Burned Out? How Doctors Recover Their Spark

Shelly M. Reese

Disclosures

July 28, 2011

In This Article

Introduction

When Steve Hyman, MD, from Nashville, Tennessee, looks back, he doesn't like the person he used to be.

"I was a lot meaner then," says Hyman, an anesthesiologist. "I was a lot less tolerant. I had a chronic depression and I didn't know what the problem was." Attributing his malaise to his workplace, he switched practices. It didn't help.

It wasn't until Dr. Hyman cut back his work schedule to 3 days a week and started using his newfound spare time to indulge a forgotten passion for piano that he was able to pinpoint the root of his problem: burnout.

Today Dr. Hyman happily splits his time between medicine and music. Three days a week he is in the operating room. The rest of the time he is a concert pianist performing recitals and playing with regional orchestras.

Dr. Hyman wasn't able to avoid burnout, but he was fortunate to find a way out of the abyss. It's something that other doctors can do as well.

Burnout: "A Loss of Ideals and Hope"

Stress and burnout are often lumped together, but they are distinct processes. Unlike stress, which is associated with overengagement, burnout is characterized by disengagement, blunted emotions, depression, exhaustion that affects motivation and drive, and demoralization. Stress produces a sense of urgency and hyperactivity. Burnout produces a sense of helplessness and hopelessness.

Archibald Hart, PhD, psychologist, author, and Dean Emeritus of the Fuller Theological Seminary School of Psychology in Pasadena, California, noted that "Burnout can best be understood as a loss of ideals and hope."

Stress is omnipresent. Underwater mortgages, the economy, job losses, and the mundane stressors of daily living affect many people. Every industry has its own cache of challenges. Doctors may have to contend with healthcare reform, EMRs, reduced rates, medical school loans, and pressure to see more patients.

What puts physicians at greater risk for burnout isn't necessarily the work-a-day stresses they face but the nature of their role as caregivers, says Neelum Aggarwal, MD, a Chicago neurologist who frequently lectures on stress and burnout. "We have to interact with many people many times a day," she says, "and the element of having to provide care for someone -- the personal responsibility for someone else's health -- that's an unconscious element that feeds into everything."

It's a role that many physicians -- unlike professionals in most other fields -- internalize, notes John-Henry Pfifferling, PhD, director of the Center for Professional Well-Being in Durham, North Carolina. "The greatest risk for burnout comes when the doctor identifies being a doctor as who they are."

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