Focus on Physicians:
Insights, Ideas, and Strategies
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
In 2025, more than 40 percent of physicians surveyed reported at least one symptom of burnout. As bad as this sounds, it was an improvement over the pandemic era, when over 60 percent of physicians experienced one or more manifestations of burnout. Yet despite this meaningful improvement, the problem remains substantial. It’s no wonder that the word “burnout” has become nearly synonymous with the state of health care.
Before we go any further, it’s important to understand that burnout is not a personal failing, and it doesn’t mean that you lack compassion or empathy. The World Health Organization (WHO) defines burnout as an occupational phenomenon that develops in response to chronic workplace-related stress.
Despite the systems that create the conditions for burnout, physicians are often made to feel responsible for the problem. You may be encouraged to be more resilient, more efficient, more mindful, more adaptable. Those things may help at the individual level, but by definition, burnout is not a weakness or a psychological illness.
Burnout can affect your life in many different ways, but the WHO makes clear that burnout “should not be applied to describe experiences in other areas of life.” This is an important distinction, because it shifts the responsibility for burnout to the workplace.
Burnout is not a failure of compassion
If you’re feeling burned out, it doesn’t mean that you don’t care. In many cases, it can mean the opposite. Burnout may arise from the painful recognition that you are no longer able to provide the kind of thoughtful, connected, compassionate care your patients need, or the kind of care you entered medicine to provide.
This is why, in a very real sense, burnout may mirror grief.
Both burnout and grief are responses to loss. Grief is not only about death. You may grieve the loss of time, purpose, identity, autonomy, connection, or the way you once imagined your work would be. And like burnout, grief can show up as exhaustion, irritability, numbness, difficulty concentrating, and a sense of disconnection from life as it once felt.
For physicians, burnout may represent grief for the doctor-patient relationship you thought you would have. Grief for the time you no longer have with patients. Grief for the ability to think deeply, listen fully, and practice medicine in a way that feels whole.
The role of moral distress
Moral distress is closely related to burnout, but is a different condition. It describes the anguish that arises when you know what your patients need, but are constrained by systems, policies, staffing shortages, financial pressures, or administrative demands that prevent you from acting in alignment with that knowledge.
Over time, that repeated gap between what you believe is right and what you are able to do can become profoundly demoralizing.
The added pain of mistrust
It’s impossible to discuss burnout and moral distress without acknowledging the role of mistrust. Social media, misinformation, political polarization, and other societal forces have changed the way many patients encounter medical expertise.
For doctors who entered medicine with a deep commitment to service, science, and the healing relationship, it can be profoundly painful to face unfounded suspicion and doubt, or to be treated as part of a system that patients no longer believe has their best interests at heart.
Burnout versus compassion fatigue
Burnout and moral distress are different from compassion fatigue.
Compassion fatigue is often described as emotional withdrawal or a reduced capacity to respond to the suffering of others, often after repeated exposure to trauma, illness, or death.
High-acuity environments often trigger situational compassion fatigue in physicians. The early days of the COVID-19 pandemic were a powerful example, particularly for clinicians working in emergency departments, ICUs, and other settings where suffering and loss were relentless.
Compassion fatigue does not mean a physician is uncaring. It means they are overwhelmed and in need of relief.
We might consider burnout and moral distress as forms of disenfranchised grief. But they are not compassion fatigue. In fact, equating burnout with a lack of compassion may be another 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 experiencing burnout are not at all indifferent to their patients. Instead, they are grieving the loss of connection with them. They are grieving the intrusion of RVU pressure, excessive clerical work, inbox burden, staffing shortages, and the constant demand to do more with less. They are grieving the gap between the care they want to give and the care the system allows them to provide.
A call to action
National organizations and many health care systems are beginning to take note, and as supportive processes are put in place, rates of burnout are gradually improving. But there is much work to be done.
In the words of the poet Rumi, “the wound is the place where the light enters you.”
If you’re experiencing burnout or moral distress, it’s important to recognize it for the wound that it is, have compassion for yourself, and create a plan to move forward.
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Why Should Healthcare Systems Invest in Coaching?
