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How to recognize and prevent physician burnout

Illustration of physician - Signs of physician burnout

2020 and the COVID-19 pandemic have caused many financial, clinical, and emotional challenges for physicians throughout the country. As the healthcare landscape continues to adapt to patient needs, many physicians are overworked and overwhelmed, unsure what the next year will bring — increasing the risk of burnout. Fortunately, knowing the signs of physician burnout can help you recognize if you are at risk and work toward relief. “The Happy MD” Dr. Dike Drummond recently presented a physician wellness webinar for Locumstory about the modern burnout epidemic. Here are his insights on how to recognize the symptoms of burnout and ways to prevent it.

Experiencing physician burnout firsthand

Dr. Drummond spent 10 years as a family practice physician in Washington before burning out at age 40.

“Every day I went into the office for about three weeks, it felt like somebody was choking me out,” he recalls about that time. “I took a sabbatical and it didn’t go away. I ended up walking away from that practice.”

He soon became certified as an executive coach, helping entrepreneurs and physicians, and later started TheHappyMD.com to teach doctors about burnout.

Recognizing why physicians are susceptible to burnout

Physicians are taught in medical school that the patient comes first, Dr. Drummond explains, but it’s not possible to put the patient first at all times.

“When you’re with the patient, the patient comes first. When you’re not with the patient, I hope you can develop an off switch to recharge your energy,” he says.

Dr. Drummond notes that physicians are also taught not to show weakness.

“We will do anything to avoid anyone thinking we are weak, can’t pull our weight, haven’t got what it takes,” he says. “This conditioning denies our humanity and blocks us from noticing our own burnout.”

Why physician burnout is a big problem

“We know from studies that burned-out doctors have lower care quality, lower patient satisfaction rate, more errors and turnover,” Dr. Drummond explains. “They also have disruptive behavior, get depressed, and commit suicide. It’s more important than ever to focus your efforts on taking good care of yourself and the people closest to you.”

Though he doesn’t yet have data on physician burnout since the COVID-19 pandemic began, Dr. Drummond notes that stress levels are up in 2020.

“You may be overloaded with COVID-19 positive patients, or your practice may have slowed down because of peaks in the disease. You may be at personal risk and may be putting your family at risk,” he says. “Then there’s the economic impacts, political polarization, and extreme weather. The pandemic has made things more stressful at work, and it’s made it more difficult to recharge at home.”

The Signs of Physician Burnout

Recognizing the signs of physician burnout makes it easier to get help.

Sign #1: Physical and emotional exhaustion

“Burnout is a disorder of energy metabolism. It goes up and down day to day depending on what’s going on. Under normal circumstances, you maintain a positive energy balance,” Dr. Drummond says. “In burnout, your energy assumes a downward spiral, crashing toward the ground.”

Though he notes that doctors are familiar with exhaustion like this, a voice in your head that says, “I’m not sure how much longer I can keep going like that,” should be a warning.

“­­You are in a position where you will put someone else’s interests ahead of your own,” Dr. Drummond says. “In that act of giving and being a helper, you can overextend yourself into burnout.”

Sign #2: Compassion fatigue

It’s common for doctors to become cynical and vent in a sarcastic way, Dr. Drummond explains, but it isn’t healthy.

“Venting can be dangerous. I see a lot of doctors under stress who will get upset for righteous reasons. They’ll vent just enough steam to go back out into their practice and keep doing the very same thing,” he says. “Cynicism and sarcasm are signs of burnout.”

Sign #3: Doubting the meaning in your work

Dr. Drummond says once doctors begin asking, “What’s the use?” or doubting that they make a difference, it’s clear they are burned out.

“Another common phrase is, ‘I’m concerned if something doesn’t change, I’m going to make a mistake and somebody’s going to get hurt,’” Dr. Drummond explains. “It’s much easier to see burnout in other people than it is in ourselves.”

Treating physician burnout

It’s important, Dr. Drummond says, to recognize that burnout is not a problem but a dilemma you can solve with a strategy.

“By definition, a problem has a solution. There’s not one thing you can do one time to solve physician burnout,” he says. “You must build your own personal resilience strategy for you and your family. The only way to get what you want is to figure out what that is and go get it.”

Personal resilience strategy tip #1: Writing an ideal practice description

Dr. Drummond recommends first creating an ideal practice description.

Write down:

  • The kinds of patients you would see
  • Hours you would work
  • Patient care you’d be doing
  • Ideal salary
  • Team dynamics
  • Type of organization
  • Location

“It may take days to weeks, so just keep writing down what seems ideal for you. This becomes your target going forward,” Dr. Drummond says.

Next, notice how satisfied you are with your practice and what overlaps between your current practice and your ideal practice.

Finally, write down a master plan. Examine what you don’t like about your current practice and prioritize what you can change first.

“Pick one item on your master plan and take one new action. Smaller is better because it’s easier to accomplish,” Dr. Drummond says. “Tell your team what you’re doing, because they’ll almost always help you. Celebrate all progress with them, and then pick another item and take an action.”

After some time, consider whether you can get to the level of satisfaction you want. If you can’t, it may be time for a job change.

Personal resilience strategy tip #2: Holding daily team huddles

Many physicians already hold daily huddles, but Dr. Drummond suggests adding more power to it and thinking of it as a tool against burnout.

“You can call a timeout any time of the day and huddle up with your whole team again if things get hairy. Run your schedule, make sure patients have everything they need before they get there, and make sure you know who’s sick in the waiting room,” he says. “You’re preventing fires and creating a stand-up meeting where you go to the people around you.”

Dr. Drummond recommends:

  • Having everyone take a deep breath as the meeting starts and ends
  • Asking if anyone has something they want to celebrate
  • Designating a huddle team captain so the team can meet without you when needed
  • Making time for fun, like a team cheer

Personal resilience strategy tip #3: Making a boundary ritual

If you have a hard time detaching from work when you’re not at the hospital or practice, a boundary ritual can help.

“Create your own boundary ritual, a specific action you take at the boundary between work and home that sends an ‘OFF’ signal to your conscious and subconscious mind,” Dr. Drummond explains.

He likens a boundary ritual to children’s TV host Mr. Rogers changing his sweater and shoes at the start of every episode to signal that he’s ready to talk. You might create your own trigger to remember your ritual, like turning off your office lights or turning off the car when you get home.

“This off-switch lets you come all the way home,” Dr. Drummond says.

More ideas for creating a boundary ritual: Work Life Balance for Doctors – building your “OFF” switch.

Putting Dr. Drummond’s tips into practice

Whether you’re struggling yourself or know a coworker who needs help, learning the signs of physician burnout and tips to combat it can make a difference. Dr. Drummond recommends stepping out of your whirlwind and taking a deep breath.

“Take joy in the wellbeing of others. By others, I mean your staff, your patients, their families, your family, your community, everybody,” he says. “We cannot prevent all physician suicides, but we can reach out to all the people we’re concerned about.”

For more on physician burnout, watch the full Locumstory webinar featuring Dr. Dike Drummond.

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