Dear Doctor, I am writing to wish you Happy Doctor's Day on the 175th anniversary of the first use of ether anesthetic during surgery, the day selected as a national day to honor your service and sacrifices. Today I hope you will take time for some self-care. You deserve it and you need it.
Recent research shows that 6 out of 10 doctors say they'd leave the medical profession if they were financially able to do so. Why? Because they are emotionally exhausted. In more technical terms, they are burned out. I'm going to give you the best Doctor's Day gift I can offer -- hope. Hope that help is on the way.
I want to instill the hope that you don't have to feel exhausted or burnout from giving the world your skills and talents and help you find a way to make your life better. Fortunately, burnout is reversible. Curing burnout does not require you to leave the practice of medicine or to cut down on your hours (if you're working a reasonable number of hours).
If it required those things, ask yourself why every physician isn't burned out. Yes, nearly half of physicians report at least one symptom of burnout and almost forty percent are experiencing emotional exhaustion or compassion fatigue. That means that nearly half of physicians are not experiencing burned out.
Research shows it isn't the length of practice that determines burnout.
The medical paradigm tends to look at broken things, things that are ill or diseased, and ask "How can we fix this?" You won't cure burnout of that perspective. You have to look at those who are doing well, those who are not suffering, the physicians who are thriving and ask "What are they doing and can those who are suffering do what they do?"
The answer is yes. Those who are thriving are resilient and they are resilient because of a combination of factors that are all learnable skills. Children can be taught to be resilient. You've made it through medical school. You can learn anything a child can learn, including skills that increase resilience.
What is resilience? Is it the ability to just keep going no matter how much pain (emotional or physical) you're experiencing? Absolutely not. Resilience comes from developing skills that reduce the pain without requiring the situation to change. Resilient people don't experience the same level of stress as non-resilient people do in like circumstances.
Since they experience less stress they have less to recover from so they expend fewer resources recovering from adverse experiences. How are you doing? Are you one of more than 50% of physicians who are experiencing at least one symptom of burnout?
During the past month:
- Have you felt burned out from your work?
- Have you worried that your work is hardening you emotionally or felt cynical toward your work or patients?
- Have you felt down, depressed, hopeless, or wondered what the point of it all was often?
- Have you fallen asleep unexpectedly or when you didn't want to such as when you were driving?
- Have you felt overwhelmed, as if there is too much to do and that completing all the tasks is impossible?
- Have you felt anxious, depressed, irritable, or easily angered?
- Has your physical health declined or have you been ill more frequently?
- Do you feel your work is important and that it matters?
- Do you find yourself simply wanting to escape your reality such as by reading a lot of fiction, binge watching shows, surfing the web, alcohol or drugs or other addictive behaviors?
See end of the article for scoring. Stress appears to be caused by circumstances but it actually begins in the mind because the way we process our experience determines the amount of stress we experience. That is good news because it is far easier to change our minds than change people and circumstances around us.
Your work is valuable. It can be a source of satisfaction to you, security for your family (yes, even in this environment-whether it feels secure depends on your perception), and it is of great value to the larger community. Medical school did not train you to use your mind in ways that are self-supportive. It's not part of the curriculum.
Resilient mindsets feel empowered. Resilience is a function of optimism, healthy self-esteem, and an internal locus of control. All three factors can be increased and when they are your energy returns. Your relationships are smoother. You sleep better. Your brain works better because your level of stress is lower.
Stress focuses our attention on problems instead of solutions. When you lower your level of stress you have cognitive access to solutions that were not perceptible when you were stressed. How well you feel and how well your life goes begins in your mind. If you believe you can the thoughts you think will reflect that belief.
If you think it is too difficult to deal with the stress of medicine, with the uncertainty, with the lower sense of autonomy and the increasing economic pressures you will suffer far more than another physician in the same circumstances who believes he or she is capable of finding solutions to each of those problems.
Our minds are very powerful but we haven't been taught to use them. We've been taught to memorize things but we haven't been taught to program our minds for success and wellbeing. Everyone's mind is programmed. Most of the programming was established by age 10.
The good news is that we can reprogram our mind at any time by consciously making decisions and using techniques that will change the programming. Life gets much better when you upgrade from the default programming. We've also all been taught to misinterpret the purpose and meaning of our emotions.
Research that is now a decade old and supported by a growing body of journal articles teaches us that our emotions are far more useful than most people believe, we just have to interpret them accurately. Burnout and even depression can be cured simply by learning the new evidence-based, experience-informed purpose of emotions.
There are ways for you to feel better soon:
- Develop skills that increase your level of resilience
- Learn and use the new definition of the purpose and use of emotions together with metacognitive techniques that reduce your stress.
- Practice self-compassion.
- Since most healthcare providers are self-sacrificing, remember that everything you learn about how to help yourself has the potential to help your patients who are also experiencing stress.
If you are experiencing symptoms of burnout it took a long time for them to develop. The road to recovery is much shorter. As you learn to apply metacognitive skills to the way you perceive your life you can begin feeling better right away and become sustainably less stressed in just a few months.
There are many stressors in healthcare, all the traditional ones and new ones created by uncertainty in healthcare laws, EHR, and loss of autonomy as the government, health systems, and insurance companies interject their priorities into the practice of medicine.
You can deal with all of these issues and more from an empowered mindset that sets you free to once again enjoy the practice of medicine. Happy Doctor's Day. Treat yourself well, not just today, but every day. You deserve it.
PS: I'm working on a book that specifically addresses burnout with a healthcare provider focus. It also includes information on other professions that have high burnout rates such as first responders and teachers.
Prevention and Recovery: Resilience and Retention won't be out until May and you deserve to feel better today. All the work I do and all the books I write teach the same skills. The examples and research cited vary but the basic skills are the same because they begin at the root cause of human thriving.
It doesn't matter if you want to ease your burnout, prevent suicide, improve your relationships, increase your academic or career success, prevent or cure mental illness, or even prevent illnesses and diseases, reducing stress by developing an empowered mindset is the root. My most recent book, Harness the Power of Resilience: Be Ready for Life, provides all the information you need to begin feeling better now.
It's the first book I've written that doesn't have a heavy dose of science. That's in response to reader feedback that while my books provided excellent information they read more like textbooks. If you prefer something with a heavy dose of science either Empowered Employees become Engaged Employees or Rescue Our Children from the War Zone will provide it.
PSS: Depression and burnout are not identical but they share many common traits. Both feel disempowered. Both can lead to suicide ideation or worse. Both are curable. In the United States, we lose about 400 physicians to suicide each year which means about 1 million patients lose their doctor to suicide.
In compliance with the International Suicide Reporting Guidelines that save lives when they are followed the following notice is provided: If you are considering harming yourself or someone else, there are people who want to help you.
Call the National Suicide Prevention Hotline at 1-800-273-TALK (8255), call 911 (outside the United States call your local emergency number), or go to the nearest emergency room. You may be experiencing one or more signs of burnout if you answered yes to questions 1-7, and 9. Question 8 is reverse scored because not feeling that your work makes a difference is a sign of burnout.