The Business of Medicine Observations from Alumni

Rounds

What advice would you give to a physician who may be experiencing burnout?

Victor Connell, MD ’74

A healthy and enjoyable life should be a balance between work and some other interests. Set a reasonable limit on your workplace hours and make sure that your schedule allows enough time to get to know your regular patients and enjoy the art of practicing medicine. Make enough time outside of medicine for friends, family, and pursuing other interests. Maintain a healthy lifestyle, including regular exercise.

Marshall Ruffin, MD ’78

I would tell that physician there are many ways in which she or he can use her or his skills, knowledge, and experience as a physician to find fulfillment in work. Try writing, consulting, or teaching. Take courses in health economics and health care business. Try working in administration or working for a business involved in health care. Health care involves one-fifth of the nation’s economy. Surely there are many jobs of interest to a bright physician.

Stephen Friedland, MD ’57

I would say that if you are financially secure, retire from practice and do something else in the universe of medicine; I still chair our hospital’s ethics committee. Alternatively, do something entirely different, either as a volunteer or for remuneration. I would sincerely hope that you have some interests other than medicine.

William Ericson, MD ’83

Say “no” to the things you know are not right. Set limits. Establish reasonable goals and expectations and, on a daily basis, try to eliminate the 20 percent of your life that causes the 80 percent of your grief.

Tamara Fountain, MD ’88

Maintain hobbies outside medicine, particularly if they involve moving your body. Exercise and being outside are therapeutic in and of themselves. Volunteering and mission work can remind you of the joys that come with our profession. Being able to practice without the burden of EHR documentation, insurance clearance, and ungrateful, entitled patients with sky-high expectations is a great antidote for what ails the U.S. health care delivery system.

As much as you can, control your work circumstances. Because many of us are increasingly employees, there is less and less of that control available, so try to carve out time away from your paying job. Pursue alone time and family time, maintain a hobby, maybe a pastime that you may have relinquished in your quest for professional fulfillment. These are the joys that a well-rounded life gives you. Unhealthy immersion in a stressful, increasingly toxic climate will take its toll.

David Fogelson, MD ’77

Peer support is key. Take time to meet with your peers for clinical supervision; I have scheduled 90 minutes of peer supervision weekly. Your colleagues will help you develop a sense of mastery over difficult clinical cases. Take control of your schedule and give yourself time to listen to and treat the patient who is hurting; do not treat only the organ that is hurting. Stay in the present and focus on the case in hand, and don’t fret over the next ten patients waiting to be seen.

Richard Peinert, MD ’73

All the symposia on this advocate “me time” as the cure. Frankly, I think this is way off. The real cause of burnout, in my humble opinion, is that the “suits” in medicine don’t care or even want to hear from the docs. Sadly, we abdicated power years ago. We have been marginalized and that is the real cause of burnout. The EMR is just another tool to keep us that way.

Samyukta Mullangi, MD ’15

What you can let go, let go. What you can outsource, outsource. The key to having it all is understanding that you never will.

Maintain hobbies outside medicine, particularly if they involve moving your body.

Gordon Bae, MD ’16

We may not be able to change the demands of our work, but we can perform activities to decrease emotional exhaustion. These include exercising, eating well, sleeping well, journaling, meditating, practicing gratitude, developing deeper relationships, and decreasing screen time. Because of our responsibilities in our work and personal lives, not all of us can do all of this. But I think we can do one activity, even if it is just five minutes of exercise each morning.

But this is just one man’s opinion.

Nathan Selden, MD ’93

Work within a system that understands this problem, with other physicians and nurses who are committed to change, and in a culture that respects clinician wellness or is on the way to a meaningful change that you can be a part of. If you are not at such a place, you need to make a change.

Samuel Katz, MD ’52

Burnout is not a problem for me. Enjoy your contact with others and your ability to help them. Slow down.

Richard Hirschhorn, MD ’58

The physician should have other activities that have as much effect as his medical career.

Ernest Bergel, MD ’56

Physician burnout is not a unitary disorder. Each case must be evaluated individually. There is, however, one urgent recommendation that I would give to the profession as a whole: Insist on a single, free, electronic health record system that all hospitals, clinics, and private practices must use. Then make it as hack proof as possible, since it will certainly be attacked.

Hugh Hermann, MD ’54

If you are suffering burnout, it is your own fault for not balancing your life in medicine with sports, hobbies, and family.

Joseph Barr, MD ’60

I’m 84 and not burned out yet, although if I had to live life over with all the rules and regulations that MDs now face, I probably would have burned out many years ago.

