Burned Out? An Expert Explains How to Know and What to Do About It

John C. Hayes; Peter S. Moskowitz, MD


November 29, 2012

In This Article

Strategies to Deal With Burnout

Medscape: We've discussed the climate and the background of burnout and how it comes about. Can you discuss your specific strategies for dealing with burnout when you're talking to physicians?

Dr. Moskowitz: Because burnout is a spectrum, appropriate responses to burnout depend on the severity and on the symptom complex, but in general, there are some aspects of coaching that are similar for all symptoms of burnout.

My overarching weapon against burnout is to help physicians understand what work/life balance really means and how to get on a path towards better balance. And I say on the path, because work/life balance isn't really a destination as much as it is a path that we're all on, and we're always working to get better balance. Our life and career circumstances are constantly changing, which require changes in strategy for balance.

There are 6 domains of work/life balance that need to be considered: physical balance, emotional balance, spiritual balance, relationship balance, community balance, and work and career balance, and each requires a different set of strategies for improvement. Physicians who ignore 1 or more of these 6 domains have a very hard time achieving work/life balance, because all of them need to be addressed.

Medscape: Could you give us some examples?

For spiritual balance, connecting to nature or reading spiritual sources are options.

Dr. Moskowitz: In terms of physical balance, a physician should have an annual examination by a physician other than themselves, and be working on a health and wellness plan put together by their personal physician.

For emotional balance, physicians need to have a consistent way to address self-awareness. That can be as simple as spending 5 minutes in solitude a day trying to get a sense of how they're feeling emotionally and listening to their own wisdom. Meditation is another way to do that.

For spiritual balance, finding ways to connect to the world of nature is one option. Reading spiritual sources is another. Having a spiritual mentor, somebody whose life is rich in the spiritual arena, is another option.

For relationship balance, we all have partnerships of one kind or another, marriages or significant others. We have working partnerships. So to get balance, it's helpful for physicians to think about each of those important relationships and ask themselves whether they are giving to that relationship in proportion to what they receive back, and if not, what should change.

As for community balance, there is a human need to be connected to other people. Physicians can achieve community balance by being connected to people in communities outside of medicine.

As for work and career balance, probably the most important thing that physicians can do is set boundaries and learn to say no. They should make decisions about how much they want to work and stick to that. In some cases, physicians may decide that in order to be happier and have better balance, they need to work less. Of course, that has financial implications for people. They may have to make less money in order to be happier and less stressed.