Burned Out or Burned Up? What’s Next for you as a Physician?

By: Gayle Morris

Burnout is a physical and emotional challenge that affects many people in high-stress jobs. And if medicine isn’t high stress, then what is?

The trick is to recognize it as it’s starting so you aren’t overwhelmed by feelings of hopelessness and dissociation from your patients, colleagues – and worse, your family. It sounds easy, but too often you’re in the throes of burnout before you’ve recognized the symptoms.

One Large Survey Says …

The Medscape National Physician Burnout Report for 2020 of over 15,000 doctors in 29 specialties discovered some interesting details about how burnout affects physicians across the U.S. Although Baby Boomers have been practicing longer, it was Generation X (people born between 1965 and 1980) that reported the most burnout. The doctors also said the top three reasons for burnout were:

Too many bureaucratic tasks
Spending too many hours at work
Lack of respect from administrators

The survey found the top two ways physicians cope with burnout were distinctly different, yet shared equal numbers who used the strategies. The first was to isolate themselves, which can sustain burnout. The second was exercise, which is a constructive way of dealing with stress.

Knowing the contributing factors to burnout may help prevent it from happening. However, if you’ve already crossed that threshold and have no interest in returning to clinical practice, then knowing those factors can help you determine what alternative career options best fit your personality without raising your risk of burnout again.

What Contributes to Burnout?

A collaborative paper by physicians and psychiatrists delved into the factors that foster burnout in doctors. A review of the literature showed that what was once thought to be an issue faced mostly by older physicians, has now made significant inroads into younger doctors.

Early in their career, physicians have nearly twice the risk of stress of their older colleagues, with some experiencing burnout as soon as their residency. The factors that raised the risk of burnout were both intrinsic and extrinsic. It was a combination of elements that appeared to increase the risk in one physician over another.

Intrinsic

These internal characteristics may have been what helped you to excel in your education. Because you have had such success in 10 years or more tapping into these traits you might think they will serve you in your career as well.

But, for the most part, unless you can harness a runaway train, it may be best to try to move closer to balance than the extreme. For example, the researchers identified the following traits that predispose doctors to burnout:

Compulsiveness
Self-denial
Perfectionism
Guilt
Denial of personal vulnerability
Delayed gratification
Self-critical
Over-commitment
Idealism

Extrinsic

Many of the extrinsic factors influencing the development of burnout originate in the organization. But there were some personal elements that also had an influence. Their literature review found women were more likely to experience fatigue from work-home conflicts, whereas men were more likely to be fatigued from a high workload. Other extrinsic factors that affect men and women physicians include:

Work life imbalance
Inadequate support systems
Poor leadership
High workload expectations
Minimal interpersonal collaboration
Meager rewards
Lack of social support
Limited advancement opportunities

What Happens if You Don’t Address the Issue?

Some of the very characteristics that helped you through your medical education may drive you further from acknowledging the issue and getting help. Perfectionism, self-denial, and delay gratification are traits that may drive physicians to over achievement and poor self-care.

The consequences of burnout are felt by your patients and families. Some of the repercussions to patients included medical mistakes, low patient satisfaction scores, workplace conflicts, and poor patient safety grades.

Physicians also reported negative effects at home and to their health, including suicidal ideation, increased risk of car accidents, mood disorders, depression, and exhaustion.

Let’s Talk Turkey: What Are Some of Your Alternative Career Options?

For some physicians, the recognition and treatment of burnout is not soon enough to keep them in clinical practice. Although medical education is highly specialized, the skills you’ve acquired are also transferable.

Here are some alternatives that allow a doctor to continue some clinical practice or return to clinical practice later if they wish. It’s important to do your research before branching out, since some changes require more preparation or start-up time than others.

For example, you may not experience a lapse in income moving from your current practice to another outside your specialty, but starting your own consultant firm can take time and money.

Clinical Practice Outside Your Specialty

Most don’t consider switching specialties since it often requires years of more training and testing. However, there are some options that draw on your experience and current practice, such as wound care.

Wound care specialists have a far less stressful and more predictable environment, competitive salary, and a job that keeps them clinically active. Doctors who have practiced in family medicine, vascular surgery, internal medicine, and plastic or general surgery are just some of the physicians who have the skills to transfer into wound care.

Medical Education

Here you can leverage your expertise and inspire the next generation of physicians. With your experience in burnout, you’ll also have the knowledge to help a young generation of doctors recognize the symptoms and find the appropriate help before they want to get out of medicine. If joining a university is not appealing, consider writing course curricula or CME programs.

Corporate Medicine

Working for corporations or insurance companies uses your expertise without patient contact. Physicians working for insurance companies may do chart reviews, or be involved in policy or guideline development. Doctors at pharmaceutical companies may support research or advise on growth strategies.

Consulting

Pharmaceutical and biotech companies often need medical expertise for product development and testing. Consider leveraging the relationships you have with pharmaceutical or device reps to investigate this career avenue.

Career Coach

Have you always enjoyed helping others succeed? And are you a self-starter? Some physicians have branched out to becoming a career coach for other doctors, counseling them on management skills, switching careers, and new sources of income for their practices. Career coaches can work one-on-one with physicians, consult with practices, give seminars, or create their own online education. Another form of consultancy is as a Healthcare Practice Management consultant who can teach others the skills learned when they ran a practice.

Whether you choose to stay in your specialty or move to another career path, it’s vital you also address the psychological and emotional toll burnout has created in your life so you don’t take it with you.

Gayle Morris is a freelance writer that’s been writing on health and wellness for over ten years. She spent over 20 years as a certified nurse and nurse practitioner before hanging up her stethoscope and picking up the pen.

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