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.