The document “Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2020” published by the Mayo Clinic, and work-life integration satisfaction among physicians and other non-health professionals. 

This study involved 7510 physicians. Of thosespecialties related to COVID-19, 38.2% reported having suffered more than one burnout symptom in 2020. Overall, compared to other professionals, the risk of burnout among physicians was OR, 1.41; 95% CI, 1.25 to 1.58 and their degree of satisfaction with work-life balance was OR, 0.71; 95% CI, 0.64 to 0.79.

And what is the situation among pulmonologists? According to the data provided by the report of the survey carried out in 2021 by Medscape, this is how the participating doctors who practice this specialty feel: 

• 61% of the 12,339 respondents were male. 
• 82% felt happier outside of work before the pandemic.
• 47% feel happier outside of work currently.
  
• 32% experienced burnout or depression.
  
• 37% consider that burnout impacts them strongly.
  
• Some of the mentioned factors that contribute most to pulmonologists burnout were:

1. 58% perform too many bureaucratic tasks.
2. 39 % Insufficient compensation/or reimbursement.
3. 38% spend a lot of time at work

• Surprisingly, pulmonologists are not looking to make more money (only 13% acknowledged that this would make them feel better) but their focus is on finding the balance between personal and professional life (52%). 
• However, their answers to the question that if they would accept a salary reduction in order to achieve such a balance slightly contradicts the above: 51% answered no. And despite the lack of time for their personal life, 63% consider they have a happy marriage.
  

 You will have already noticed that the solution to most burnout risks is reaching balance, but how to find it?

Since external factors are so difficult to control, it is necessary to find a way to govern what happens inside. Thus, it is advisable strategy and stick to it; it seems like a simple solution, but tell me: are you clear about yours? I don't mean isolated ideas, but a set of guidelines so coherent that you could even stop reading this for a moment to put them in writing, in whatever you have at hand.

To defeat burnout, I will not suggest what you already know: eat healthy, exercise often or seek professional therapeutic help; those are effective measures, but most people fail to carry them out as they would like to. Do you know why? Because they don't have a map. To get to a place you need a map that show the destination, the road to follow and the intermediate stops. Make your own!

And preferably put it in writing; not to remember what needs to be done, but so that you can assess whether you have reached your goals to balance your life. When these are not materialized in words, it is easy to feel that one does not advance, but after a while, review them and you will be surprised to notice what you have achieved.

In addition, for this to be practical it must be flexible. Make all the required adjustments until you find the right dose of habits and practices that give you the greatest therapeutic effects to combat burnout.

One more thing to keep burnout under control: take advantage of technology to make your daily work easier and faster. The SpiroScout is an ultrasonic spirometer that allows to perform fast, accurate, reliable tests, and it generates reports that are easy to interpret and graphical trends to easy follow, Besides you can claim the following CPT codes*:

Code 94010. $36.00. Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation.**

Code 94060. $62.00. Bronchodilation responsiveness, pre-and post-bronchodilator administration.

Code 94150. $26.00. Vital capacity, total (separate procedure).

Code 94200. $26.00. Maximum breathing capacity, maximal voluntary ventilation.

Code 94375. $40.00. Respiratory flow volume loop.

 Click here to find out how to take advantage of this ally in your daily practice. 

*CPT codes and reimbursements are provided as an example only and constitute no promise by Schiller or its subsidiaries regarding coverage or payment.

** CPT Code 94010 is the most commonly used in the market.

 REFERENCES

Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2020 https://www.mayoclinicproceedings.org/article/S0025-6196(21)00872-7/fulltext 

Medscape Pulmonologist Lifestyle, Happiness & Burnout Report 2021 https://www.medscape.com/slideshow/2021-lifestyle-pulmonologist-6013523#8

 GOAL 1. Empower people with COPD, their families, and caregivers to recognize and reduce the burden of COPD.

While it has long been known that poor lung function can predict a coronary event, it was uncertain if different patterns of lung deterioration had the same ability to predict such events, whether non-fatal or sudden death.

The study that Suneela Zaigham et al. conducted, considered an analysis that included the adjustment of potential factors. This is what they found: 

• 1 standard deviation reduction in FEV₁ was associated with a Hazard Ratio (HR) for Sudden Cardiac Death of 1.23 (95% Confidence Interval (CI) 1.15 - 1.31).

