By Michael M. Kearney, MD

What have I or my colleagues done to protect from physician burnout? How fortunate we are that people come to us for help, we know how to help them, earn a comfortable living as we help them, and our work is respected by society.  Yet too many of us face burnout in our work. Burnout may be one of those things that is hard to define. Hopefully, we know it when we see it.  It may arise from our own personal habits or foibles. Alternately, it may arise from what external forces have done to our practice situation.

Our life work can be interesting and stimulating, but it can be boring, frustrating, and stressful at times. When I finished training, I knew a lot, but I still had a lot to learn about practicing medicine.  My personal weaknesses included impatience, overly serious and silent demeanor, unrealistic expectations about a lot of things, and occasionally a short fuse.  I credit both the people around me and myself with identifying strengths, weaknesses, and making changes.  Practice still includes periods of boredom, frustration, and stress, but a pleasant and supportive practice environment carries me through.

Situations external to direct patient care can trigger burnout in our practice: personal health, family situations, difficult colleagues, clumsy and time consuming EHRs (electronic records), productivity quotas, administrative hassles, etc. A couple of decades ago my wife pointed out to me that I was working too much and I listened.  In the office I make a conscious effort not to be drawn into conflicts that occasionally arise.  Often both sides are a little bit right and sometimes the conflict will be insignificant or petty in the long run. When I take longer to think about the issue, it seems to be more likely that I won’t regret my comments later. A few years ago my practice group lost a unanimous court decision.  The case was about a non-medical issue and my sentiments were with my family member who had brought the suit.  I felt a cool atmosphere in the office.  I consciously treated each partner as I had before the polarizing issue arose. I didn’t build walls because that would be useless. The office staff was very supportive to me. I feel indebted to them and to my partners who put it behind them.

What would I do if our practice pattern were changed by dictates from higher-ups that ruined my desire to come to work?  I might get out of the practice, but if that choice presented too many negatives, I would try to adapt. Perhaps it would be possible to mentally compartmentalize the bad stuff so that it wouldn’t ruin the satisfying part of the practice. Like an unsolvable patient problem, I may not have any hope of an excellent outcome, but I would work to be happy that I had arrived at the optimal outcome.  Most of us may find ways to soften or avoid the situations that cause burnout, but for a few of us, the best response is to change our occupations. Many of us will face the risk of burnout. Good luck.