Burnout and how we can put this fire out
Dun dun diddly doo ba cries my phone at 2am with the longest most jarring ring to frigidly wake me up from my semi-slumber.
“Hello?” I mumble in a somewhat crackly voice.
“Is this the nurse practitioner?” she utters mildly incoherently.
“No. It’s the doctor on call.” Why in the year 2021 do people still assume physicians are male when medical school classes are pretty close to 50-50 genderwise?
“Can I get an order for docusate?”
What?
Why couldn’t they ask about this during the day?
WTF.
I want to scream.
I get to be sleepless and round on 30-something patients tomorrow while she’ll be done with her shift in a few hours.
I’d like to yell and blow off steam but I know better than that.
Cue brief daydream sequence:
Me, screaming at the top of my lungs, followed by an incident report and email chain, potential humiliation in front of my partners, and my senior partner putting the fire out.
Seems like something I should avoid and shut the f%ck up about and keep a lid on.
Don’t get me wrong. I love helping patients. I love having a positive impact on the world and feeling like I am healing the ill with my work. But it’s all the other bullshit in the medical system that gets in the way.
The above account is simply a snapshot of events that lead to physician burnout. Having to remain composed all the time while getting needled regularly. Imagine being in charge of little human beings at home on top of having the weight of people’s health on your shoulders. It’s a heavy load.
Doctors know what I’m talking about. The administrative nonsense, the insurance companies refusals to provide patients with good care and poor hospitals with appropriate reimbursement. The state of medicine includes worsening demands of the physician with reduced autonomy and workplace control. Medical culture is arduous and expects perfectionism and tirelessness. These expectations often fuel a perpetual inadequacy for doctors. Self-care and mental health are not particularly accepted in the medical field as a whole.
Physicians show symptoms of burnout at a rate of double other careers.1. “Burnout is characterized by a low sense of personal accomplishment, emotional exhaustion, cynicism, and depersonalization.”2 Physician burnout is multifactorial. Electronic medical records, administrative red tape, excessive work load, complexity of care, and poor work-life balance all contribute towards burnout. Furthermore, burnout leads to increased errors and suboptimal care. Physician unhappiness often ends in increased job turnover, reduced physician retention, early retirement, and interpersonal relationship difficulty.
Physicians are dropping like flies: via suicide or perhaps in a clinical depression requiring megadoses of Zoloft. Worse, some turn to illicit substances to self-medicate while others are flat out leaving the field.
There has to be a better way.
How can we manage this?
Well,
We can choose to speak up to the proper channels.
We can choose to love ourselves above all else.
We can say no when we are asked for too much.
We can say no by establishing boundaries.
We can separate ourselves from our jobs.
We can make use of our free time and vacation days more deliberately.
And that’s just the beginning.
I see you. I know you’re suffering.
You can tap into your own power and kick burnout in the balls.
Get in touch with me to get started.
1. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014 [published correction appears in Mayo Clin Proc. 2016;91(2):276]. Mayo Clin Proc. 2015;90(12):1600-1613. doi:10.1016/j.mayocp.2015.08.023
2. Gazelle, G., Liebschutz, J.M. & Riess, H. Physician Burnout: Coaching a Way Out. J GEN INTERN MED 30, 508–513 (2015). https://doi.org/10.1007/s11606-014-3144-y