Has Stress Burned You Out?

Greg A. Hood, MD

Disclosures

September 28, 2016

In This Article

Stay or Go? Review These Questions First

So, how can physicians try to be internally honest with themselves about needing a change? Before you make any rash decisions, ask yourself these questions:

1. How is your passion? Do you wake up ready to go to work or with a sense of frustration and dread? Do you look forward to the possible challenges and opportunities, or is the fire extinguished?

2. How are your nerves? Have you become anxious in an out-of-character way? If you're consistently feeling stressed and negative or unhappy about work, then it's time to move on.

3. How is your health? An unhealthy work culture can lead to negative health consequences for you, physically and mentally. Is the stress causing weight changes, new medical diagnoses, or a need for a higher dose of medication?

4. How is your relationship with your peers and coworkers? Anyone who has worked for a long time will surely have had run-ins or personality conflicts with someone they've worked with. That's a given. However, your burnout and fatigue may be coloring your perspective of others and affecting your approach to your work, with consequences like engaging in micromanagement or unpredictable work styles that make the day difficult for others.

5. How do you fit in with the company? What if you don't fit in with the corporate culture, don't believe in the company anymore, or both? Especially in this era of government regulation and penalties, you may feel that there are ethical or moral differences in how the practice operates vs what you believe in. The personal economic consequences of swimming against the tide can be severe. Yet even if it doesn't come to an actual economic impact, cultural and ethical misalignments can create an irreconcilably uncomfortable workplace.

6. How is your work productivity? Productivity and capability aren't inevitably intertwined. If your performance is suffering, it doesn't matter that you're capable of doing the job from an education and skills standpoint. Something else is getting in the way.

7. Are your skills being fully tapped into? In medicine, as much if not more so than in most any other profession, "practice" makes perfect and allows physicians to fully contribute in a meaningful way to our calling.

8. Are you bored? If you're not growing or learning anything new, then you're shrinking. Yes, there are always new things being discovered in healthcare. However, a scientific advance isn't always a personal knowledge advancement. For those of us who see patients regularly, there's always the mystery of the individual patient and the unique course of a person's health. But if this isn't satisfying your intellectual cravings, then for the sake of your own growth, it may be time for a wholesale change.

9. How is your work-life balance? Life in medicine has been out of kilter with domestic tranquility for generations. However, in recent years, the intrusive and laborious nature of the electronic health record has extensively affected the workflow and total time commitment necessary for most jobs in healthcare. This alone can profoundly affect the amount of time available to be with your family. At times, it can seem that there's no way to successfully commit the necessary time to your job, if you would also like to sleep. This can be a subtle suggestion that you should consider looking elsewhere.

10. How is your compensation? As your duties and job descriptions have changed (increased), has your compensation matched your efforts? If you said "yes" to this, you're in rare company in US healthcare. This can be a very valid reason to make a change; but, again, it's difficult to match a doctor's income and thus difficult to transition from healthcare, for many reasons. In spite of the demands, healthcare often remains one of the best options for sufficient and ongoing income.

11. How well are you being heard? A large bureaucracy often can't react and reward employees in motivational and effective ways. Even multiowner private medical groups can have difficulty reaching appropriate and timely consensus. If your ideas aren't being heard or you feel they aren't valued, then perhaps it's time to help swing the pendulum back to small group practices. Reaching out to small, independent, established groups within your specialty—particularly if you have the patient following and/or the personal financial buffer with which to make the transition—may turn out to be the most rewarding path.

12. Are you safe? This should go without saying. However, if you're experiencing verbal abuse, sexual harassment, or other similar behaviors, then this is the time for action.

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