Focus on Physicians:
Insights, Ideas, and Strategies
Managing Uncertainty as a Physician
Uncertainty is woven into the life of every physician. Patients don’t always get better, there is not always one best choice or right answer, and sometimes your decisions are affected by factors that are completely out of your control.
For most physicians, managing uncertainty doesn’t come naturally. Perfectionism may be an ever-present companion. In many ways it can be a strength. But when you set unrealistic standards, perfectionism can shift from being an asset to becoming a barrier, undermining both patient care and your own well-being.
An earlier version of this article appeared on this website in July, 2022
Uncertainty is woven into the life of every physician. Patients don’t always get better, there is not always one best choice or right answer, and sometimes your decisions are affected by factors that are completely out of your control.
For most physicians, managing uncertainty doesn’t come naturally. Perfectionism may be an ever-present companion. In many ways it can be a strength. The drive to excel benefits your patients and fuels your professional growth. But when you set unrealistic standards, perfectionism can shift from being an asset to becoming a barrier, undermining both patient care and your own well-being.
Layered on top of that is the responsibility you carry. Every decision can directly affect another person’s health, and that weight can make uncertainty feel almost unbearable.
And then there’s medical culture, which often rewards confidence and conviction, even when doubt is inevitable.
Add the natural physician desire for control—to fix problems, to restore order—and it’s no surprise that “not knowing” can feel like failure. Together, these forces make it difficult for physicians to acknowledge, much less embrace, uncertainty.
The Cost of Intolerance for Uncertainty
A recent study of over 2,000 faculty physicians found that intolerance of uncertainty was associated with a three-fold higher risk of burnout. Physicians who struggled with uncertainty were also less likely to feel satisfied in their careers and more likely to be disengaged at work.
As you might expect, those who struggled with uncertainty were much less likely to be satisfied with their career, and tended to be less engaged at work. Factors that correlated with a greater intolerance of uncertainty were
Female gender
Primary care
Earlier stage of practice
Lack of a trusted advisor.
Yet intolerance of uncertainty was not limited to these groups. The study found that many male physicians, specialists, and senior clinicians also struggle with its impact.
Burnout and physician unhappiness are crucial pain points in our current healthcare environment. Not surprisingly, stress from uncertainty correlates with depression and low levels of resilience. Intolerance of uncertainty has been linked to poorer outcomes and even to increased healthcare costs. And burned out physicians are more likely to leave the practice of medicine.
Naming the Challenge
Medicine rewards precision and stoicism. From training onward, physicians are expected to project confidence—even when the answers aren’t clear.
That’s why it’s especially powerful when senior colleagues and mentors acknowledge that uncertainty is part of the work. Simply hearing “I don’t always know either” can normalize the experience and help younger physicians feel less isolated.
Building Skills to Navigate the Unknown
Although becoming comfortable with uncertainty may always be a challenge, managing your response to uncertainty can open up opportunities to react to life’s curve balls in ways that are both positive and beneficial to all involved.
In their thorough analysis of the issue, Samuel Reis-Dennis and colleagues describe “three corrective virtues” that might help physicians navigate the challenges that uncertainty creates. These include:
Courage: avoiding the tendency to run away from threats by developing strategies to cope with new challenges
Diligence: seeking guidance from trusted colleagues and staying current on the medical literature
Curiosity: addressing uncertainty by viewing it as an opportunity to learn and grow
These virtues remind us that uncertainty isn’t a personal failing but a natural element of the constantly shifting world of medical practice.
Finding Support
Recognizing the impact of uncertainty is one thing—navigating it is another. Medical schools are beginning to teach these skills, but once in practice, many physicians find they still need additional support.
