Thriving through career challenges: Building and maintaining resilience

Abstract

The focus on interventions to prevent burnout has shifted over the past five years from those exclusively aimed at the personal circumstances and personalities of surgeons and other healthcare workers, to approaches that affect the systems we work within. Systemic factors that create psychological stress, anxiety, feelings of helplessness, and moral injury have proven to be serious instigators and compounders of burnout. Additionally, strategies that contribute to enhancing engagement and building resiliency are widely recognized as essential to creating an environment where a physician may not only thrive, but survive the inevitable personal and professional challenges that arise. This chapter explores how resilience is best supported to survive not only the serious systemic issues that create moral injury and burnout, but personal issues that arise that can negatively impact a wonderful career. Interventions aimed at increasing engagement and promoting resiliency include those that contemplate strategies for individuals, healthcare institutions, and national organizations. Reviewing information supporting a range of interventions is important to understanding how to implement change meaningfully. Prevention of burnout and identification of factors boosting resilience should start early in training with modeling and messaging from mentors, and should incorporate individualized stress management strategies. Critically, however, the most compelling data for building resilience requires structural re-organization of institutions to align their values and processes with those of physicians and allied providers. Advocating for changes at the institutional and national level that preserve our relationships with our patients and colleagues, provide time for reflection and for outside interests that recharge and restore, should be a common goal and imperative for healthcare reform.