New twist on an old discussion: Burnout begins at home

Bobbi Byrne, MD

Gary L. Freed, MD, MPH, FAAP

When discussing burnout among clinicians, long hours, challenging cases, compassion fatigue, and other work-related issues most often come to mind. However, conflict at home can significantly impact work and contribute to burnout as well.

This was the focus of a session on Saturday, November 3, at the American Academy of Pediatrics (AAP) 2018 National Conference and Exhibition in Orlando, Florida, titled “Negotiation at home and at work: Skill building to reduce burnout and enhance well-being.” 

Led by Bobbi Byrne, MD, associate professor of Pediatrics and Neonatal-Perinatal Medicine at the Indiana University School of Medicine, Indianapolis, and Gary L. Freed, MD, MPH, FAAP, professor and associate chair in the Department of Pediatrics and professor of Health Management and Policy at the University of Michigan School of Public Health, Ann Arbor, also Editorial Advisory Board member for Contemporary Pediatrics, the session put a twist on old burnout discussions, looking into how home conflict can impact work instead of work negatively impacting the home life.

At least a third of all pediatricians report burnout, and more than half struggle with work/life balance, according to the Pediatrician Life and Career Experience Study (PLACES), an initiative launched in 2012 by the AAP to track the experiences of pediatricians over the course of their careers. It was the data revealed in the PLACES study that inspired Byrne and Freed to lead this talk.

“Physicians are increasingly reporting symptoms of burnout, and physician burnout is related to decreased quality, safety, and performance to name just a few issues. Work-home conflict significantly increases burnout in physicians, but is potentially modifiable,” Byrne told Contemporary Pediatrics ahead of the conference. “Furthermore, female pediatricians are often primarily responsible for household work and childcare, even if both they and their spouse/partner work full time. It is important for pediatricians to better understand how, through negotiation at home as well as at work, they can make positive choices that benefit both them and their partner.”

This session focused on negotiating at home and the fact that both male and female pediatricians need to recognize some of the factors that have historically influenced the imbalance of work-home responsibilities leading to conflict and burnout. Byrne and Freed also introduced tools to help individual pediatricians prioritize important home and childcare tasks that they would like to discuss with their partner, as well as tips for negotiation so that that pediatricians can respectfully resolve work-home conflicts with their spouse/partner. 

“Given that work-home conflict significantly adds to burnout, we are hopeful that giving concrete tools to assist pediatricians in decreasing or resolving this conflict will positively impact patient care through reduction of stress and burnout,” Byrne says. “Increased emotional exhaustion levels have increased patient mortality ratios in intensive care units and burnout is an independent predictor of reporting a recent major medical error. Tools that we will explore in this session will also assist pediatricians in work negotiations, but a successful work-life balance incorporates negotiation at home as well.”

The first issue in resolving home-life issues that lead to burnout is to break barriers and address stereotypes that happen at home, Byrne says. The second is to learn how to negotiate in a respectful way and create a more balanced home.

There is a quiz that can help, Byrne says, from the white paper “Who’s doing the dishes?” The quiz investigates what is most important to each partner and what bothers him/her most. It helps determine who underperforms and overperforms in certain areas and can help provide a roadmap for working through a list of household duties.

Byrne and Freed also discussed some negotiating tools from the Harvard Business School and how to apply them at home. These conversations can help spouses split household duties based on what is important to the other and what works best for the partnership.