Nov. 21, 2023, David Mitchell — Fifty-three percent of physicians responding to Medscape’s 2023 Physician Burnout & Depression Report said they had experienced burnout, up 11% compared to the publication’s pre-pandemic report in 2018. Sixteen of 29 specialties considered in this year’s report had burnout rates of 50% or higher, including family medicine (57%).
Timothy Riley, M.D., would like to make it clear that his peers aren’t the problem.
“I don’t think we have a resilience deficiency among family docs,” said Riley, associate professor and associate vice chair for wellness at Penn State’s Milton S. Hershey Medical Center. “We can’t blame the toast for getting burned. It’s the environment that needs to change.”
Riley, who also is core faculty at Penn State Hershey Family Medicine Residency, will be the featured speaker in two free upcoming webinars focused on physician suicide awareness and prevention:
“One of the most dangerous things for someone who’s suffering with burnout, depression or suicidal ideation is isolation,” Riley said. “What I want is for people to leave these webinars feeling empowered and inspired to say something to a colleague who may be in distress so that they might form a connection when someone really needs it.”
Riley, who suffered with asthma and allergies as a kid while growing up in Syracuse, N.Y., knew as early as middle school that he wanted to be a family physician. Spending nine months with Joseph Hinterberger, M.D., FAAFP, at his full-scope family practice in Watkins Glen, N.Y., as part of SUNY Upstate Medical University’s rural training track, cemented Riley’s career choice.
Although he was doing what he had dreamed about, Riley found himself experiencing burnout seven years into practice in a community setting.
“I experienced myself what it was like to not feel fulfilled as a result of the work that I was doing,” he said. “Each patient, and each problem that patients brought up, was little more than a barrier to get to the end of the day and a source of frustration rather than an opportunity to help someone.”
Riley recognized that he was burned out on clinical medicine and transitioned to an academic role with fewer clinical duties. At the Hershey residency program, he was tasked with developing a practice management curriculum.
“I was well aware that one of the key things we need to manage is our own well-being, so I weaved physician well-being into our practice management curriculum,” he said. “This was before it was required by the ACGME.”
Since then, Riley has taken on roles related to physician well-being at the local and national level. He participated in the AAFP’s Leading Physician Well-Being Program in 2022 and has been a speaker at the Academy’s Family Physician Health and Well-being Conference for the past two years. He also has served as faculty for the AAFP’s Resident Well-being and Burnout Prevention Project ECHO, leading a session on physician substance use, depression and suicide.
“I’m grateful that I accepted that challenge,” he said of the ECHO, which offers residents free, online, peer-based learning sessions. “The more I learned about physician depression and suicide, the more it became something that I’m passionate about. I feel like I need to spread the word and help people feel empowered to make the changes.”
Along the way, Riley also learned a lot about mindfulness and now teaches that topic, too.
“It has really positioned me to weather challenges with greater ease and to soak in the joyful elements of practice,” he said. “I’m in a much better position now to wade into the challenges my patients present. I am better able to prioritize self-care in a healthy way, and I look out for my friends and colleagues.”
Riley devotes about 75% of his time to clinical work, including precepting residents.
“The thing that really pushed me into academic medicine was that I wasn’t doing well with purely clinical work, but what has kept me in academic medicine has been the genuine joy that I feel when I am interacting with learners — teaching students, teaching residents and mentoring them. It’s been a major source of fulfillment for me.”
Riley, who graduated from the Lancaster General Hospital Family Medicine Residency Program in 2005, was among the first wave of residents who trained with duty hours restrictions. He’s since witnessed an increase in the number of resources available to students, residents and physicians to address their well-being.
“I think there’s tremendous hope for our profession and our specialty as the next generation comes along because I think there’s been dramatic movement in the culture,” he said.
Riley said physicians can make a difference not only by taking care of themselves but also by advocating for change.
“I’ve had the opportunity to have a few conversations with people who operate the levers of power locally and at the national level, and they don’t always have a clear sense regarding what levers to pull,” he said. “People doing the work need to be the ones proposing the solutions. We need to get involved.”