From the Happy MD
By: Dick Drummd, MD
From within the misery of physician burnout it is difficult to see, but there is a purpose to this suffering. Burnout actually has a highest and best use. When you do a good job of burning out, you will look back on this as an important turning point in your life. A turning point for the better.
I have worked with hundreds of burned out doctors and physician leaders at this point and a clear and universal pattern has emerged. Let's see if you can see it too.
Try this snippet of anthropologic research
Think of a physician you respect and look up to - someone you feel has their act together in their practice and private life. Ask if you can have a cup of coffee and a conversation with them. When you are together, try this question.
"Please, tell me your burnout story."
Here is their most likely reply. "Which one?"
Often they will end their story with something like, "... and thank god that happened or I would still be back in that grind and none of this would be possible."
The lifetime incidence of physician burnout is right around 100%
My experience is this. People don't get their act together without burnout. It marks the place where you have followed someone else's job description to a logical end point - where it becomes undeniably clear this is not your path.
If you continue on this route you will have violated your own values, denied the people you love and slide into a "life of quiet desperation". Burnout gets you to finally say, "I can't do this any more. There has to be another way."
Physician burnout will eventually push you to near breaking. I hope and pray that when you reach that point you bend and spring back rather than snap like some of the unfortunate among our brothers and sisters.
It is at this point -- when you have no energy left to keep putting out the fires of other people's demands and priorities -- that something important happens.
You collapse and look in the mirror. You realize with undeniable clarity that you have other choices available and the path you have been on all this time is also a choice you have been making over and over again.
The reality hits you like a brick wall
1) You can keep fighting all the things that you don't want. You can keep trying to fix the problems by working harder.
2) You can decide what you really want in your practice, your life, your relationships with the people you love ... you can get crystal clear on that instead ... and go get it.
No matter how far you have gone on a wrong road, turn back.
~ Turkish proverb
A Useful Metaphor
It is as if you became a little train engine on your first day of medical school and climbed onto a set of tracks someone else had laid down for little trains like you. The tracks lead in a straight line to your medical degree. The only way off is to derail yourself. We all know someone who fell off the tracks along the way, but that was not you.
In residency you moved to a new set of tracks. In your job, you are running on the tracks of "the way we do things around here". These are still not your tracks. You did not lay them. Burnout is when you figure out how to lay your own tracks or better yet, realize you are a four wheel drive vehicle - not a train on tracks. You can navigate any terrain you choose.
Physician Burnout is Hard Wired into Doctors
Much of the struggle and ultimate crisis of physician burnout is rooted in human neuroanatomy and the conditioning of our medical education.
We are creatures of habit. Most of our habits as practicing physicians were installed deep in our subconscious by the medical education process. And we cannot deny our human wiring and gender plays a role. Let me tease those apart here.
~ We are wired deep in the Reticular Activating System to be on the lookout for and avoid pain and danger. It is the strongest basic impulse of any life form. It is a foundational feature of our human anatomy.
~ Our medical education teaches us to see danger everywhere. Everyone is sick until proven otherwise. Each patient encounter offers the opportunity for a missed diagnosis and disaster. The basic act of a differential diagnosis raises catastrophizing and paranoia to an art form for gosh sakes.
~ We are conditioned in residency to be workaholic, superhero, lone ranger perfectionists. No one shows us the off switch.
~ Since the first day of medical school we have been 100% focused on doing what other people want us to do. Despite exhaustion, sleep deprivation, burnout ... come hell or high water ... we get the job done, because the patient comes first - dammit.
With this as a backdrop, we face all challenges/problems/issues/concerns in our lives in the same way. We work harder in an attempt to bulldoze the problem with sheer will and massive effort.
Good luck with that. It is an old habit pattern. It won't work with everything. It won't give you any quality of life. Your significant other won't love you more for this tendency of yours.
"The definition of insanity is doing the same things
over and over
and expecting a different result"
~ Albert Einstein
Then physician burnout wears you down to a nub.
Your ability to continue on these tracks and this path ... falls away.
Here is where meaningful change can start. It can come in the form of a full blown crisis or by conscious choice. I sincerely hope you fall into the latter category when your time comes.
Here is a way to begin that has been proven in my own life and with hundreds of our coaching clients, in the real world of clinical medicine.
Time to Do the "Big 180"
In order to see the way through, you must step out of your programming and make a 180 degree shift in your awareness.
Move from avoiding the things you don't want
To figuring out what you really want ... and go get it
"No problem can be solved
from the same level of consciousness that created it"
~ Albert Einstein
I often get asked this question, "If I can just avoid all the things I don't want, I will get what I want ... right?" What do you think the answer is?
Here is the Reality
- When you take the time to decide what you want in your life and career
- Then start taking baby steps in that direction
- You begin to free up your purpose
- Wake up the dreams you tucked away when you entered medical school
- Get off the tracks others have laid for you to follow
- and put physician burnout to its highest and best use
And perhaps become that wise and respected mentor I asked you to think about at the beginning of this article
When would "now" be the right time for you to step off those rails of other's expectations and move on to your own path?
And if this post is not talking specifically to you -- who else do you know who is struggling right now and could use this information to make a change?
Please forward it to them.