From the desk of the EMD: Because I’m happy….

February 6, 2017

Dr. Blaiss

I’ll bet you remember the Pharrell Williams song "Happy" from the 'Despicable Me 2' soundtrack. It’s one of those songs you can’t get out of your head. When I started reading the new 2017 Medscape's Physician Lifestyle Survey and looked at some of the findings, that song took up residence in my brain again—at least for a short time. Let me explain.

The survey asked allergists and at least 27 other specialties how they racially and ethnically self-identify in order to explore associations with patient care, personal choices, and levels of happiness. As part of the survey, physicians were quizzed about burnout. I know what you are saying: Please not another article on burnout. All the stories on burnout are making me more and more depressed. Yes, it is a hot topic in the media because it is having a major impact on the practice of medicine in the US. After Drs. O’Halloren and Verghese’s lectures at last year’s College meeting, we got feedback from you, the College members, saying it is an issue in the field of allergy. The College has formed a Task Force related to Physician Well-Being headed by Gailen Marshall, MD, PhD, FACAAI to work on solutions. But are allergists really suffering the same degree of unhappiness and burnout as physicians in other specialties? This survey helps give us some answers to that question.

How did Medscape define “burnout”? It is a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. So when I read that allergists were the 3rd happiest specialty in the workplace, the Pharrell “Happy” song start playing in my brain. Only dermatologists and ophthalmologists were happier. When I saw that urologists were the least happy at work, I was glad I didn’t become one like my brother-in-law, who was in my medical school class. Among all physicians reporting that they are very or extremely happy outside of work, allergists ranked fourth from the top for all specialists. Now, I was starting to do the “Snoopy” happy dance.

Unfortunately, the “Happy” song and dance did not stay for long. As I delved further into the data, I saw that everything was not rosy for our specialty. When Medscape asked allergists to rate the severity of their burnout on a scale of 1 to 7, where 1 equals "It does not interfere with my life" and 7 equals "It is so severe that I am thinking of leaving medicine altogether," allergists had the 6th highest score, 4.3. Urologists' rating was the highest, at 4.6, followed by otolaryngologists' and oncologists', both 4.5. Again, glad I’m not a urologist.

It was interesting to see exactly what issues were leading to burnout in the allergy community. The highest to lowest were: "too many bureaucratic tasks," "insurance issues", "increasing computerization", "family stress", and "threat of malpractice." My guess is that there are others unique to allergists leading to increased stress such as the immunotherapy compounding issue and remote practice of allergy.

Here are a few of the other gems I found mining this survey. Seventy-seven percent of allergists that were not burned out exercise at least twice a week, compared to 51% who were burned-out. There was a higher rate of allergists with burnout being overweight or obese compared to ones who were not burned out. When looking at debt, more non-burned out allergists were debt-free compared to burned out ones. More studies are needed to understand the relationships between allergist burnout and lifestyle.

There are no easy answers here. no quick fixes. When I “Tweeted” the link to the Medscape survey with the comment “Allergists are the third highest specialty on happiness at work”, I got one message back stating “And it’s still just 41% of the allergists happy at work. That’s a big problem”. Yes, that allergist is correct. Even though there is some good news here, it ‘s important to realize that many in our specialty need help in coping with practice. The College is committed to helping in this endeavor. Hopefully one day, every allergist will hear the “Happy” song.

Because I'm happy...
Clap along if you know what happiness is to you
Because I'm happy...
Clap along if you feel like that's what you wanna do
Lyrics by Pharrell Williams

Michael Blaiss, MD, FACAAI, Executive Medical Director