•   However, 1 standard deviation in FEV₁ was associated with a lower (but significant) risk of non-fatal events with a Hazard Ratio (HR) of 1.08 (95% CI, 1.04 – 1.13; P (probability) for equal associations = .002).
• ·  The results were the same among participants who had never smoked, with a Hazard Ratio for Sudden Cardiac Death of 1.34 (95% Confidence Interval, 1.15 – 1.55). The HR for non-fatal events was 1.11 (95% CI, 1.02 – 1.21; P (probability) for equal associations =.038). 

Those figures show a higher risk of fatal coronary events than non-fatal ones, even in people whose lung function was slightly below the normal range (but still considered normal). Therefore, this suggests that there exists a relationship between lung health and Sudden Cardiac Death.

In fact, Dr. Zaigham reported that a low FEV₁ was indeed associated with both, Sudden Cardiac Death, and non-fatal coronary events; but in addition, a low FEV1 was strongly associated with the prediction of Sudden Cardiac Death.

She also suggests taking advantage of spirometry early in life, as this simple test can go a long way in stratifying the risk of Sudden Cardiac Death. In other words, the use of spirometry is a great tool to reduce cardiovascular risks.

Reference

As you know, the effects of this problem are devastating for patients on a physical, emotional, and economic level. Comorbidities, such as osteoporosis and cardiovascular problems that affect the patient's (and their family's) life, often occur, leading to depression. And on the economic side, it is estimated that the costs, direct and indirect, for the U.S. health system reach 36 billion dollars annually.  

This makes it clear that having a good management of this disease results in an enormous improvement in the well-being of patients, the hospital system, society and for you, as a health professional. Unfortunately, one of the most useful and effective tools to achieve this is often undervalued, and therefore underused: spirometry.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD), in its 2020 report, emphasizes how important it is that the first contact physician to be able to detect the disease to immediately refer the patient, so the specialist can provide appropriate treatment and management of COPD on time.

As you know, individuals who require spirometry for diagnosis/evaluation of their pulmonary function are as follows:

• Patients with recurrent respiratory events. For example, acute bronchitis, undertreated flu, chronic coughs, or people with excessive sputum production.
• Patients with a history of exposure to risk factors. That is, smokers, former smokers, passive smokers, patients with alpha-1-antitrypsin deficiency and occupational exposuretodust, vapors, organic and chemical materials.
• Subjects with limited physical activity due to dyspnea.
• People with a family history of COPD.

The fact that the first contact physician indicates routine spirometry or, as the case may be, body plethysmography, speeds up diagnosis, which is vital in the long term for assessing response to treatment, medication adjustment, and monitoring disease progression.

A relationship between FEV₁/FVCperformed 15 minutes after inhalation of a Short-Acting Beta-Agonist SABA bronchodilator (salbutamol, albuterol)<0.70 confirms the existence of a persistent or fixed limitation to airflow. And this can only be known with certainty by spirometry.

Despite the recommendations of various international organizations, spirometry remains underutilized in primary clinical practice. In general, its limited use is attributed, on the patient’s side, to ignorance about the benefit of the early diagnoses of the disease, to lack of time and/or resources. Or to the lack of familiarity with the technique and interpretation process on the side of the primary care physicians.

Although patients may be referred to the specialist for diagnosis, follow-up in those circumstances will always be limited due to late detection. By the time COPD is diagnosed, the patient has already gone through incorrect treatments or has already lost valuable time that may have improved the prognosis and management of the disease.

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886101/

The growing demand for pulmonary function testing due to the COVID-19 pandemic has lead many physicians to consider renewing their spirometers or acquiring more units. And even doctors who previously did not offer this test are deciding to get spirometers to provide better care to their patients from the first appointment. 

Whatever your reasons for buying equipment, here are some practical tips to help you make the best decision.

In Schiller, we have SpiroScout an ultrasonic spirometer that covers the points mentioned above. One of its big strengths in times of pandemic is that it avoids cross-contamination because:

• It uses our unique ScoutTube mouthpiece, which isolates the patient's exhalation and avoids contact with the device´s sensors.
• The device can also use a high-efficiency PFT filter, which is a must nowadays.
• The health care professional can perform the test while maintaining the distance recommended by CDC (Centers for Disease Control and Prevention)