health response to the pandemic.

“There is often a stigma with seeking help, even among those we typically consider as the helpers,” Dr. McClafferty said. “We must work together to make sure physicians are given the respect, privacy and opportunity to be heard without stigma or professional penalty and continue to advocate for the wellbeing of physicians at every stage of training and practice.”

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.