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The Importance of Financial Health in Preventing Physician Burnout

Dr. Kirsten Lindner & Sebastien Chevrier - Aug 31, 2021
Physicians have experienced increased stress and burnout due to the pandemic. Financial health is an important and often overlooked factor to consider in improving physician well-being.

Recently, the Ontario Medical Association put out a paper entitled, “Healing the Healers: System-Level Solutions to Physician Burnout.” The piece discussed the prevalence of this “work-related syndrome,” referencing research that characterized it as being defined by symptoms of “emotional exhaustion, depersonalization or feelings of detachment and cynicism toward people and work, and a reduced sense of personal accomplishment.” Far from being a unique experience, the OMA referred to it as both an “epidemic” and “public health crisis.” The OMA has created a “Burnout Task Force,” which has listed its “Top 5 System-Level Solutions to Physician Burnout.”

 

These are as follows:

1. Streamline and reduce required documentation and administrative work.

 

2. Ensure fair and equitable compensation for all work done.

 

3. Increase work-life balance by making organizational policy changes.

 

4. Promote the seamless integration of digital health tools into Physicians’ workflows.

 

5. Provide institutional support for Physician wellness.

 

The piece also clearly stated that “No single intervention can fully address the problem,” and refers to the need for a multi-faceted approach to solutions. With this in mind, we’d like to discuss another important (but often overlooked) factor in physician burnout prevention: financial health.

 

The intersection of personal health and financial health

Financial health is defined as “the state that results from the way in which a person uses their finances…and ultimately, how their financial decisions, behaviours, routines, and habits impact their overall well-being” as per Financial Health Institute. In our financial literacy presentations to medical students and residents, we talk about how, much like personal health, financial health is achieved by an active process that requires education and action, and the fact that they are actually quite interrelated (see diagram below).

 

 

For most physicians, the slippery slope begins during training, where spending can escalate due to increased required and discretionary expenses (especially when a substantial line of credit is available and easily accessed), earnings are low and substantial debt accumulates. Once practice begins, with already hefty debt in place and a much larger paycheck, there is a strong temptation to reward the fruits of some very hard and prolonged labour, and lifestyle costs expand rapidly into the new earnings. Without a mindful plan in place, the cascade begins. As expenses rise (car loans, big mortgages, etc.), debt often persists or escalates, and, because earnings in medicine are typically related to task-oriented activities (new consults, follow-ups, procedures, etc.), in order to make more, you have to do more. This results in increased time at work (and exposure to all the workplace risk factors already identified as being burnout promoting), to the detriment of other interests, activities, and hobbies that have a protective effect on burnout. The eventual result is a sense of physical and mental exhaustion, with a sense of loss of control about how much one must work and for how long, in order to meet established financial demands.

 

Physician or not, finances are a significant source of stress for the majority of people. This article references a 2020 study that found that 73% of respondents rated finances as their number one cause of stress. Though the article is American and is not specifically physician focussed, it provides some great insights into the causes of and antidotes to financial stress (financial decisions, behaviours, routines, and habits). When you add this common element of mental duress to the extensive list of stressors placed on physicians on a daily basis, it’s no wonder burnout levels in medicine are referred to as endemic.

 

 

Achieving Financial Health

Improving financial health starts with improving knowledge from a reliable source in order to maximize opportunities for healthy choices and decisions related to personal finance management. In short, it requires some degree of financial literacy. The TIAA Institute-GFLEC Personal Finance Index (P-Fin Index) provides an excellent example of the impact of financial literacy on financial health. The P-Fin Index measures levels of knowledge and understanding that enable sound financial decision-making and effective management of personal finances among U.S. adults. The index is based on responses to 28 questions across eight functional areas: earning, consuming, saving, investing, borrowing/managing debt, insuring, comprehending risk, and go-to information sources.

