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A Closer Look at the Factors that Shorten Our Time to Burnout Fuse in Radiology


Addressing ancillary repetitious inhibitors to radiology workflow could go a long way to mitigating burnout risk.

Every now and then, one hears a flurry of chatter about burnout in radiology. Other than the peer pressure influence of “people are talking about it, we should too,” I am unclear why the topic should trend in waves. Near as I can tell, the factors creating — or ameliorating — burnout seem pretty constant.

I resist the urge to write about what everyone else is at the moment. Why strive to be heard above the din? Sometimes, events demand it. For example, the NPP piece I wrote last week was prompted by a new study, which created a lot of buzz. There was no point in waiting months before offering my two cents.

For now, folks don’t seem to be going on and on about burnout, so it is an opportune time for me to put forth a notion I have had on the matter.

Most writeups make a big show of struggling to define the term. A lot of them have titles like “What is burnout?” Then these articles go on to talk about its subjectivity and the challenge of quantifying it but soon tacitly admit that people know darned well what it is.

I don’t know what proportion of other rads would agree with the sentiment, but any time I have perceived burnout in myself or colleagues, it has never been about the actual work we do. It’s about all of the ancillary “stupid stuff” as one of my internship mates liked to say.

If we could stroll into our workplaces (or fire up our telerad machines at home) and seamlessly read cases in the setting of quality, reasonably efficient health-care delivery, I don’t think many of us would feel burned out at all.

However, nonsense often gets in the way. This could come in the form of software or hardware that never seems to work the way it should. There could be protocols that either don’t get followed or were poorly established in the first place. Other obstacles may involve administrative hassles and maladaptive workflows.

The hallmark of many of these burnout makers is their frequency. They might be minor annoyances compared with higher order radiological dissatisfactions (RVU cuts, NPP incursions, etc.), but they make up for it by constantly presenting themselves, sapping morale via a thousand tiny cuts.

Each time, for instance, that my voice recognition software makes the exact same mistake it has for the past couple of years, despite my retraining it God knows how many times, it’s not an isolated irritation. It invokes the cumulative disgruntlement from every single previous instance of the same thing. I am not just getting pelted with grains of sand. I am constantly reminded that I am gradually being buried on a very unpleasant beach.

At some point, probably when I was overdue for a vacation, I realized that I could actually quantify my burnout. Instead of vague verbiage (“I’m a little burned out.” “I’m very burned out, but not as badly as I was at my last job.” “I’m more burned out than I’ve ever been”), I could see how much of a workday went by before something made me hit the “I’ve got to get outta here” point. I started thinking of that interval as my TTB or “time to burnout.”

The shortest TTB I can recall for myself was, I think, 12 minutes. Granted, I already knew I was leaving that job. Ideally, you shouldn’t even have a TTB on most days. Even if you aren’t enthusiastically joyous to be at your job, it’s a bad sign if you dream of leaving it on a typical day or even worse if that happens frequently or within the first hour at your post.

Another reason why these swarming irritants are effective at getting under the skin is that they seem like they could be fixed so easily if only the powers that be cared. A lot of the rads I have known genuinely don’t feel like anybody seeks their input about what plagues them on a many-times-per-day basis. Not finding such receptive ears, they have even less hope of corrective action.

Yet correction seems so tantalizingly within reach. If every rad on the team has the same issues with protocol X or workflow Y, either change policies or explain to the team why such a change isn’t feasible. Let them workshop other solutions. If every rad agrees that the voice recognition or some other piece of software is hamstringing the team, invest in better gear. Heck, give them the option of relinquishing a fraction of their annual bonus to help pay for the upgrade.

Simply making a gesture in that general direction goes a long way. A lot of the repetitive insults that lead to a short TTB sting as much as they do because there’s a sense of “You’re going to have to put up with this as long as you’re here.” That spell is easily broken with just a little bit of effort.

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