2018 MindGames Top Ten Teams

Please join us in congratulating our “MindGames” team, Dr. Laura Romer (PGY-4), Dr. Svetlana Famina (PGY-3) and Dr. Melissa Sullivan (PGY-3), from the University of Louisville, on their recent success. They finished fourth in the nation on the MindGames competition – narrowly missing the opportunity to compete in New York at the Annual APA meeting finals. Please see additional information below from the American Psychiatric Association. Again, congratulations to these residents! For more information…MindGames

Burning Out?

Are doctors burning out? Yes, indeed. In recent years, physician burnout is becoming a growing national issue, even a public health concern. Work-related stress heightens personal dissatisfaction, cynicism, and frustrates feeling accomplishment. That can result in compromise of professional function and home relationships. Depression and/or anxiety sometimes follows and the risk for substance abuse is greatly increased. Denial of such problems and feelings of inadequacy exist even when there is overt evidence to the contrary.

       Burnout negatively affects patient care and productivity while doctors become less professionally engaged or understanding of their patients. That also impacts physician recruitment, retention, and early retirements. <br>


Why is this? Loss of professional autonomy, too brief time with patients, and very cumbersome electronic medical record keeping are a big part of the problem. The intrusion of so many insurance company regulations; pharmaceutical access refusals; and similar hospital, billing, or other bureaucratic burdens at providing medical care harms the spirit and energy of doctors. Ethical and financial asymmetries between physicians and their leadership add to the dysfunction. Inefficient, rushed office practices are another concern. This is especially so since group practices are often controlled by outsiders and/or the influence of money making.

What to do? Intervention can follow two pathways: the local, individual approach and the organizational focus.

Every practitioner should be personally proactive at awareness for signs of trouble. Self-care and office management adjustments can help. Colleagues and office staff ought to be alert to aid one another and if indicated, to suggest outside assistance. The same applies within group practices. Less “bottom-line” objectives probably would be beneficial.

Medical schools and residency training programs should offer more guidance on these matters. Providing more staff assistance at data entry, transcription, patient follow up, and medication prescribing hurdles or reconciliations would free doctors to perform patient care.

Having a much shorter, focused, and simplified electronic medical records system is a great place to start remediation. Medical organizations should take a more active role in such corrective measures. Legislation can assist, particularly to facilitate reform of institutional rules and regulations; however, this requires physician input and advocacy. Universal, affordable health care and greater access to prescribed medications would also reduce stress. Obviously, this takes coordinated cooperation by many people, medical and health care organizations, big companies, and our government. Easier said than done.

Good luck!

Steven Lippmann, M.D.

Clinician Resilience and Well-Being Resources


Dr. Steve Lippmann is a Distinguished Life Fellow of the APA and is recently retired tenured Professor at the University of Louisville School of Medicine. He volunteers much of his time now working with refugees and victims of war. In his free time, he enjoys traveling with his lovely wife to visit their grandchildren.

Members Course of the Month

Lithium and Bipolar Disorder in Children

Lithium continues to be highly recommended in international guidelines for the pharmacotherapy of bipolar disorder, but worldwide usage by clinicians seems less frequent than expected. This may be due to a lack of appreciation of the strength of the evidence base favoring lithium use, but also, studies show high discontinuation rates in patients started on lithium, and clinical experience may be similar, leading to a reluctance to initiate prescriptions. The side effect burden of lithium is considerable, and clinicians may not be up-to-date on reasonable strategies for managing side effects. This presentation reviews the advantages and disadvantages of lithium as a treatment in bipolar disorder in children and discusses the major side effects and how they can be optimally managed. Presented by Othman M. Mohammad, M.D. of Baystate Medical Center.

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