Working with a coach or trusted advisor can provide space to process uncertainty, identify strengths, and discover practical strategies tailored to your unique needs. Building these skills doesn’t just benefit you—it also enhances your care for patients, strengthens your resilience, and can help to restore meaning in your professional life.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
References
Allison, J. J., Kiefe, C. I., Cook, E. F., Gerrity, M. S., Orav, E. J., & Centor, R. (1998). The association of physician attitudes about uncertainty and risk taking with resource use in a Medicare HMO. Medical decision making : an international journal of the Society for Medical Decision Making
Begin, A. S., Hidrue, M., Lehrhoff, S., Del Carmen, M. G., Armstrong, K., & Wasfy, J. H. (2022). Factors associated with physician tolerance of uncertainty: an observational study. Journal of general internal medicine
Berg, S. (2020). Feeling burned out? Try picking up the phone to call your coach. American Medical Association
Cook, J. (2022). Forget resilience, improve your uncertainty tolerance. Forbes
Iannello, P., Mottini, A., Tirelli, S., Riva, S., & Antonietti, A. (2017). Ambiguity and uncertainty tolerance, need for cognition, and their association with stress. A study among Italian practicing physicians. Medical education online
Reis-Dennis, S., Gerrity, M. S., & Geller, G. (2021). Tolerance for uncertainty and professional development: a normative analysis. Journal of general internal medicine
Simpkin, A. L., Khan, A., West, D. C., Garcia, B. M., Sectish, T. C., Spector, N. D., & Landrigan, C. P. (2018). Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study. Academic pediatrics
Sinsky, C. A., Brown, R.L., Stillman, M. J., & Linzer, M. (2021) COVID-related stress and work intentions is a sample of US health care workers. Mayo Clinic proceedings
HALT: A Self-Coaching Stress Management Tool for Physicians
As a physician coach specializing in burnout and professional transitions, I've seen firsthand how the current state of healthcare can push even the most resilient doctors to their limits. To get you back on track, the simple acronym "HALT" – Hungry, Angry, Lonely, Tired – can be an important tool for self-awareness and self-care.
An earlier version of this article appeared on this website in January, 2024
As a retired cardiologist and a physician coach, I've seen firsthand how the current state of healthcare can push even the most resilient doctors to their limits. On some days, it might feel like one more disrespectful message, incomplete handoff, or chaotic clinic day could push you over the edge.
In these tough moments, HALT can help. It’s a quick and powerful prompt that helps you to check in with yourself, pause, recalibrate, and respond with intention.
HALT stands for Hungry, Angry, Lonely, Tired. Originally developed by psychiatrist and addiction specialist Dr. David Streem, HALT was designed to help people recognize the triggers that might lead to a relapse. But for physicians, the acronym serves as an intuitive tool that can remind you to mindfully take a pause and acknowledge what you need, instead of lashing out with a reaction that you might later regret.
Why HALT Matters for Physicians
Burnout is recognized as a natural human response to a dysfunctional workplace. Key features include emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment. Most physicians experience one or more of these aspects of the syndrome. Burnout is not your fault. Nor is it a mental health diagnosis. But when left unchecked, burnout can fuel emotional outbursts and reactive behavior that may jeopardize your professional standing, strain your personal relationships, and leave you feeling even more overwhelmed.
Whether or not you’re experiencing full-blown burnout, it’s likely that you encounter frustration on the regular. How you navigate these challenges can have ripple effects. When you’re running on empty—emotionally or physically—you're more likely to lash out, shut down, or say something you’ll regret when you’re triggered. These reactions don’t just affect patient care and team dynamics; they can also have serious consequences for your career.
That’s where HALT comes in. Ask yourself if you feel:
❓Hungry
❓Angry
❓Lonely
❓Tired
If the answer to any of the above is yes, take a breath, slow your roll, and give yourself a moment of self-compassion and grace.
Here's how HALT works:
Hungry
If you’re like many physicians, hunger may be your default mode. Although it shouldn’t be the norm, it’s painfully common for physicians to skip meals or eat irregularly due to hectic and overbooked schedules.
Junk food from the snack machine or physician’s lounge might fill you up, but it can often make you feel even worse. One easy strategy to counter the “hangries” is to take a few minutes each evening to pack something nourishing for the next day. Nuts, a piece of fruit, or a protein bar can go a long way.
But hunger isn't just about food. It's often about other unmet needs, whether emotional, physical, or intellectual.
Take action on all kinds of hunger by building in a 10–15-minute break to reset your mind and body once or twice daily whenever possible. When you fill up the tank, stabilize your blood sugar and slow down your sympathetic nervous system, you’ll likely find it easier to maintain a steady mood and energy level.
In the long run, the few minutes you carve out to care for yourself will pay off in more respectful relationships, improved productivity, and better health.
Angry
Anger is a natural emotion, but how you handle it in the workplace is crucial. Unchecked anger can lead to conflicts with colleagues, write-ups from staff, and unpleasant meetings with administrators. When it carries over to the bedside or operating room, it may impact the doctor-patient relationship, undermine teamwork, and even affect patient care.