Brandon Lujan, MD ’02

It’s balance, as always. Physician, heal thyself: physically, mentally, emotionally, and spiritually. You don’t have to be perfect, just be honest and share what is going on inside of you with another human being. You are not alone, whatever struggle you are facing. Breathe and focus on what works with gratitude.

Roy C. A. Weatherley-White, MD ’58

Suck it up—you chose it. If you don’t like it, do something else, hopefully something equally worthwhile.

Mary Flowers, MD ’78

Apply for a job in television, acting on ER or some other show and pretend to be a physician—more glamour, more money, more respect.

Joseph Burnett, MD ’58

Switch research interests or go abroad.

Hena Ahmed Cheema, MD ’18

My husband and I are both resident physicians. We were long distance our first year married and were both in very demanding training years (intern and PGY-4). We both, ironically, got a pet our first year of residency, and it has been the best protection against burnout. Having your spouse, closest family members, and best friends on speed dial doesn’t hurt, of course.

John Stanley, MD ’58

I don’t know what I’d say. I’ve never felt burned out but have often felt overworked. My advice is to take a long vacation.

Bruce Barnett, MD ’75

Even the most gratifying work can be exhausting. Physicians should take enough time out to recover their physical and psychological strengths. A few weeks may suffice, but sometimes a tired physician needs to take a break from practice for many months or even a few years before returning to medicine with a fresh and energized perspective.

Carolyn Aldredge, MD ’63

Continue to amend your practice to perhaps go in a different direction.

William Kupsky, MD ’78

Become involved now in activities outside of work. Waiting until later may be too late.

Carl Needy, MD ’49

I’d recommend going home to your wife earlier.

Even the most gratifying work can be exhausting. Physicians should take enough time out to recover their physical and psychological strengths.

Richard Aadalen, MD ’65

Continue to have time for and give time to your family, your spouse, and avocations that you enjoy.

Kaihi Fung, MD ’82

Physicians can only do their best. God controls everyone’s fate.

Kim Smith, MD ’89

As a physician coach and champion for physician wellness, my advice to anyone experiencing burnout is to reach out to someone you trust. At all cost, avoid isolation. Look into resources and use them!

The causes of burnout are multifactorial. For most, burnout develops slowly and, more importantly, inconspicuously, like an insidious disease. The key is that it can be curable. Take action to find the solutions needed for your health. It’s time for us to become a priority as our own number one patient.

Lloyd Hamilton, MD ’54

If you don’t enjoy it, don’t do it. American medicine has declined. It no longer puts the patient first. It is a money-making apparatus essentially run and governed by the insurance moguls, who are not, I can assure you, exactly philanthropic.

William Hood Jr., MD ’58

I would recommend that the physician spend some time contemplating her or his good fortune at arriving at this stage of life and use that insight to stimulate interest in continuing on as before.

John Merrifield, MD ’59

Talk to trusted people. Find another line of work; one of the strengths of medicine is that there are many different lines.

Donald Dillon, MD ’59

In retrospect, I think seeking help (which I did, with a psychiatrist) is necessary, but also pondering ways to improve self-worth could be helpful before taking an abrupt action (as in retiring). Consider other ways in government, academia, or business employment.

Joseph McCabe, MD ’74

Work a schedule that is not too stressful. Take time for yourself, make sure you are paying attention to personal relationships. If you are spending a lot of time feeling angry, see if there is something you can do to change the situation. If you can’t change things, find a new position.

Exercise regularly. Take time to nourish your body and soul. Talk with colleagues about how you are feeling and what could be done to improve the situation.

You don’t have to be perfect, just be honest and share what is going on inside of you with another human being.

Dick Dobrow, MD ’62

I think burnout is a newer phenomenon, one that was not common when I was in practice. I would advise physicians to try to avoid medical systems that pile meaningless tasks on the physician and to try to be as independent as possible.

Samuel H. Kim, MD ’62

Take a step back, focus on what bothers you the most, and adjust or eliminate.

Bartholomew Tortella, MD ’80

Look within yourself to discern those things in medicine that, not so long ago, drew you to the profession, and put them back in your life. Give yourself permission to leave medicine if your inner spirit tells you that would contribute to helping people in a manner different from your current career.

Royce Moser Jr., MD ’61

Do not despair! Trite, but true. I have often felt the same. Start remembering the productive times and a few actual lifesaving events.

David Dorsky, MD ’82, PhD ’82

You may have to change career tracks, at least slightly. There are so many ways that medical training and knowledge can be used. If you have to change tracks, think creatively and network extensively. I think that the keys to professional satisfaction are avoiding boredom and knowing that what you do has significance for others. Be curious. Find something that interests you and pursue it, even if you have to volunteer your time at first. Then, look for a niche in which you can make a difference.

Image: iStock.com