Burned out or tuned in

Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions expressed here are that of the authors and not UBM / Medical Economics.

Years ago, when I practiced family medicine, I was so burned out I felt crispy. I stumbled through a maze of challenges, self-doubt and shaming before emerging at the other end, satisfied with what I created, grateful for what I was doing and financially stable.

According to research by Tait Shanafelt, Director of the Stanford WellMD Center and Chief Wellness Officer for Stanford Medicine, about 53 percent of all physicians experience burnout. For doctors in its clutches, the best recipe for recovery comes from within, not from a mythical knight in shining armor who appears from nowhere. I know this now, based on more than 2,100 hours of coaching physician leaders: Your satisfaction and happiness are your responsibility. 

Here are some steps to take control and move beyond burnout:

Start with where you are

First, if you’re feeling burned out, admit you’re unhappy. Not in a “woe-is-me” way. More of a “Yeah, I’m here and I’d rather be elsewhere. Let’s start planning.” 

You paid a lot of money and gave a lot of time to become a physician. You accumulated debt and gave up much of your personal life during medical school and training. In business those are known as sunk costs. You’ve incurred them, and they’re not coming back. They’re not relevant to your future.

Gather evidence

If you were working up a patient, you’d order tests, which we call assessments in coaching. Do the same for yourself. 

1. Start with your values. If you’re working at an organization whose values aren’t aligned with yours, you’ll never be happy. I have several Road to Resilience Values Decks, which I used with dyads, teams and teaching. I like this option because they’re two decks in one. One side has values. The other side has discussion questions, such as “How does recognizing my top value make a difference in my life?”

2. Discover your strengths. Determine whether your strengths are being well-utilized in your current situation. The VIA Institute on Character in Cincinnati offers a free strengths assessment at http://www.viacharacter.org/www/. You can take the Clifton Strengths assessment at https://www.gallupstrengthscenter.com/store/en-us/for-individuals, or get a shorter list of your strengths through buying one of the StrengthsFinder books.

3. Take a test that measures your skills. I recommend Nicholas Lore’s book, The Pathfinderand his Career Testing Program. After debriefing my results, I learned why I had a hard time with anatomy, and with rote memorization of my lines. That is not my strongest skill. I also learned that I am highly rated in creativity, which helps explain why I became a coach.

Assess your options 

Draw three columns. In the left column enter what you’re considering. Becoming a consultant? Moving into research? Pharma? Becoming a professor? A high school science teacher? Traveling the world? Becoming a photographer? Roller blading along the boardwalk of San Diego’s Pacific Beach like Slomo, formerly John Kitchin, MD?

In the middle column, enter the advantages for each option. For example, becoming a consultant may mean you’re saying “yes” to “I choose my hours.” In the right column, enter the disadvantages, or what you’re saying “no” to. Becoming a consultant may mean you’re saying “no” to regular income and financial security as you build your consulting practice.

No option will give you everything you want. Sadly, no path provides all the benefits and none of the downsides. If you’re like most people, you’ll focus on the negatives. If you have huge expenses, such as kids in private schools or colleges, a second home and vacations in Italy, reconsider what’s important and what’s not. I know some career advisors advocate following your passion. Good idea, and it’s also critical to consider financial and personal consequences.

Establish YOUR routine

This isn’t the “get up in the morning, get dressed and-grab a coffee for the drive to the hospital.” This is a routine for you that involves a minimum of 15 minutes of mindfulness practice, 15 minutes of reflective writing, and 30 minutes minimum exercising-an hour per day. (On weekends I take a break from the gym, my choice.) Introduce each part individually, if that’s easier for you, in the order of importance for you. Try each for three weeks and then decide whether to continue.

Get a coach

High performing and high potential executives in business often engage coaches to work with them as thought partners and guides. Coaching has often been referred to as “charm school” in medicine, a punishment for misbehaving physicians. A few academic medical centers still operate this way. However, progressive medical organizations such as Mayo Clinic, The Cleveland Clinic, Bon Secours, UCSF and others recognize the value in providing coaches.

“Coaching done well may be the most effective intervention designed for human performance…,” Atul Gawande, MD who has written brilliantly about the medical profession, said in this 2011 New Yorker article.  “In the past, I’ve thought nothing of asking my hospital to spend some hundred thousand dollars to upgrade the surgical equipment I use, in the vague hope of giving me finer precision and reducing complications. . . But the three or four hours I’ve spent with [my coach) each month have almost certainly added more to my capabilities than any of this.”

In addition to Gawande, Bill Gates, Eric Schmidt, John Noseworthy, MD, the president and CEO of Mayo Clinic all have coaches. 

Shouldn’t you?

Margaret Cary, MD, MBA, MPH, PCC, is a Washington, D.C.-based physician, credentialed executive coach for practicing physicians and med students, and speaker and writer on physician effectiveness. For more information, go to: https://thecarygroupglobal.com