While Physician burnout is not a psychiatric disorder, it can sometimes look like one. Whether you’ve been working too hard, feeling like you’re in a bad job fit, or just feeling overwhelmed by tough hours or difficult patients, ignoring the signs of burnout can lead to emotional exhaustion, medical mistakes, and symptoms that look virtually indistinguishable from clinical depression. The best ways to fight burnout include spotting it early and taking action to make time for your passions, free up your schedule, and maintain your relationships. But what happens when these options aren’t possible?
Although it’s better to catch burnout early, sometimes you may have to push through – whether it’s keeping up with the demands of residency, a staff shortage in the emergency room requiring extra on-call time, or an unexpected onslaught of difficult surgeries, the reality of practicing medicine is that sometimes it isn’t possible to alleviate burnout right away.
So while the best – and most essential – course of action is to make changes in your lifestyle that benefit you long term, there are temporary actions you can take to make burnout a little more bearable. Here are some tips for how to work through burnout:
1. Recognize the Signs
Even if it’s not possible to treat burnout right away, simply recognizing the signs that are there – such as making more mistakes, complaining about your patients more than usual, lacking empathy, feeling irritable, or leaving the clinic feeling drained – can stop you from taking these things personally. One common sign of burnout is losing your sense of professional effectiveness, and if you’re suddenly making mistakes, snapping at coworkers, or becoming irritable with your friends and family, it can hurt your self esteem or even make you question your decision to become a doctor!
However, recognizing these behaviours for what they are – signs of burnout – can help alleviate some of the personal burden: you’re not a bad doctor, parent, or friend, just a tired one. Even if you aren’t able to take significant action on burnout right away, knowing these things can happen can also help you understand how to work through burnout by scheduling or organizing things to avoid scenarios that have left you feeling down or frustrated before. For example, you could avoid making difficult decisions at the end of a long day, stay away from conversations with coworkers when you’re in a cranky mood, or arrange to take at least a few minutes to yourself before you see your spouse or family after work.
While simply noticing the signs of burnout doesn’t offer you a well balanced work life or help to fight the problem long term, it can potentially keep it from snowballing into a cycle of self blame. After all, compassion is a key part of your job – so make sure you have some for yourself as well!
2. Call Out When You’re Sick
Many physicians feel taking time out for themselves – even if it’s to heal their own illness – inconveniences their patients, puts them behind schedule, or makes them seem ‘weak’ to other doctors. However, ‘presenteeism’ – coming to work when you’re too sick – is just as big of a problem and can exacerbate the symptoms of burnout even more. Not only do physicians make twice as many mistakes when they’re burned out, they’re also at greater risk for automobile accidents and near misses – if you add in illness to this mix, the results are not good! When you take time to recover from illness, you not only protect yourself, you protect the people around you. So while it isn’t always possible to take time away from the office when you’re busy and burned out, illness should always be the exception – and your patients will likely agree!
3. Create Internal Rewards
Pushing through never ending piles of paperwork or feeling like your workload has spiralled out of control can leave you missing a sense of satisfaction or accomplishment in your work. Experts on physician burnout say it’s this perceived loss of control over a heavy workload that makes burnout so pernicious – a long day could feel satisfying if you’ve managed to tick off everything on your to-do list, but when your best laid plans get sidetracked for even more work, it’s hard not to feel swamped.
Research into physician burnout suggests that one of the reasons physicians – who typically enter the profession for altruistic motives and see it as a calling rather than a job – burn out is because of the health care system’s mismatch between the monetary rewards it offers to compensate for long hours and the internal rewards doctors are looking for. In a study of over 15,000 doctors, half said they would give up $20,000 of their annual salary if it meant working less hours – including the youngest and lowest paid physicians.
So if money isn’t a motivator, what is? The same research indicates that feeling competent, autonomous, and having a sense of belonging is key to doctor’s happiness. When overwhelm is unavoidable and your workload is out of control, try to focus on getting these aspects of your practice back into balance:
- doing easy tasks at the end of the day can build feelings of competence,
- setting aside blocks of time to complete administrative tasks can rebuild your sense of autonomy, and
- connecting with colleagues who are in the same boat can help foster a satisfying sense of community.
4. Ask for Help
The most important thing to remember when you’re burned out – whether you’re taking action on it right away or you’re looking at how to work through burnout – is to ask for help. If you’re working through burnout now, odds are that you’re going to need to take greater action in the future, whether it’s planning a more flexible schedule or making more time for the work that fires you up – and making these changes often doesn’t happen alone.
If you’re feeling burned out, depressed, depersonalized, drained, or feel your burnout has reached a crisis point – don’t delay. If things are bad, it might be best to reach out to professionals. However, going to a friend or colleague and talking about how you’ve been feeling is a good first step.
Research on burnout indicates that the doctors who have been in the office the longest – physicians who had practiced for 31 years or longer – enjoyed the lowest amounts of burnout. Although much of this likely comes down to a reduced workload prior to retirement, some of the reduced stress enjoyed by doctors who have long been in practice likely comes down to a deep understanding of the profession – older doctors have seen burnout in their colleagues and themselves for the better part of their lifetime, and are uniquely qualified to help you deal with it.
In a Times magazine article, senior doctors at Stanford’s medical school created a peer help network for physicians in the program, including a variety of specialists who could treat young doctors who rarely seek medical assistance for themselves. Having older physicians to air tough work problems to and get advice from was crucial for the residents, even if it was something as simple as having someone listen to a difficult situation you had to witness. Because medicine is so unique in its scope and practice – and provides challenges different from any other profession – having other doctors around to talk to about burnout can be the difference between rising above burnout and drowning in it.
Medicine may have traditionally held stigmas against burned out doctors seeking help, but the tides are changing – and more than ever, there are resources available to help. In the past, resources on burnout tended to focus on building doctor resilience, with guidance centered around mindfulness training, eating well, exercise, and sleep. All of these factors are important, but experts and research around physician well being have all suggested that the problems around physician burnout can’t be addressed without systemic change – and a focus on removing the stigma around asking for help when you need it.
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