What a well-oiled democracy can teach radiologists about burnout
Physician burnout has a lot to do with democracy, Richard B. Gunderman, MD, PhD, wrote in the Journal of the American College of Radiology this month—and radiologists should be following the lead of the American College of Radiology (ACR) to combat it.
“Perhaps as the most democratic of American radiology’s major professional organizations, the American College of Radiology has an important role to play in this time of rising rates of burnouts among medical professionals,” wrote Gunderman, who works in the department of radiology at the Indiana University School of Medicine in Indianapolis. “Two of the most important contributors to burnout are loss of autonomy and inefficacy; both seem to be in decline.”
The field can learn from the ACR, he wrote, because, unlike other major radiology organizations in the country, it relies on a council whose members represent state chapters. That council is largely responsible for policymaking and leadership positions are typically elective, so the college succeeds in maintaining both autonomy and efficacy.
“Yet democracy is a complex and fragile thing,” Gunderman wrote. “If members do not understand the nature, benefits and rationale of democracy, as well as the conditions under which democracies can thrive, then not only the ACR but the entire profession of radiology is likely to suffer in ways that are reflected, in part, in sustained and worsening burnout among radiologists.”
Democracy is, at its core, a system that provides a country’s people—or an organization’s members—with an opportunity to contribute to decision-making and coalition- and policy-building, Gunderman said. While many professional organizations allow members to vote, he said those ballots work “merely to rubber-stamp decisions made by a few members of an executive committee.”
Rather than basing decisions around a set group of contributors, the author suggested the ACR’s route of an all-inclusive committee that allows more voices to be heard. A wider range of perspectives means a wider range of votes and input, he said, but even if a member is unhappy with a decision, they at least feel as though their voice was heard.
Opening input to a greater audience also cultivates a greater sense of civic-mindedness and dedication to radiology, Gunderman wrote, since involved members are more likely to stay up-to-date on modern healthcare policy and care about how that policy will affect their organization.
“Members feel less like passengers on a plane and more like co-navigators and copilots,” he said. “Almost by definition, engaged professional citizens tend not to burn out.”
Gunderman wrote fostering democracy doesn’t have to be a tiring process—in fact, he said, it could be a virtual one. In-person meetings present great opportunities for members to interact, discuss and debate, but some of those same conversations can be held in online forums, where more voices can be heard.
“To reduce burnout, members need to be well-informed about what is going on,” Gunderman said. “They need to feel that the organization relies on them to help formulate its policies and carry out its initiatives. They need to believe that it is upfront about admitting its mistakes. If burnout is the disease, democracy is one of its most important therapies, and the ACR has a distinctive role in fostering it.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.