 

They found that those with greater financial literacy are:

More likely to save and plan for retirement

More likely to have non-retirement savings

Have a greater propensity to track spending

Less likely to be financially fragile (i.e. have an emergency fund)

More likely to make loan payments on time

Less likely to be debt constrained

More likely to seek financial advice

 

For those who have the time and interest, reading up on personal finance can be empowering and enjoyable and everyone should gain at least a basic understanding of personal finance management. For those who don’t have the time or interest, the thought of trying to research and sift through the myriad of financial literature can feel overwhelming. In that case having a trusted and fiduciary financial planning team who understands your personal circumstances, who can provide expert guidance, and help you navigate the many critical financial events that occur through life is important. In order to create a strong financial foundation and healthy financial habits moving forward, your team should provide personal finance coaching as needed and help you set up a personal finance management system if you don’t already have one.

 

 

Where to start? Putting you and your financial well-being first

Physicians have become so busy advising others about their health and well-being that finding the time to focus on your own health and well-being has become an increasing challenge, especially with the pressures of never-ending work and never enough time. The consequence is that personal needs get put on the back burner and become afterthoughts. In order to change this paradigm, a few steps need to take place.

 

First, it’s important to understand what components of your finances are currently on your mind the most and work backward from there. Become mindful: What are your top priorities and goals that will improve your finances and reduce your stress (billings/paying bills on time/saving). Take some time to sit down and go through the exercise of putting your areas of concern down on paper and prioritize them. Doing this can bring a lot into focus and in and of itself reduce stress and worry. Studies have shown that “while tasks we haven’t done distract us, just making a plan to get them done can free us from this anxiety.” So while it may feel like an extra bit of work to sit down after a long day and write down each of your financial concerns, you’re likely to earn that time back in the days ahead by no longer worrying about them at your previous high levels.

 

Once you know where you want to focus, create a plan to address it and work towards incorporating the activity into your daily life. Make it a habit. Based on the psychology of building a habit, 4 conditions need to be in place:

  1. make it obvious
  2. make it attractive
  3. make it easy
  4. make it satisfying

 

Schedule It In

Scheduling in time to attend to something is a great way to make it obvious. By putting it into your calendar and allotting only a small amount of time to do it i.e. 5-10 minutes, that makes it attractive and by doing things when they are top of mind, that will make it easy. The reward of accomplishment, i.e. a to-do item ticked off, a goal achieved, will make it satisfying. For example, billing as you go and dedicating a few minutes in your schedule daily to completing and submitting your billings daily instead of waiting till the end of the week or billing cycle will result in more accurate billings and consequently a bigger paycheck. Taking the time to automate your bill payments and contributions will create more time to do other things you enjoy and will protect your credit score and increase your savings.

Outsourcing or getting advice from trusted resources can also relieve the mental load that many of us carry. Perhaps you took out a loan related to COVID-19, and want to confirm you’ve properly paid it back. Maybe you have a large purchase to prepare for and are worried you’ll go over budget or wonder how to use your corporate savings without getting a big tax hit. Or you could just want to put yourself in a position to prepare for retirement and aren’t sure how to get there. Being able to access expert advice on how to navigate these decisions can do a lot to reduce your concerns and worries about these things.

 

Some other guidelines:

We’ve already discussed becoming mindful and working backward from the areas that are on your mind the most, and while that’s generally a good strategy to alleviate some of the mental pressure you may be experiencing, some other guidelines include:

  • Tick off the small items – Find a few easy wins to start with. Sometimes small accomplishments can pay big dividends mentally.
  • Remember, not everything needs to be solved overnight – Finances are important, but not every concern you have needs to be fixed in the next few hours. Once you’ve followed the process above, you’re in much better shape to address your worries. Consider that a huge step and keep moving forward.

 

While burnout and its prevention is a complex matter, financial health as a contributor to burnout protection is something that can be directly addressed and optimized with some dedicated planning and support.

 

If you feel you could benefit from some assistance in getting on track, we are here to help.

Contact us to learn more.

 

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