Often the first warning sign of anger is your physical reaction. Become aware of this emotion, and notice how it feels in your body. When you find yourself getting angry, take a moment to pause and step back. Give yourself time to process and reflect, so that you can move forward with intention instead of reaction.
Deep breathing, a short walk, or even bluntly but respectfully discussing your feelings with a trusted colleague can open up a fresh perspective and prevent words and actions that you’ll regret later.
Lonely
Even if you’re surrounded by people all day, the medical profession can be isolating. The weight of responsibility, the fear of making mistakes, a constant pressure to perform, and the need for confidentiality can all leave physicians feeling emotionally disconnected.
When you’re feeling lonely, your stress response may be more intense—reactivity, irritability, or emotional withdrawal can all be signs that you’re running low on connection.
Acknowledging loneliness is the first step toward countering it. Even brief yet meaningful interactions with friends, family, or trusted colleagues can help restore a sense of belonging. Get outside of the boundaries of the clinic or hospital, even if it feels a little uncomfortable at first. Finding a hobby or activity that gets you out of the “doctor” mindset can offer much-needed connection and perspective.
Tired
When you’re tired, everything just feels harder. It’s no surprise that fatigue is a common issue among physicians. Long hours, high stress, and fractured sleep while on call mean that more than 40 percent of doctors surveyed report that their work schedule simply doesn’t allow for adequate sleep.
Chronic tiredness can impair your judgment and your empathy. Although it can be hard to feel compassion for your staff and others though the fog of fatigue, noticing what’s driving your irritation can soften your reaction to stress.
While you may not always be able to control your schedule, small changes can still make a meaningful difference. Prioritize consistent sleep when possible, even if it means saying no to non-essential obligations. When you’re sleep deprived, use short breaks during the day, even if it’s just five to ten minutes, to stretch, breathe deeply, or take a quick walk. Even modest improvements in rest and recovery can help restore your clarity and replenish your emotional reserves.
How to Use HALT in Your Daily Practice
✅ Check In: Before reacting, take a breath and run through your HALT checklist. This simple pause can reset your frame of reference.
✅ Be Proactive: Make time for healthy meals, use brief but effective stress-relief practices like mindfulness, get regular exercise, cultivate a life outside of work, and do your best to get restful sleep.
✅ Seek Support: If you're struggling with anger, loneliness, or fatigue, professional support can be a lifeline. Therapy, coaching, or peer support groups may offer the perspective and tools you need, depending on your circumstances.
✅ Communicate with Colleagues: Foster an environment where it's safe to respectfully express what you’re feeling. This kind of openness can build stronger, more supportive team dynamics.
Simply recognizing your internal state is often enough to shift your response. It’s also a powerful reminder that caring for yourself is neither selfish nor optional.
When you meet your needs with intention and care, you’ll create the capacity to show up more fully for your patients, your team, and yourself.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Thriving Amidst Chaos: Prioritizing Health, Self-Care, and Mindfulness
When your days are busy and your evenings are full, making time for your own well-being can sometimes feel like another thing to check off your endless to-do list. If you’re like many physicians, self-care often falls by the wayside.
The truth is that you need to recharge and refresh in order to be the best version of yourself. And, as important as it is to care for your health and happiness, it’s not just about you. When you care for yourself, you’ll be better equipped to care for those who depend on you.
In this article, we’ll explore why self-care matters, including the impact of self-care on stress management, and I’ll give you some simple steps that will help you to thrive amidst the daily storm of clinical practice.
An earlier version of this article appeared on this website in October 2023
When your days are busy and your evenings are full, making time for your own well-being can sometimes feel like just another thing to check off your endless to-do list. If you’re like many physicians, self-care often falls by the wayside.
The truth is that you need to recharge and refresh in order to be the best version of yourself. And, as important as it is to care for your own health and happiness, it’s not just about you. When you care for yourself, you’ll be better equipped to care for those who depend on you.
In this article, we’ll explore why self-care matters, including the impact of self-care on stress management. Next, I’ll give you some simple steps that will help you to put these ideas into motion. By caring for yourself, you’ll be empowered to thrive amidst the daily storm of medical practice.
The Impact of Stress on Burnout
It’s common to think of stress as harmful and something to be avoided. But stress can affect your health positively as well as negatively.
Positive stress (or eustress) happens when you face a challenge or a deadline that you know you are capable of meeting. It might be a stretch, but you know it’s possible. And importantly, there is a reward waiting on the other side.
