Imagine you are a physician on call. Emergency after emergency keeps happening; one minute, a patient who was previously well is now in respiratory distress. The next minute, you’re explaining to another patient and their family that you can no longer do anything to help treat them and that they need to start putting their affairs in order. With each situation that piles up on your plate, you find yourself slowing down, physically and mentally. You’ve noticed for the past few months that it’s been harder to enjoy doing the work you dreamed of during medical school. You are burned out. But you can’t simply drop everything and leave work to go home and rest. What if there was a way to combat burnout, a method that allowed you to feel as though you were sequestered from the source of your stress just for a little while?Dr. Brian D. Gonzalez, a PhD at Moffitt Cancer Center who specializes in quality-of-life improvements for cancer patients, developed a virtual reality app meant to combat burnout in healthcare professionals. Optionality, as in most situations, is a key component of this app. Not everyone experiences stress the same way or has the same method of dealing with stress, so the app accounts for this by having a variety of settings for users to customize how they want to destress. If you are a beginner to mindfulness or relaxation exercises, there are soundtracks to guide you. If you are a long-time master of meditation, you can put on one of several musical selections or simply sit in silence while observing one of the nature simulations.

"By simply stepping away from your workroom and using a VR headset in a quiet space in the hospital, you can transform the hectic flow of the clinic into stressful thoughts flowing out of your mind".

Although you can’t physically distance yourself from work, you can do so mentally through this simulation.

In the little ways, burnout shows. Burnout rears its ugly head when we start to delay a little bit longer before seeing a patient, when we snap at a colleague who didn’t do anything wrong, or when we cannot summon the empathy we would otherwise have had for a patient going through a tough time. Physician burnout is associated with a myriad of terrible outcomes, such as higher rates of depression, substance abuse, divorce, medical errors, and patient dissatisfaction.¹It can also lead to job changes or early retirement, which disrupts continuity of patient care and prevents patients from being able to seek care from experienced physicians.¹ In the worst-case scenario, it can lead to a physician ending their own life. Roughly 300 to 400 physicians die by suicide each year.² Physicians who are particularly enthusiastic about their work early in their careers and have high aspirations are more at risk for burnout.³

So how can we support others when we are depleted and have nothing left to give? We are not machines whose parts can be easily replaced with a simple click online for next-day delivery. What can we do to help our burned-out health care workers help themselves? Hospitals could have dedicated spaces where employees can venture into virtual reality when they start to feel burned out. On a practical level, the cost of a few VR headsets for employee use is not much. The Meta Quest 3, the latest model, is about $500. When you compare that with other hospital expenditures or the potential litigation fees from a burnout-induced medical error, the total cost of a few headsets, which have high reusability, suddenly seems like small change. The time “lost” to VR use is minimal as well; in one study, a brief 10-minute VR session daily for a week relieved anxiety and improved psychological wellbeing in users.⁴

But all this shiny new technology lacks power without cultural change driving and encouraging its use. If a medical culture of putting our noses to the grind until nothing is left continues, the VR headsets will sit in an empty room collecting dust with health care professionals afraid to take care of themselves when they need it most. While some improvements have been made in terms of the nature of the discourse surrounding mental wellness, the stigma against self-care remains quite strong in medicine. By recognizing that we have limitations as humans and pushing for organizational support for our wellbeing, we can begin to turn our hope for a healthier, more resilient workforce into a reality.

References

1. Lacy BE, Chan JL. Physician burnout: the hidden health care crisis. Clin Gastroenterol Hepatol.2018;16(3):311-317. doi: 10.1016/j.cgh.2017.06.043. Epub 2017 Jun 30. PMID: 28669661.
2. Pospos S, Young IT, Downs N, et al. Web-based tools and mobile applications to mitigate burnout, depression, and suicidality among healthcare students and professionals: a systematic review. Acad Psychiatry. 2018;42(1):109-120. doi: 10.1007/s40596-017-0868-0. Epub 2017 Dec 18. PMID: 29256033; PMCID: PMC5796838.
3. Wiederhold BK, Riva G, Gaggioli A, Wiederhold MD. Physician burnout: improving treatment efficacy with virtual reality. Stud Health Technol Inform. 2016;220:454-458. PMID: 27046622.
4. Hatta MH, Sidi H, Siew Koon C, et al. Virtual reality (VR) technology for treatment of mental health problems during COVID-19: a systematic review. Int J Environ Res Public Health. 2022;19(9):5389. doi: 10.3390/ijerph19095389. PMID: 35564784; PMCID: PMC9102209.