Steven Selbst, MD, previews his physician burnout research at PAS 2023

Contemporary Pediatrics®:

Well, thank you so much for joining me today. My name is Morgan Petronelli with Contemporary OBGYN and Contemporary Pediatrics.

Steven Selbst, MD:

Hi, I'm Steven Selbst, MD. I'm a pediatric emergency medicine physician at Nemours Children's Hospital in Delaware, and part of Sidney Kimmel Medical College, Thomas Jefferson University in Philadelphia.

Contemporary Pediatrics®:

Awesome. So, I want to get into, you know, the topic that I know you collaborated on that's going to be presented at PAS this year. So can you kind of explain what this presentation about? I know you're not presenting on it. But what is this presentation about? Why did you choose this topic?

Steven Selbst, MD:

Well, it is going to be presented by Heidi Klausner, who is the lead author. And Heidi Klausner from University of Wisconsin, one of the authors on this study, It came out of our wellness special interest group of the Academic Pediatric Association. We were concerned about burnout among academicians and realize is, there's a lot of talk about burnout in medicine, but not that much about academic pediatrics, what are the stressors. We thought maybe it's a little bit different. Maybe there's different stressors on pediatricians who work in an academic setting as compared to people who are in office practice or to other specialties. So this was part of work that we did surveying the members of our APA, the Academic Pediatric Association, finding out about burnout. And this particularly focused on mistreatment, who has been mistreated, how often it happens. We don't think of pediatricians mistreating each other, but it does happen in every specialty. And what we found out it happens in academic pediatrics as well.

Contemporary Pediatrics®:

And what was the most surprising about these findings?

Steven Selbst, MD:

I think it was surprising how often that happens in pediatrics, I think what we found out was that more than 20%, about 22% of the members who responded had been bullied in the workplace. And another 17% reported there has been discrimination that they have experienced in the workplace. So more than a third of our members report maltreatment while they're working in pediatrics, which is somewhat hard to understand, again, where pediatricians are usually kind, gentle people. But it happens in every setting, and it happens with our group as well. And then almost 8% have had some form of harassment and 3% of the members who responded report sexual harassment in the workplace. So it does happen everywhere. And I think it's very disappointing. And, and we do believe that this leads to burnout. This is one of the big reasons people burnout in medicine, if you're unhappy in a workplace, if you're mistreated in the workplace, it clearly can lead to burnout.

Contemporary Pediatrics®:

Yeah, absolutely. That is so surprising that, you know, bullying, especially used, like you said, among pediatricians or some you know, some of the nicest people in the world, that they experiencee bullying in the workplace too. And that can, you know, possibly lead to burnout. I know, obviously, coming from Contemporary Pediatrics, we just featured, you know, a great piece on physician burnout in one of our previous month's issue. So, you know, we keep hearing this coming up over and over again. So, onto that, what do you ultimately wish will happen? And what kind of impact are you hoping this research will have on physician burnout, and, you know, other studies of this type?

Steven Selbst, MD:

Of course, the first thing is to recognize that you have a problem, you can do anything with it until you admit that there's a problem. So I think calling attention to this is the first step. But I hope we are hoping that this will encourage hospitals, academic hospitals to go back and look at the culture at their hospital, and see if there's something systemic, in that culture that leads to mistreatment. And then we can tackle how we resolve this problem.

Contemporary Pediatrics®:

Just another question here for you, in a real world setting, have you observed any hospitals yourself where they've kind of looked at,"Hey, we have a problem here with burnout. This is one possible solution." Have you seen any solutions that have worked? Or are we kind of still on the cusp of even just generally recognizing it, and then coming up with some some solutions?

Steven Selbst, MD:

I think everybody is still trying to find solutions. Certainly, we are very careful at our hospital in terms of mistreatment or this zero tolerance policy for that and we have taken some senior people to, to counseling if there is any report of mistreatment on their behalf. And we certainly look out for our residents to make sure that they're not mistreated, and there's a hotline that everyone can call if they do recognize this treatment in the workplace. And we have a great wellness group here at our hospital. Dr. Mo Leffler is our chief wellness officer. So the hospital has put money into this resources into making sure or that we take on the issue of burnout. And looking out for people, making sure people get can get counseling if they need it, that's always been an issue of finding help for people who need it. But I think many academic institutions now are devoting time, energy and money and money to this problem to make sure that we recognize the problem and we get resources to people who need the help.

Contemporary Pediatrics®:

Absolutely. And my last question I have for you here is being in pediatrics for so long, you know, you have all this advice. Do you have any advice for young pediatricians, residents, if they are dealing with this kind of situation. What should next steps be? What should they do? How can they speak up?

Steven Selbst, MD:

Well, we do know, it is usually the younger people that are at greatest risk. The ones who have the least power are the ones who are more likely to be mistreated. But we do want them to speak up. And that's why there is a 24 hour hotline, zero retaliation policy. And I think many academic centers have similar policies in place that we want people to speak up, and we want to take some action. We don't want you to suffer in silence. If you're being mistreated. You have to let people know so that we can do something about it. And it could be probably mistreatment. That's what it usually is verbal mistreatment, often from a senior member who's just not as patient not as kind to a junior member, but that can't be tolerated. And certainly when it crosses the line, we have to do something about that.