While positive stress can propel you towards your goals, negative stress (sometimes called distress) can lead to frustration and burnout. Negative stressors are those forms of stress over which you have no control. A boss (or spouse) who is never happy, a job for which you are never rewarded or thanked, and escalating demands at work without adequate time off to rest and reset are all forms of negative stress.
Constant and unrelenting stress can lead to burnout. The World Health Organization defines burnout as an “occupational phenomenon.” Burnout is characterized by
Exhaustion and loss of motivation
Cynicism and negativity
Inefficiency
Given the current state of healthcare, it’s no surprise that nearly half of physicians reported at least one manifestation of burnout in 2024.
It’s important to remember that burnout is not your fault. By definition, it is a symptom of a dysfunctional system or workplace. Perfectionists, people-pleasers, and so-called workaholics seem to be more susceptible. Not surprisingly, these personality types are common for physicians. But developing some tools to help you get through tough times can lessen the impact and improve your overall happiness and wellbeing.
Self Care and its Benefits
Self-care is not just about pampering yourself. It's about taking care of your mental, emotional, and physical well-being.
Committing to self-care can enhance your focus, improve relationships, lower stress, and mitigate burnout. Acknowledging the mind-body connection is often the first step towards effective self- care.
Nutritional Psychiatry and Stress Management
The new field of Nutritional Psychiatry focuses on the growing body of research that strongly connects what you eat to how you feel. Without a doubt, mental health is complex and multifaceted. Diet is only one part of the big picture.
But when you’re famished and pressed for time, the quickest options can undermine you, sabotaging your best intentions and sapping your energy.
As it turns out, those ultra-processed foods that often pass for nutrition in the doctor’s lounge or office snack machine can raise your risk of anxiety, sleep disturbance, depression, food addiction, alcohol use disorder, and increased inflammation. Artificial sweeteners in particular have been linked to a greater risk for depression.
Instead, consider switching in simple elements of the Mediterranean diet like fruits, nuts, whole grains, olive oil and fish. You probably know that the Mediterranean diet supports heart health and may reduce the risk for certain cancers. But this diet is also linked to improved symptoms of depression and better mental health and well-being. There’s also emerging evidence that a Mediterranean diet can improve perceptual performance.
It might take a little planning, but going Mediterranean doesn’t have to be complicated. Simply packing a nourishing lunch or advocating for healthier options at work can make a difference.
Exercise and Health
You already know that regular exercise will lower your risk for heart disease, cancer, bone disease, and dementia, among other dreaded conditions.
But research has also shown that exercise can reduce anxiety, improve sleep, and improve immune function. It doesn’t take a lot of exercise to reap the benefits. A brisk 15 minute walk a few days a week is a great way to get started.
Mindfulness and Self-Care
"Mindfulness is the awareness that arises when we nonjudgmentally pay attention in the present moment.” These are the words of Jon Kabat-Zinn, PhD., Professor of Medicine Emeritus at the University of Massachusetts Medical School, and the godfather of mindfulness in healthcare.
Put even more simply, mindfulness is undistracted attention.
Practicing mindfulness has a wealth of benefits, some of which you might not anticipate, including
Less stress and anxiety
Greater parasympathetic tone
If it all sounds a little woo, know that mindfulness doesn’t have to be about practicing yoga or meditating. You don’t need a special cushion or a meditation app, although those can be nice. Instead, it’s about being undistracted, nonreactive, and fully present in the moment.
Getting started with mindfulness isn’t complicated. Simply set aside 3-10 minutes of quiet time each day to observe the present moment. Notice your thoughts and let them go, returning to the present when your mind wanders.
It is this practice of continually returning to the present moment that develops the “mindfulness muscle.”
When you practice mindfulness, you may find that your presence, and hence communication, with patients and colleagues becomes easier and more engaged.
Create an Action Plan
Creating an action plan will help you to set realistic goals and track your progress. Write out the steps that you need to take to commit to your self-care. And develop a plan that is realistic and actionable.
Consider enlisting a partner or friend with whom you can share accountability to help you to stay committed. Something as simple as a daily reminder on your phone may also keep you on track.
The ripple effect of taking your own self-care to heart will show up in your energy level, creativity, and relationships. You may notice a greater sense of self-compassion and equanimity. And in time, your path forward toward the goals that matter will become more clear.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary coaching discovery session, click the button below.
References
Adan, R. A. H. et al. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 29(12), 1321–1332.
