Kindlelife

Insight, Inspiration, Motivation

Why Physicians Burnout – and Why They Don’t Seek Help


In my last blog post, I wrote about the problem of surgeon burnout. Although the particular paper cited was about surgeons, burnout is not a problem of surgeons alone. It is common amongt all physicians, and even among medical students and residents these days. It is becoming more prevalent, as the stresses in life all around us seem to be getting worse.  I have been pondering on the reasons for this, and have come up with the following:

Physicians are High Achievers – Most of them have been high achievers from their school days, and have been consistently working hard, putting in long days and nights, through their medical school and residency, and even afterwards, in most cases.

Delayed Gratification that wasn’t! Many of them chose to “work while their companions played” (a little poetic justice used there), thinking that if they worked hard now, they could have the good life later (trust me, I know. My father promised me that if I worked really hard in the last 2 years before college, and got into med school, I would never have to work so hard again)! They often come out of their residency with huge student loans, that they find themselves working even harder to pay off. If they have a family, or other responsibilities, then it is one thing after another, and before they know it, they hit the middle ages, and feel cheated.

The Ever Changing Health Care System– It is becoming more and more difficult to practise medicine with the diminishing resources, and increasing expectations, that there is a great deal of frustration on a day-to-day basis.

High Expectations – Physicians are seen as knowledgable, and ‘life savers’ by their families and their patients, and when they do not get good results, they often find it difficult to accept. While they enjoy their successes, many take the treatment failures quite badly. They also want to be really good at what they do, and so are their own worst critics.

Sources of Strength – Physicians are the sources of strength for their patients and families, at their most vulnerable times, ie, when they are sick, or have a sick relative. Because they carry out this function really well, most of the time, they are somehow seen as strong people, and so, they try to live up to that image subconsciously, even in the face of their own stress.

Why do they not seek help?

Unfortunately, physicians are their own enemies, in that they are the last to acknowledge their own problems, and even when they do recognise it, are unwilling to seek help. This may be because of two main factors.

Fear of appearing weak – Physicians may not want to seek help because they are afraid to be seen as weak in any way, considering they are the sources of strength at home and in the community.

Lack of Support – There really isn’t much support to the physician at risk of burnout, or who is going through excessive stress. There are physician hotlines for when they have reached a pathological level that they are unable to function, and have either broken down completely, or worse, are considering suicide!

What we really need is coaching to help guide them through troubled waters, and PREVENT suicidal ideation, rather than treatment for it.

Tell me, what do you think might be some other factors in physician burn out, and what you have found helpful in your own experience, to overcome it.

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March 10, 2012 - Posted by | Personal Journey, Psychology, Self Improvement | , , , , , , , , ,

6 Comments »

  1. I really enjoyed reading this post, and applaud your candid look at physician burnout. As a physician who did burnout and changed career tracks, I think much of what you talk about is right on the money. I would add that being part of a dysfunctional system and not having a voice in improving that system is a real mindkiller – even if you WANT to be part of a solution, a broken and visionless administration may not have the slightest bit of interest in maintaining anything except the current status quo.

    Look forward to more posts from you!

    ~Lumi
    http://www.mywhitecoatisonfire.com

    Like

    Comment by Lumi St. Claire | March 11, 2012 | Reply

    • Hi, Lumi,
      Thanks for your comments.
      You were spot on, about the lack of vision in the administrators and decision makers. We see this time and time again. For every new decision or policy, it is the front-line workers who are able to spot the possible problems. When they try to voice their concerns – these conerns are either not heard, or totally ignored, most of the time. Of course, when the problems do occur, the policy makers are nowhere to be seen. TRhis ends up being a huge source of continued or recurring stress for those working in the hospital set-up.
      I read your blog posts, and really liked your style of writing – honest, straight from the heart! Obviously, you are enjoying your new career very much. The only sad thing is that it takes a lot of time and effort to train a paediatrician, and the country lost a good one.
      With my coaching career, which I am doing alonside my medical work, I am hoping to prevent exactly that, so that we have winners all around. Wish me luck!

