Physician Burnout: The Common Problem

The stresses of medicine have been well chronicled within the medical profession, and the issue with physician burnout has recently come to the forefront in mainstream news outlets. Many of the stories in the news discuss the difficulty physicians have in coping with administrative, regulatory, and legal pressures of the field in addition to the multitude of complex life-altering decisions they make on a daily basis. While these stories do justice to the current plight of physicians, they typically fail to cover the etiology of physician plight that dates back to medical school. Many physicians simply do not learn the typical signs of burnout and fail to recognize it in themselves or their colleagues. More commonly than we as a profession care to admit, many physicians are too proud to admit burnout and reach out for help.

Everyone Has Stress. Doctors Are No Exception.

Stress is a part of everyone’s life. Why are doctors any different? Well, doctors are human too and go through typical daily stress like everyone else. So, what does “normal” stress even mean? Stress is any type of threat or demand that one experiences. In the days of cavemen, this would typically be physical stress. Having evolved considerably, modern stress is usually psychological (will I do well on this test, will I meet this research deadline, did I mess up in front of my attending, will I get this residency spot, will XYZ and blah blah blah happen???). Normal stress allows you to get enough adrenaline to sharpen your concentration, speed your productivity, and rise to any temporary (keyword!) challenge in front of you. Normally, all of these things come to an end and you return to your baseline.

Prolonged Stress is Stealthy

Chronic stress is unfortunately part of the job as a doctor, and getting used to it is incredibly important (and possible!). However, chronic stress can catch up to any well-adjusted physician. Chronic stress is the kind of thing that gradually wears you down, whereas overbearing stress can acutely overwhelm you. Either way, these stresses knock you down below your baseline. The problem with prolonged stress is that it creeps on you over time without much warning. At this time, you may feel temporarily overwhelmed, and be more anxious or irate than usual. Eventually, you mentally convince yourself this is the “new norm” even though its away from your baseline. At this stage the next stressor may be the final bump down a steep hill.

The Burnout Phase

This is the dark path no one wants to see any part of. At this point, stress has caught up to you and you have descended below the threshold of burnout (obviously far from your baseline). Many symptoms are associated with burnout. Mentally, you may feel constantly anxious, pessimistic, apathetic, and unfocused. Burnout can take an emotional toll as well, causing you to feel typical signs of depression and irritation. People deal with burnout in many different ways, and unfortunately they are commonly unhealthy behaviors such as alcohol/drug use, binge eating or sleeping, avoiding work, and loss of hygiene. While it is easy to say that reaching out at this point is obvious, most people in this state may feel shameful and would rather cocoon into their own corner. Good social support at this point is vital, as burnout is best detected by those who know you most.

For more tips to avoid burnout, see the Four Horsemen of the Physician Burnout Apocalypse and strategies for preventing burnout in medical school.