Being a physician is a demanding job. It entails handling serious responsibilities, enduring long hours, navigating a complex and constantly shifting health care system and dealing with a built-in level of failure. As a result, physicians are suffering from burnout in record numbers. The major symptoms of physician burnout are exhaustion, cynicism and doubt. Exhaustion is not just physical. Exhaustion can be mental, emotional or even spiritual. Cynicism or depersonalization, is sometimes dubbed compassion fatigue. And doubt, of course, is a lack of utility: Wondering why you bother.
Burnout not only affects the physicians. It impacts family, co-workers, patients and the hospital or health system in which they are working. The importance of recognizing and dealing with burnout cannot be overstated.
With all of this in mind, here are ten steps a physician can take to stave off burnout:
- Go Home at the End of the Day.
Many physicians work long hours and find it hard to separate their office life from their home life. But to prevent burnout, the best advice for doctors is: At the end of the day, go home — and leave your work at the workplace.
- Just Say “No.”
The road to hell may be paved with good intentions, but it is also paved with bricks made of the word “yes.” Being open and receptive to new things is a positive way to live, but it is impossible to say yes to everything. Before answering in the affirmative to a request, ask yourself: Will it enhance my career? Will it lead to balance or imbalance in my life? Will it take away from time with my family and friends?
Take one. Take several. Take days off on a regular basis — so regularly that your staff and patients get used to the concept. While you are on vacation, turn off your cell phone and do not check your email.
- Find a Niche.
What aspect of being a physician do you enjoy the most and at what you feel youare best? Try to focus on that: Do more of what you enjoy doing.
- Develop a Support System.
Whether it is a spouse, friend or colleague, everybody needs a person who can listen to them, cut through the clutter and say, “Maybe you need a vacation” or “You’re working too hard; why don’t you take a day off?”
- Be Flexible. Adapting to change is tough. Balance is not a concrete concept. Stress and busy times are part of any career. But remember Darwin’s “survival of the fittest.” That does not mean strongest. It means most able to adapt to change.
- Stay a Student. Commit to lifelong learning. Educate yourself, formally or informally. Take the time to learn new things.
- Be Ethical. Doctors face ethical decisions every day. Often these dilemmas are straightforward: What is in the best interest of the patient? But managed care, profits, insurance and regulation apply pressures that can undermine the best of intentions.
- Slow Down. The business plan might call for spending 15 minutes with a patient and moving on, but it is possible to be too efficient. At times, you will benefit not only the patient, but yourself, by slowing down, listening and taking a few extra minutes out of your schedule. Doing so can be a surprisingly enriching experience.
- Accept Limitations. At the end of the Clint Eastwood movie Magnum Force, the bad guy drives away as Eastwood’s Dirty Harry looks on. The car explodes and Harry says, “A man’s got to know his limitations.” Well, it is true of physicians as well. You cannot save every patient. You cannot anticipate every possible outcome. Sometimes you cannot even finish the items on your to-do list. Accept it and move on.
Depression and burnout are not necessarily the same thing, but they often overlap. Take steps to avoid burnout and, if you feel yourself slipping over into depression, get help. An extreme version of physician burnout is suicide. Although coming up with hard numbers is difficult, it is estimated that between 300 and 400 physicians commit suicide every year. Start with the AMA’s educational module, Preventing Physician Burnout. Take the eleven-question wellness survey. Physician wellness reverses the impact of physician burnout.