American Medical Association & American Medical Association. (2024, July 2). Physician burnout rate drops below 50% for first time in 4 years. American Medical Association. https://www.ama-assn.org/practice-management/physician-health/physician-burnout-rate-drops-below-50-first-time-4-years
APA Dictionary of Psychology. (n.d.). https://dictionary.apa.org/eustress
Brulé, G., & Morgan, R. (2018). Editorial Working with stress: can we turn distress into eustress? ResearchGate. https://www.researchgate.net/publication/324531212_Editorial_Working_with_stress_can_we_turn_distress_into_eustress
Davidson, R. J. et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic medicine, 65(4), 564–570.
Ezzatvar Y, Ramírez-Vélez R, Izquierdo M, et al. (2022). Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose–response meta-analysis of data from 1 853 610 adults. British Journal of Sports Medicine 56:1188-1193.
Gilbert, D., & Waltz, J. (2010). Mindfulness and health behaviors. Mindfulness, 1(4), 227–234
Lane, M. M. et al. (2022). Ultra-Processed Food Consumption and Mental Health: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients, 14(13), 2568.
Loucks, E. B.et al. (2015). Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Current cardiology reports, 17(12), 112.
Martinez-Gonzalez, M. et al. (2019). The Mediterranean Diet and Cardiovascular Health: A Critical Review. Circulation Research 124:779-787
Munoz, M.A. et al. (2009). Adherence to the Mediterranean diet is associated with better mental and physical health. British Journal of Nutrition. 101 (1821-1827),
Samuthpongtorn C et al. (2023). Consumption of Ultraprocessed Food and Risk of Depression. JAMA Netw Open. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770
Shanafelt, Tait D. et al. (2022). Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clinic Proceedings, Volume 97, Issue 12, 2248 - 2258
Stubbs, B. et al. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry research, 249, 102–108.
World Health Organization: WHO. “Burn-out an ‘Occupational Phenomenon’: International Classification of Diseases.” World Health Organization, 28 May 2019, www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.
Yin, W. et al. (2021). Mediterranean Diet and Depression: A Population-based Cohort Study. International Journal of Behavioral Nutrition and Physical Activity, 18(1). https://doi.org/10.1186/s12966-021-01227-3
Young, H. A. et al. (2022). Mediterranean diet, interoception and mental health: Is it time to look beyond the ‘Gut-brain axis’? Physiology & Behavior, Volume 257.
Overcoming Disrespect in Medicine: Protecting Physician Dignity
Treating patients with dignity is a fundamental tenet of our profession. Most of us aspire to create a sense of safety and respect for those in our care. Yet the flip side of this equation is rarely mentioned. And the truth is that physicians are often not treated with dignity by their systems or their patients.
In this article, I’ll go over the fundamental changes that have contributed to disrespect for physicians, and give you five strategies you can use to combat the disrespect and reclaim your dignity.
An earlier version of this article appeared on the KevinMD website in August, 2023.
Treating patients with dignity is one of the cornerstones of our profession. While we’ve all had moments when we—or our colleagues—didn’t quite measure up, most of us genuinely aim to make our patients feel safe and respected. But what about the flip side of this dynamic? It’s not talked about nearly enough: physicians are often not treated with the same dignity by their systems or even their patients.
In this article, I’ll dive into the major shifts that have led to this reality and share five practical strategies to help you push back against the disrespect and reclaim your sense of dignity.
The Roots of the Problem: Disrespect and Breakdown in Advocacy
We’ve been conditioned to expect, and even accept, that patients in distress might lash out, but the toll this has taken on physicians in recent years has been enormous. As recently as five years ago there was still a general expectation of respect for the expertise and sacrifices that a physician’s work entails.
But disrespect from patients is currently at an all-time high, sometimes even escalating to physical violence from patients. A recent study found that more than one third of public health workers in the US experience some form of workplace violence. Examples included stigma or discrimination, job-related threats, and bullying or harassment.
Adding fuel to the fire is the rise of administrative oversight of physicians and their practices by people who may have little experience in direct patient care. Their reach extends not only to metrics and billing, but into personal and professional decisions that once would have been completely off limits.
What’s more, employed physicians may have little say into whether threatening patients can be dismissed from their practices.
And at the intersection of patient and administrative stress are the widely published patient satisfaction scores. While these scores often have no relevance to patient outcomes, they’ve become yet another pressure point, pushing physicians to prioritize arbitrary expectations over doing their best work.
