This week’s blog is a guest post from an allied health provider who has transitioned to an alternate career herself. With the ubiquitous concerns around physician burnout and the ramifications for our health systems, I felt this was an interesting share. Are you afraid of burning out early in your career? Let me know what you think in the comments below. -Barbara Hamilton, MD

Working in a healthcare environment is intense and demanding. The epidemic numbers of physicians experiencing burnout has grabbed the attention of third–party payers, legislators and professional organizations.

As the level of technological advancement in medicine rose, healthcare leaders hoped it would improve the levels of physician productivity and satisfaction. Yet digitizing processes had the unintended consequence of producing alienation and disillusionment in even medical students, residents, and early career doctors. 

Knowing the factors that contribute to burnout can help keep you from burning out yourself. Just knowing the viability of alternative career options can reduce the risk you’ll feel stuck, should you experience burnout in your career.

Burning out by the numbers

The Medscape National Physician Burnout Report for 2020 surveyed over 15,000 doctors. Results showed:

• Urologists, neurologists and nephrologists experienced the highest level of burnout.
• Women were 11% more likely to experience burnout than men. 
• Bureaucratic tasks, hours at work and lack of respect from administration topped the list of reasons that contributed to burnout. 

The report also found that reported coping mechanisms ranged from constructive to destructive. The strategy most used was isolation, which can perpetuate burnout. However, the second most used strategy was exercise, which is a constructive method of reducing stress.  

Slightly more than 50% of women were willing to take a pay cut to have a better work life balance. But, isn’t there a better option?

Consequences of Physician Burnout

According to Dr. Dike Drummond, author, speaker and consultant on physician burnout, “There is an epidemic of physician burnout in the United States, and it has a pervasive negative effect on all aspects of medical care, including career satisfaction.”  

Burnout is directly linked to striking number of consequences:

• Post-Traumatic Stress Disorder 
• Depression
• Lower patient satisfaction
• Lower quality of care
• Higher number of medical errors
• High turnover
• Increased risk of malpractice
• Physician substance abuse
• Physician suicide 

A survey of doctors in 2014 found that 54.3% had symptoms of fatigue. 32.8% reported excessive fatigue, and 10.5% reported a significant medical error in the last three months. It’s no wonder we are afraid of burning out. The price paid by physicians and society is steep.

Contributing Factors

After completing hours of one-on-one coaching with physicians who experienced burnout, Drummond determined that the five biggest causes are: 

• Interacting with people who are sick, scared and dying. 
• The stresses of on-call rotations, hospital politics, and personality clashes at work.
• Inability to balance one’s personal and professional life.
• Character traits such as being a workaholic, superhero, or perfectionist.
• Poor-quality leadership.

Like factors named by Gagné and Deci, who study intrinsic motivation in the workplace, these factors increase a doctor’s risk of burning out. The pillars of intrinsic motivation are autonomy, competence and relatedness. Each has suffered as a result of healthcare restructuring.

Physicians experience a lack of control over their time, contributing to burnout. They are forced to check off boxes to meet billing standards, leaving them less time to develop therapeutic relationships with their patients. These factors are related to the three top contributors to burnout found in the Medscape 2020 report: bureaucratic tasks, hours at work and sensing a lack of respect from administration.

Treating Burnout

While work-life balance may not have been stressed during medical education, it’s critical to foster a personal balance as a physician. The characteristics that supported great grades during medical school should also be channeled toward personal wellness. Finding balance starts with identifying physical and emotional areas that may have been overlooked in the pursuit of a rewarding yet often demanding career.

Self-care basics: exercise, nutrition and sleep. Under the stress of work, maintaining relationships, and growing a family, basic self-care can fall to the wayside. However, prioritizing physical and emotional health is key to avoiding burnout in the long term. This means adequate exercise, healthy eating  and getting 7 to 8 hours of quality sleep each night. These basic strategies improve a physician’s ability to withstand external stressors.

Set boundaries. Doctors who don’t uphold personal boundaries may be at increased risk of burning out. A lack of boundaries between work expectations and down time can create tension and stress, in turn raising the risk of burnout. It is vital to deliberately set boundaries and then protect them as a physician.

Knowing and practicing these simple strategies may help you reduce the potential for burning out in the future.

Career Alternatives for Physicians Who are Burning Out

The skills gained during medical education and practice are remarkably transferable to different career options. Yet a physician’s education is highly specialized. Here are several alternative options that may allow a physician to return to clinical practice later if they are burning out.

Clinical Practice Outside the Specialty

Physicians may not consider clinical practice outside their specialty but it is a viable option. Physicians from a variety of specialties find wound care challenging and rewarding. The subspecialty has less stress, a predictable environment, a competitive salary and keeps physicians clinically and procedurally active. Family practice, plastic surgery, internal medicine and vascular and general surgery are just some of the specialties that involve skills that transfer into wound care.

Hospital Administration

This is a long-standing option that physicians have taken over decades. Physician administrators may be more apt to initiate change based on the challenges and frustrations experienced by clinical staff. Physician administrators often have the respect and goodwill of other doctors in the hospital, which improves their ability to be successful. Hospitals are seeking a balance of clinical and administrative skill to more fully integrate the needs of physicians with the demands of third-party payers. One hurdle some physicians face is a lack of business knowledge needed to run a hospital profitably. Some have completed an MBA to overcome this challenge.

Academics

Teaching offers physicians the option of continuing clinical work while engaging with medical students. Most academic positions are seeking physicians who have published in peer reviewed journals and prefer doctors who have specialized. This is an opportunity for physicians who prefer a daily routine and have the background and clinical practice to support an academic career.

Medical Journalism

Doctors who enjoy writing and translating complex medical concepts into language the general public can digest may consider this alternative career. Pharmaceutical companies, research studies, and editorials all offer venues for physicians to help propagate medical knowledge.

Telemedicine

This is an option that allows physicians to continue to interact with patients through clinical practice, while benefiting from predictable hours. Telemedicine is flexible, allowing for a part-time or full-time schedule. In an environment where more people are apt to stay at home, the global market for telemedicine is growing.

Telemedicine and in-home visits are a hot topic and area of study, even in interventional radiology! So if you are afraid of burning out, take comfort in all the options at your fingertips, from preventative strategies to career alternatives in the future.

Author: Gayle Morris is a freelance writer who has written 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. 

To hear my personal take on early career burnout and some strategies I used to deal, check out my recorded talk on balance. You can access it by clicking here.

And let me know what you think about this post in the comments below! Share your experience, or your unanswered questions. Are you afraid of burning out?