Identifying signs of burnout in yourself, or someone else, is the first step to tackling a solution — as with anything, awareness is key. If we don’t see it, we don’t know how to approach the problem. Even if we know burnout exists, now what? How can we begin to manage something this big given its multifactorial contributors?
I wanted to spend some time on the solution aspect of burnout, as quite frankly, physicians are getting a bit frustrated with “all talk and no action.” And it isn’t just impacting physicians, in fact, many jobs put people at risk of burnout, such as: where people feel overworked leading to an imbalance between work and personal life; other health care professions; “helping” professions in general such as counselling and teaching; feeling little control over your work situation; inherent competitiveness within the work culture; feeling unfulfilled with work.
Let’s start with a quick overview of some of the signs of burnout
The most commonly cited signs of burnout, include the triad of exhaustion, cynicism and reduced effectiveness. Another way to describe these signs would be as follows — feeling emotionally and physically exhausted where you don’t feel restored; disengaging from your work and those around you; becoming less productive and less confident in the value of your work. These signs are often insidious and chalked up to the demands of the job. People might say “you are working too hard” or even “work harder” while your inner voice is saying, “I hate this job.” As a physician, the rewards that come with the profession, monetary and otherwise, may be thrown in your face so that you end up feeling guilty and shameful on top of feeling totally depleted.
Then one day, you either look at yourself in the mirror, or someone else holds the mirror for you, and you realize that your current state is unsustainable. This happened with my husband, and by the time we fully appreciated he was burned out, it seemed so obvious, but again, it can creep up on you as mounting stress does before it literally almost knocks you over.
So what three steps can you take to manage burnout?
We are starting to see a lot of information on management, specifically related to physician burnout. Along with international and national physician health conferences, much research is being conducted on physician burnout, and the American Medical Association has created initiatives such as STEPS Forward and the Canadian Medical Association recently released a policy addressing physician health. These are all steps in the right direction, but when it comes to actionable steps that we can take right now to address our own job burnout, I have boiled it down to the following three below:
1. Regain control. It can be easy to slip into the victim role where everything is happening to us, however, we have control over our destiny. How many of us with kids say to them “you can be or do anything you put your mind to.” Somehow along the way, we may lose sight of this due to external demands making us feel overwhelmed, exhausted and stressed. Having said this, even by making small tweaks, we can regain that sense of control we desire. We alone can control how we react to situations, and most of us have more power over our external environment than we realize. When we are suffering from burnout, it is easy to fall victim to our circumstances because it takes less energy. By taking back control of your life, you will not only feel empowered, but you may also inspire those around you to do the same.
2. Identify stressors. Burnout can be a consequence of life, but our discussion today is focusing on burnout from working as a physician. Taking stock of what our work stressors are can be very enlightening – we may not even realize what triggers us until we reflect on those areas that stress us the most. It might be the people you work with, your EMR, too many meetings, being overbooked in clinic, families of your patients, etc. How can you modify some of these stressors? Learn to say “no” more often, look at alternative data entry solutions, carve out time to simplify and organize, discuss new strategies with your staff, etc.
3. Set boundaries. This can be a very effective way to address some of your stressors. Once you know where you want to regain some control and what your stressors are, set some boundaries. This is what I will and will not do – everything in the middle is negotiable. Sometimes our perceived barriers are just that — perceived. Knowing our personal boundaries is essential to self-preservation.
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