Although physicians are tasked with regular training in sensitivity and respect for patients and employees, they get little instruction in how to protect their own dignity. Often physicians are advised to just let it go.
It’s not unusual for doctors, especially women, to attempt to deal with these situations with passivity and even self-deprecation, in a misguided attempt to get along. Younger physicians who lack strong mentorship may be especially vulnerable to these situations.
Unfortunately, these well-meaning attempts to smooth things over often have the opposite effect. They can actually embolden the bully and do nothing to improve the situation.
The status quo is not sustainable, and it is incumbent on healthcare systems to work to create safe and respectful environments. As a physician, you have more power than you may realize. Here are five ideas that you can implement right now:
How to Reclaim Your Dignity
1. Establish Boundaries
Boundaries are essential for maintaining professional relationships and protecting your sense of self. Being a compassionate and caring physician doesn’t mean being a friend to your patients or colleagues.
Keep a clear line between work and personal life—avoid interacting with patients or administrators on social media, and be intentional about separating the two spheres. Setting clear expectations for respectful behavior can help prevent issues before they arise.
2. Advocate for a Respectful Work Environment
If you don’t stand up for yourself, who will? Open discussions about mutual respect—at meetings or through anonymous feedback systems—can pave the way for change.
Remember, you’re not asking for anything unreasonable. Advocating for policies that address disrespect and burnout can help create a healthier, more supportive workplace for everyone.
3. Strengthen Doctor-Patient Communication
Good communication is at the heart of the physician-patient relationship. By being empathetic and respectful in your interactions, you can set the tone for civility with both patients and staff.
Stay calm during difficult conversations—pause, take a deep breath, and step away if needed. Active listening, showing genuine interest in patients' concerns, and involving them in decision-making can help build trust and respect.
And although the EHR is great tool for communication, keeping EHR messages brief and focused can help to maintain your professional boundaries while addressing patient concerns.
4. Don’t Accept Disrespect
Firmly but politely calling out an incident of disrespect can be a first step towards creating a solution. When an issue persists or escalates, document what’s happening—it’s often more effective than just voicing complaints.
But if you feel that your safety or that of your staff is at risk, don’t allow yourself to be talked into accepting a dangerous situation. If you’re employed, your healthcare system bears responsibility. If your concerns are not addressed, sometimes engaging with and reporting to security or even law enforcement personnel is the best course of action to protect everyone.
5. Take Care of Yourself
Prioritize your own well-being. Make time for self-care, whether it’s through exercise, meditation, or hobbies to help you recharge emotionally and mentally. Mindfulness practices can give you tools that help you to stay present, focused, and composed during difficult encounters, preventing potential escalation.
Don’t overlook the importance of making time for your family, friends and loved ones. By nurturing these ties, you will stay connected to the world outside of your practice.
Reclaiming your dignity as a physician will require commitment and fortitude. While it’s crucial to acknowledge the culpability of our healthcare systems, real change will depend on strong advocacy from physicians like you. By starting with the steps above, you can begin to build a workplace that’s not only more respectful but also more sustainable. And ultimately everyone, including the patients you care for, will benefit.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary coaching discovery session, click the button below.
References
Burnout is an Expression of Grief, Not a Lack of Compassion
“The wound is the place where the light enters you.”- Rumi
With over 60% of physicians surveyed reporting burnout in 2021, it’s an epidemic in our profession.
Burnout is not a personal failing or a psychological illness. Rather, burnout is a response to chronic workplace-related stress.
But burnout is not a failure of compassion. In fact, burnout may be a natural reaction to the recognition that you are unable to provide the compassionate care that your patients need.
An earlier version of this article appeared on the KevinMD website in June, 2023
Over the last 5 years, the word “burnout” has become nearly synonymous with the state of healthcare. With nearly 50 percent of physicians surveyed reporting burnout in 2023, it’s an epidemic in our profession.
Physicians are often made to feel responsible for their symptoms of burnout, but by definition, burnout is not a personal failing or a psychological illness. Rather, burnout is defined as an occupational phenomenon that happens in response to chronic workplace-related stress.
Burnout is not a failure of compassion.
If you’re feeling burned out, it doesn’t mean that you don’t care. In fact, burnout may be a natural reaction to the recognition that you are unable to provide the compassionate care that your patients need.
The experience of burnout may mirror in some ways the experience of grief. Both are a response to loss. And like burnout, grief is often experienced as exhaustion and difficulty thinking clearly.