      Like

      Comment by kindlelife | March 11, 2012 | Reply

  2. Dear Raji,
    Thanks for addressing this issue.This is the elephant in the room that we all refuses to acknowldege. The Doctor burn out is a fact, which we all refuses to acknowldege. Suddenly , the autumn of the life is on you and you look back and see the glorious summer that passed by.Reasons may be many ; yet another multifactorial mess. The society only expects miracles from doctors and are willing to punish them when the rabbit fails to materialise from the magical hat. The population is aging, resouces are shrinking and the magic is all the more difficult to perfom. The solution probably lies among us.Mentorship may be a way forward. Not a coach, . Can be done among the peers. A non-judgemental listening service, a ray of light shining on our forgotten and under appreciated achievements, a mirror to show you the true and sometimes ugly image, a guide. Some one who will listen and guide you to realise what you really want. May be you are one of them, the mentor.

    Like

    Comment by sivaraman nair | March 13, 2012 | Reply

    • Dear Sivaraman,
      Thanks for the candid comments. The ‘elephant in the room’ is probably the best way to describe it.
      The difference between a mentor and a coach is that the mentor gives you his idea of how to fix things. The mentor has certainly been ther, and understands the problems, which broadly, are the same. However, when they offer their own solution to your problems, it may not really work for you. The truth is that there is no dearth of mentors in our profession. Everyone of us can name at least one senior colleague, who has guided us, given us good advice along the way. The question is, how many of them have taken their own advice? How many of them live balanced lives themselves?
      Coaching is based on the principle that if you look within, you will find all the answers you need. You just need to clarify your needs, your values, your situation, well. The coach doesn’t presume to know what is good for you. He/She only helps you clarify your own priorities and values by asking you the right questions, listening actively in a non-judgemental and safe environment, and supporting you through your journey of self reflection. You get to decide what your options are, and what actions you will take. The coach then helps you strategise, and will stand by you, while you carry out your plan.
      In my case, it certainly helps that I am both a coach and a physician, since I know the problems from my own experiences, and can help as a coach.

      Like

      Comment by kindlelife | March 13, 2012 | Reply

  3. Thank you for writing this blog. I’m a resident in paediatrics, and have recently been feeling more and more like giving up, for all of the usual reasons (stress, feeling like I’m not good enough, etc.). I came online looking for stories of people who have happily/successfully left medicine, but reading through your posts has reminded me of many reasons why I should persist, especially this remark: “We live in a period of instant gratification, and entitlement. People are quick to give up on their dreams at the very first sign of difficulty.”

    It’s sad that there is never any such motivational counselling offered in medical school or residency. On the other hand, in my residency program we were recently given a lecture detailing cases of junior doctor errors leading to catastrophic patient outcomes. We were told that as doctors, we should be “capable of perfection” in our jobs, never make mistakes, and that we would be penalised if we do. As if we needed this reminder! What we needed was coping mechanisms to deal with our workload and many stresses.

    Like

    Comment by kc | November 26, 2012 | Reply

    • Thanks a lot for that!
      You are so right. Medical schools have now started training young doctors in the areas of money management, professionalism, billing practices, etc, which are all required in real life. However, the idea that stress is something that needs to be acknowledged, doesn’t seem to have caught on. Most people like to see themselves as strong, and try to keep the ‘stiff upper lip’, denying the stresses, until they pile up and finally overwhelm.
      As for being told never to make mistakes, I think that is asking too much. If any physician can tell you that they have never made a mistake, then you can be sure they are lying. Will you always get into trouble if you make a mistake? maybe that will be the topic of my next blog! Thanks for the inspiration! And please come back and read it.
      Thanks again for your input.

      Like

      Comment by kindlelife | November 27, 2012 | Reply


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