Don't Be Reluctant to Seek Help

Denise Hanisch, MD
President, South Dakota State Medical Association

November 2023

Last month, I had the grand idea to build myself a garden fence. I watched multiple YouTube videos, made a supply list and rented an auger to dig the post holes (after I dug two holes by hand). The auger got stuck and seized up while digging the third hole. I spent hours trying to dig it out……..well, because, I was not going to ask anyone for help. The next day, after again spending several hours trying on my own, I caved and called my two nephews, who are in their 20’s. That evening, they drove 45 minutes to my place, were able to rescue the auger from the thick clay and dug 10 more holes in the time it would have taken me to dig one. I felt guilty and that I had failed because I had to ask for help. I have no doubts that this inability to ask for help is a common trait among physicians. It is inherent in our nature and part of our culture to appear that we are at the top of our game at all times.

We are drawn to this profession because of our love of medicine and providing the best possible care to patients. But, add in electronic health records, increased administrative burdens, insurance struggles, the pandemic and is it no wonder that the equation leads to a degree of burnout? “Physician burnout” has become a buzzword the past several years and when a term becomes commonplace, I feel we all develop a sense of “numbness” to it. Burnout continues to escalate and physicians continue to be resistant to ask for help. Burnout and depression often overlap but burnout is specifically defined by the WHO as “a syndrome resulting from chronic workplace stress that impacts physical, mental , and occupational well being” with key symptoms comprising of “exhaustion, cognitive impairment, poor work performance, empathy loss, and social withdrawal.”

There are several reasons why physicians are reluctant to seek help. A Medscape survey in March 2023 found that 24% of physicians experienced symptoms of depression and 40% of those did not tell anyone because they felt they could handle it on their own. Even though physicians feel overwhelmed at times, our culture has the tendency to “normalize” feelings of distress. The sense that we are supposed to “just handle it and move on’ is prevalent. Another reason was the fear that medical boards, their employers or coworkers, would find out or that they would be judged by their colleagues.

Efforts by many medical associations and societies, including the SDSMA and AMA, have pushed licensing boards to change questions on credentialing applications that have the tendency to discourage physicians in seeking treatment for fear of losing their license or privileges. South Dakota has been at the forefront of this change and given credit in a recent publication by the American Bar Association entitled Physician Burnout and Career Fatigue Part III. I encourage you to read the entire article here.

Where can we find help? The SDSMA has developed the South Dakota Physician Well-being Program that provides support for all South Dakota physicians, not only for tackling burnout, but also addresses issues such as family/life balance, substance abuse, career changes, anxiety and depression. This resource is completely confidential and encounters are not filed with insurance and are not reportable to the SDBMOE or an employer. The SDSMA has contracted with Midwest Health Management Services (MWHMS) who has had a longstanding history of providing resources and support for South Dakota physicians and other health care professionals. Over 40 physicians in South Dakota have already enrolled in the program. You can find more information at the SDSMA home page or by calling 605-275-4711. I encourage you to share this information at medical staff meetings or other encounters with physicians to increase awareness regarding this valuable resource.

Asking for help can feel foreign and uncomfortable, but, overcoming that first step opens us up to the fact that there are people and resources available to provide support.

Be well.