Physician burnout and issues with work-life balance are higher than the general population. At ACC.19, a dedicated Clinician Wellness Intensive session was held to bring attention to physician burnout and provide tools to promote physician wellness.

The session kicked off with keynote speaker Tait Shanafelt, MD, chief wellness officer at Stanford University, who presented the background of physician burnout and its effects on the personal and professional lives of individuals at risk. These risks include broken relationships, substance abuse, depression, suicidal ideations, decreased productivity, decreased quality of care and decreased patient satisfaction. Three key features of burnout include emotional exhaustion, depersonalization and low personal accomplishment, which can lead to decreased work effectiveness. A key take-home point from his lecture was that burnout can be prevented if we can spend more than 20 percent of our efforts in activities that we find the most meaningful at work. Once this effort drops below 20 percent, there is a significant rise in burnout. Shanafelt identified several tools at an individual level that can promote wellness such as identifying one's values; maintaining self-care through sleep, health, exercise, personal hobbies and interests, spiritual and religious activities; and maintaining personal relationships.

The session also highlighted stories of burnout from fellow colleagues and included panelists from different stages of career. Early career professionals struggle from burnout as they transition from fellowship into their new career. Some of the highlighted risk factors that are pertinent to early career professionals include lack of work-life balance, financial stressors, building a new practice, administrative burden, lack of dedicated time for scholarly activities, and providing mentorship to fellows and residents when still needing mentorship. A key point is to find support amongst your colleagues within your institution, local ACC chapter or fellow ACC members. ACC's Member Hub is a platform that can be used to connect with other early career professionals to share stories and support one another.

The rest of the session focused on tools to prevent burnout and promote wellness, which start at an individual and organizational level. Shanafelt noted that battling burnout responsibility is one-third individual and two-thirds organizational. The first step is to focus on changes that one can make on a personal level. Anand Chockalingam, MBBS, FACC, from the University of Missouri, provided several tools to help promote wellness, including mindfulness and meditation, exercise and sports, gratitude, the concept of flow, intermittent fasting, and ikigai (a Japanese concept meaning "a reason for being"). One of his final thoughts was, "Participate in activities where you lose track of time."

Several digital tools to help promote wellness were highlighted by Kapil Parakh, MD, medical lead for Google Fit, and focused on physical activity, nutrition, sleep and wellbeing. Shanafelt identified tools that organizations can use to promote a culture of wellness through leadership, peer support, flexibility and employee appreciation. Studies found that increasing time with colleagues at work via dedicated weekly small group sessions significantly decreased physician burnout and improved their meaning in work over a one-year period.

While achieving balance and wellness is a challenge, it is crucial in order to find enjoyment in one's personal and professional life. It is important that we acknowledge physician burnout and raise awareness so that we can come together as a society to recognize burnout and promote wellness. Take-home points from this session include:

1. Identify the things at work that are most meaningful to you, and spend at least 20 percent or more of your time doing those things.
2. Support your colleagues, share your stories, take coffee breaks together, and seek help when you notice signs and symptoms of burnout.
3. Maintain self-care through hobbies, health, exercise, personal relationships and mindfulness.

This article was authored by Tamara M. Atkinson, MD, cardiologist at the Portland VA Medical Center in Portland, OR, and Poonam Velagapudi, MD, MS, FACC, cardiologist at the University of Nebraska Medical Center in Omaha, NE.