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Abstract
Physicians suffer more burnout than many other American workers and rank near the top of all professions in burnout. Physicians who perform independent medical evaluations (IME) face the usual challenges (too many bureaucratic tasks, too many hours of work, insufficient income, and loss of status) that contribute to burnout among all physicians. Both “innate personality traits” and external factors (circumstances, examinees, time, performance, and risk) contribute to burnout among physicians who perform IME. Stressed because of multilayered litigation, insurance, and bureaucratic processes, IME physicians face a high concentration of difficult patients who are disgruntled with their jobs and, often, their lives. Examinees’ negative attitudes and outlooks contribute to pessimism and depression that can be contagious to the examiner, and because IMEs are one-time evaluations with no longitudinal care, the opportunity to establish rapport is limited. Physicians who are coping with the pressures of the IME milieu may need to realize that they have a greater sphere of positive influence than they realize: By conducting oneself in a professional and ethical fashion, writing fair reports, relying on evidence-based medicine, and applying the AMA Guides to the Evaluation of Permanent Impairment in a proficient manner, physicians who conduct IMEs can recognize and, one hopes, avoid IME burnout.
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Shanafelt TD, Boone S, Tan L et al.Burnout and satisfaction with work-life balance among US physicians relative to general US population. Arch Internal Med. 2012;172:1377–1385.
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Krupa C. Nearly half of physicians struggle with burnout. http://www.amednews.com/article/20120903/profession/309039952/2/. Accessed 6/9/2015.
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Peckham C. Physician burnout: it just keeps getting worse. Medscape. 26 January 2015.
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Peckham C. Physician burnout rate by specialty. Medscape. 28 March 2013.
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Drybye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clinic Proceedings. 2013;88:1358–1367.
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Linzer M, Levine R, Meltzer D, Poplau S, Warde C, West CP. 10 bold steps to prevent burnout in general internal medicine. J Gen Intern Med. 2014; 29:18–20.
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Barth RJ. Chronic pain: fundamental scientific considerations, specifically for legal claims. Guides Newsletter. January–February 2013.
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Dersh J. Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders. Spine. 2006;31:1156–1162.
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Monti DA, Herring CL, Schwartzman RJ, Marchese M. Personality assessment of patients with complex regional painsyndrome type I. Clin J of Pain. 1998;14:295–302.
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Fishbain DA, Goldberg M, Meagher BR, Steele R, Rosomoff H. Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria. Pain. 1986;26:181–197.
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Gatchel RJ, Garofalo JP, Ellis E, Holt C. Major psychological disorders in acute and chronic TMD: an initial examination. J Am Dent Assoc. 1996;127:1365–1370, 1372, 1374.
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