Compassion fatigue on the other hand is defined as a sense of indifference to the suffering of others. It’s an emotional withdrawal often caused by exposure to traumatic events. For physicians, it may be a response to relentless illness and death. The COVID-19 pandemic is a classic example of a driver of compassion fatigue, especially for those who worked in the ER and ICU in the early days of this disaster.
It’s not uncommon for physicians to experience compassion fatigue from time to time. It doesn’t mean that they are not compassionate people, but rather that they are suffering and in need of relief.
We might consider burnout as a type of disenfranchised grief. But it is not compassion fatigue. In fact, equating burnout with a lack of compassion may be a heavy-handed way of placing the blame on physicians while deflecting it from the systems that created the problem.
As a coach, I have found that many physicians with burnout are in fact grieving the lack of connection to their patients. Often this is due to system-wide emphasis on RVUs combined with excessive clerical work that undermines their ability to spend meaningful time with patients.
National organizations and many health care systems are beginning to take note, and as supportive processes are put in place, rates of burnout do seem to be slowly improving. But there is much work to be done.
If you’re experiencing burnout, it’s important to recognize it for the wound that it is, have compassion for yourself, and create a plan to move forward.
In the words of the poet Rumi, “the wound is the place where the light enters you.” What does this light illuminate for you?
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
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How Do You Know if You’re Burned Out?
It’s no surprise that nationwide, levels of burnout reached record highs during the pandemic. But now that we are back to a semblance of normal, the percentage of physicians experiencing burnout symptoms still hovers a little under 50 percent-- far above the “baseline” of 38 percent in 2020. In this article, you'll learn how to know if you are burned out. And we'll go over the costs of burnout in both dollars and patient care.
Burnout is not going away.
It’s no surprise that nationwide, levels of burnout reached record highs during the pandemic, impacting over 60 percent of physicians. But now that we are back to a semblance of normal, the percentage of physicians experiencing burnout symptoms hovers a little under 50 percent. That’s still far above the “baseline” of 38 percent in 2020.
Topping the list of burnout-inducing specialties are
💉Emergency Medicine,
💉Internal Medicine,
💉OB-GYN
💉Family Medicine
Although burnout has decreased in all of these groups, more than 50 percent of doctors surveyed in these specialties described classic symptoms of burnout.
While any improvement is good news, the fact that nearly one in two physicians across the board are suffering from burnout is nothing to celebrate.
Not only is burnout demoralizing, but it also contributes to job turnover and increased healthcare costs. Not surprisingly, a Mayo Clinic study found that burnout can raise the likelihood of medical errors. And a 2019 study reported a conservative yearly cost to the US healthcare system of $4.6 billion dollars.
So how do you know if you're burned out?
❓ A. Is it just a feeling?
❓ B. Is it something we can measure?
If you answered B, you're right. Burnout isn’t just a trending term. There are standardized tools to measure burnout. The Maslach Burnout Inventory is the granddaddy of burnout tools, and has been in use since 1981.
Burnout affects doctors of all ages and across all spectrums. It is not a personal failing, and it’s not a mental illness.
If you’re experiencing burnout, it’s important to understand that burnout is not your fault, and you’re not alone. Here’s what you need to know:
✴ According to the World Health Organization and the ICD-11, burnout results "from chronic workplace stress that has not been successfully managed."
✴ Symptoms of burnout include:
🚫 feelings of low energy or exhaustion
🚫 negative feelings or cynicism about your job
🚫 loss of motivation and a sense of detachment from work
✴ Burnout is not a mental health condition.
So how do you know if you’re burned out? If you're wondering if you've just hit a rough spot or if you're truly burned out, you could invest in the Maslach Inventory. Or you could save yourself a little time and money and take a simple Two-Minute Burnout Inventory created by Chris Bailey for Harvard Business Review.
If you're a physician living with burnout, you don't need to suffer in silence. There are ways to get through it, but you can't always get there on your own.
Systemic changes to our profession are critical, and there are signs that change is coming. But while we wait for the slow gears of progress, it's important that you take care of yourself now.
Your health, your loved ones, and your patients are counting on you. If you’re feeling burned out, consider coaching, either through your institution, or through a certified Physician Coach. Studies, including a randomized controlled trial published in 2024, have found coaching to be an effective strategy for reducing physician burnout.
There are no easy answers to the complex issues facing healthcare today, but getting clarity on your own needs and values will empower you to chart your own course.
An earlier version of this article was published in April 2023.
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