Regardless of specialty or experience, all physicians may experience burnout at some point in their career. Let’s talk about how to assess and treat the symptoms of burnout, and what some alternative solutions may include.
What is Burnout?
The World Health Organization describes burnout as a workplace phenomenon characterized by feelings of exhaustion, cynicism and reduced efficacy. It is a result of chronic stress over time. Working long hours with a heavy workload, feeling like there is a lack of control in the workplace and toxic work environments are among major factors that contribute to burnout. Health care, by virtue of being a helping profession, is another factor.
Symptoms of Burnout
People experiencing burnout may experience poor sleep, physical exhaustion and fatigue, changes in eating habits, headaches, stomach aches, high blood pressure, diabetes, heart disease and substance abuse. When I was experiencing burnout at its worst, I felt like even twelve hours of sleep was insufficient. I had completely walled myself off into my own private shell. I no longer wanted to engage with friends or in activities I enjoyed. And when I did, I was not fully present and I did not really enjoy myself. I still managed to exercise four times a week.
I was not clinically depressed, but I was not myself. It was not until a family member told me that I had changed into someone unrecognizable to her that I realized something was wrong and I needed to take action. That was my wake-up call.
You Realize You’re Burned Out – What To Consider Next
The burnout treatment plan includes taking care of you: your mind, your body, your soul and your finances. Avoid alcohol, minimize caffeinated beverages, eat clean, well-balanced nutritious foods, exercise, sleep, make time for stillness throughout the day and take time to connect with loved ones. If you are even contemplating that you have reached this point, consider cutting all unnecessary expenses and live well within your means. Start saving as much money as you can as a preparation for the worst case scenario. Knowing you are not stuck financially will empower you to think with a clear and level mind.
Since a lack of control is part of burnout, look for ways where control can be exerted in the workplace.
Maybe that means adjusting your schedule. Maybe that means swapping a task with a colleague. Maybe that means turning off all gadgets and eating a real lunch. In my case, it ultimately meant leaving a toxic workplace and finding a place where I could curate what it was that I wanted to do.
I’ve Done Everything You Told Me To and I Still Can’t Shake the Burnout
It is time for introspection. Have you given everything you can give and now feel stagnated? What else can you learn in your current position? How else can you grow? Is there something you can change in your existing structure that will make it palatable to stay? Have you reached the point of diminishing returns?
If there really truly is nothing left for you to grow, consider looking for a new job. Even if you do not quit your existing job just yet, it is always great to know what else is out there and what salary you can command.
The Great Resignation
According to the U.S. Bureau of Labor Statistics, 4 million Americans quit their jobs in July 2021. Mid-career employees between ages 30 and 45 years old have had the greatest increase in resignation rates, with an average increase of more than 20% between 2020 and 2021.
It is hard to know if these resignations are the result of an increased demand for mid-career employees or if employees have reached wake-up calls of their own and are seeking work-life balance or different work environments. The tech and healthcare industries, fields that had experienced extreme increases in demand due to the pandemic, had the highest resignation rates, at 3.6% and 4.5% more, respectively.
When Leaving Is the Only Option
You’ve been taking care of yourself. Your blood pressure, cholesterol and HgbA1c are normal. You’ve been exercising, meditating, sleeping, spending time with friends and family and engaging in hobbies. You’ve changed whatever you can change within your existing work structure. Yet you still feel exhausted and cynical and burned out.
Before you make any drastic decisions, make sure you have an emergency fund and a financial roadmap ahead of you.
Know exactly how much money you will need to survive per month. You have two options: keep your current job while you look elsewhere or, if you have the finances set in place, leave your current job before getting a new one. Bear in mind that the new job will ask questions about why you left and why there is a gap in your employment.
Apply and interview at other places. Make sure you can meet and speak with people who are wearing boots on the ground. Ask about turnover rates and physician satisfaction. Take a second look if you need to. If you do accept an offer, make sure to use MGMA data to negotiate a fair salary (gender pay gap, I’m looking at you). If you stayed at your job while looking for a new one, review your existing contract to determine how much notice you will need to provide your existing employer that you are leaving.
A common question and concern people have is wondering if they should tell their employer why they are leaving. It all depends on why you are leaving. Are you leaving for more pay? A different industry or skill set? If your workplace is so bad that you have to leave, do you think that your employer actually cares about making things better for your replacement? Only you know your circumstances and answer to this, but most likely a simple letter of resignation with your last work date is sufficient.
I Left My Job – Now What
Take some deep breaths and congratulate yourself on your bravery and courage. It takes gumption to make big life changes. No matter where you work now and in the future, be mindful that it is your responsibility to take charge of your own well-being. Take stock of all the circumstances that led up to having to find a new job and be careful not to fall into the same traps in your new job.
Just like primary care physicians work on preventative health, part of your new job at work and in life is burnout prevention, the circle of wellness, which comes back to taking care of yourself: your mind, your body, your soul and your finances. Take small steps daily in each of these areas to cultivate a lifelong skill set in wellness.
Take some time this week and figure out where you stand with burnout. Remember, you can start small and still be prepared for whatever comes. Prioritize taking care of you: your mind, your body, your soul and your finances. Remain prepared financially for a worst-case scenario. Be sure to keep an updated CV ready to go. Finally, take small steps daily to cultivate a lifelong skill set in wellness.
Uzma Khan, MD, is a practicing Internist and a blog writer for Women in White Coats. She can be found on Facebook as Uzma Khan, MD, and on Instagram and Twitter under @uzmakhanmd.
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