Physician burnout: When work is not the cause

When it comes to physicians burning out, for the most part, it is assumed that work is the primary cause.  After all, physicians work long hours, have demanding schedule, and have to deal with the endless politics that comes with medicine. However, I often encounter burned out docs (many of who wear multiple hats outside of the home) who would claim themselves that work was not their primary cause of overwhelm and exhaustion.  They love what they do and have supportive leadership.  So, what is the underlying cause in this case?  There can be several factors that commonly get overlooked that contribute to the exhaustion, overwhelm and fatigue.  In an informal poll of doctors, here are some of the top non-work causes I’ve heard.

1. Chaos at home. After a long hard day at work, when a physician comes home to what is supposed to be a haven, and finds more stress and/or chaos, it robs them of the opportunity to decompress from the day. Instead, one goes from being the fixer at work to the manager. Dealing with this day after day wears down anyone’s ability to cope let alone a physician who already feels a sense of responsibility to fix and bring order to things.  What to do: Sit down with the spouse (if you have one) and/or the children and create a structure that is a win-win for everyone if possible. Allow it to be a team effort to encourage full participation.  The key to having this work is in the setting and enforcing of boundaries once the structure is in place.

2. Perceived lack of support at home. I tend to hear this particularly from the Dr. Mommies I coach (and I can personally relate to ). Notice I use the word “perceived.” Often times the perceived lack of support is more a function of not having asked for the support than anything else.

As women in medicine, we are at high risk for the “superwoman syndrome,” partially as a conditioned response from our medical training (or even modeled to us by our parents and mentors).  We either forget to ask, or feel like we should be able to handle it all.  Furthermore, we may have asked in the past, but not gotten the results we wanted so we just say “forget it” and decide to do it all alone. Finally, we just have control issues (let’s face it, it’s part of our training as doctors). The thing to do: Make a list of the things you would feel comfortable giving away and then ask for help. You can ask for help in a way that makes it a win-win for your spouse or children (like above) and be vulnerable and tell them how it will help you to have this assistance. It’s not easy, but it is simple.

3. Lack of intimate personal connection. When I refer to intimate personal connection, I don’t only mean with spouse. As physicians, we can get so consumed (from a time standpoint) up in our work, it edges out the other people (and fun activities) in our lives.  That can be lonely.  I’ve spoken with Dr. Mommies that haven’t been on date nights with their husbands in months, let alone go out for any “friend” time.  The thing to do: Put a date night on the calendar! Period!  If you are not married, this date night can be with girlfriends.  Plan a play date (or family date) with friends who have children the same age as yours. It’s a great way to socialize and have family time. If you are married, plan a date night! (Yes, I know I’m repeating myself, but this is important). Plan a freakin’ date night!

4. Inefficiency of charting. OK, now I know this is related to work, but it’s not about the work environment as much as it is technique. I talk with so many physicians whom if this one thing was corrected it would make their lives workable. They would leave work on time, not take charts home, therefore, would be able to be present with family (not worrying about how behind they are in charting). This is one major domino that can truly affect life beyond work. The thing to do: Get help.  Find the power user in the office and have them show you their templates.  Create templates of your own. I recently wrote a blog article that gives the top 4 tips of Power Users. The point is, you don’t have to suffer through endless charting alone. Ask for support.

5. Superwoman/superman syndrome. I mentioned it earlier, but it bears giving it its own attention. We are trained to be the lone ranger, superhero types; never asking for help and feeling guilty if we take time for ourselves. We need to remember that we are human just like everyone else, and it’s okay to set aside time to decompress, rest, and recharge. This especially is true for those physicians who are introverts. Of note, introverts are drained by the constant interaction with people (which is kind of our job, right?). Physicians who are introverts are especially at high risk for burnout because of this and need to take care to set aside time throughout the day and at the end of each day just to be with themselves.  When they do this, they can then recharge enough to be present with the family at home and feel less overwhelmed in general.

These are just a few things that are non-work related that can contribute to burnout in physicians. Other of note: Aging parents, financial struggles, high needs children, marital problems, and personal health problems to name a few.  The bottom line is that while there is a significant amount of work stress, workplace bias and bullying, and bureaucracy that contributes to burnout, if we only focus on that we are missing a significant opportunity in creating solutions.  We save lives, but are still human. We would do well to remember this for ourselves.

Maiysha Clairborne is an integrative medicine physician and can be reached at The Stress Free Mom MD.  She is the author of The Wellness Blueprint: The Complete Mind/Body Approach to Reclaiming Your Health & Wellness

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