Nearly half of physicians report burnout, and replacing just one doctor can cost a healthcare system up to $1 million. Studies show that coaching reduces burnout by 17% and improves physician engagement. Investing in coaching is a proven strategy for healthcare systems to strengthen care, retention, and organizational success
An earlier version of this article originally appeared on this site in August 2022.
Over the past decade, the pace of change for physicians in medical practice has accelerated dramatically. Consolidation of practices, evolving healthcare laws, the COVID-19 pandemic, and shifts in ownership models have reshaped the landscape.
With a few exceptions, the era of the independent solo practitioner, or even the small single-specialty group, is largely behind us. By early 2022, nearly three-quarters of U.S. physicians were employed by hospitals or corporations—a 19% increase over just three years, according to Avalere Health. And in 2023, the percentage grew by another 5 percent, representing nearly 20,000 additional doctors.
While recent events have highlighted the considerable risks, the consolidation of care also brings potential benefits such as cost savings, improved outcome measurement, and more streamlined delivery systems. At the same time, in acquiring these formerly independent practices, large healthcare systems may not have fully recognized the immense responsibility they were assuming for the satisfaction and well-being of their employed physicians.
Bridging the Gap: Physicians and Healthcare Systems
Healthcare administrators are a diverse group. Many have some background as healthcare professionals, but they may not fully understand or embrace the qualities that lead individuals to pursue the life of a physician.
Physicians are, by nature, highly intelligent, driven, and often perfectionistic individuals. Many view medicine as a calling— a mindset that can make it difficult to set limits, leaving physicians vulnerable to overwork and exploitation.
Recognizing these character traits makes it all the more concerning that in a 2024 survey, more than 40 percent of physicians reported at least one symptom of burnout, compared to about 25 percent in 2000. Much of this is driven by systemic pressures: declining autonomy, heavy documentation requirements, and increasing challenges to civility and trust between patients and physicians.
Healthcare systems carry a responsibility to address these challenges. Meaningful reforms in workload distribution, clerical support, and leadership culture are essential. But alongside systemic changes, physicians need tools that help them navigate the pressures of their daily work. Many organizations are discovering that coaching offers a meaningful and measurable way to support their physicians.
How can coaching help?
Coaching is not the answer to burnout, but it can be a powerful intervention. A study from the Mayo Clinic found that after 6 coaching sessions by credentialed coaches, the rate of burnout decreased by over 17 percent. In contrast, burnout in the control group increased by nearly 5%. And rates of emotional exhaustion dropped by nearly 20% in the coached group but increased 10% in controls.
Beyond mitigating burnout, coaching can help physicians navigate the challenges of daily practice, including:
Identifying inefficiencies and improving time management
Reducing wasted effort and improving organization
Strengthening communication and leadership skills
Managing difficult and distressing interactions and scenarios
Reconnecting with meaning and purpose in their work
The Cost of Doing Nothing
Failing to address physician well-being carries enormous financial and human costs. Burned-out physicians are more likely to disengage from patients, impact staff morale, and ultimately leave their organizations. More importantly, quality of care may also suffer and medical errors increase.
Physician disengagement also hits the bottom line. According to the American Medical Association, replacing a single physician can cost between $500,000 and $1 million. And burned-out physicians may increase healthcare costs and decrease patient satisfaction. Ultimately this results in lost revenue and loss of social currency.
A Smart Investment
As hospitals and healthcare systems plan for the future, retaining high-quality, satisfied physicians will only grow in importance. Coaching represents a supportive, tangible, and mutually beneficial investment. It signals that organizations value their physicians as people, not just as interchangeable “providers.”
While coaching alone cannot resolve the systemic challenges in healthcare, when used as part of a comprehensive strategy it can:
Improve patient care and satisfaction
Strengthen teamwork and communication
Foster a healthier, more resilient workforce
Enhance physician well-being
As healthcare systems position themselves for the future, investing in physicians well-being is both sound strategy and good business.
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.
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.
When Physicians are Disrespected: My Guest Appearance on the Podcast by KevinMD
It was an honor to be invited back to Kevin Pho, M.D.'s KevinMD Podcast.
In this episode, we talk about the epidemic of disrespect faced by physicians today, and steps you can take to advocate for yourself and reclaim your dignity.
When physicians and others in healthcare are treated respectfully, the practice of medicine becomes more sustainable and more inclusive.
If you’re a physician, or anyone active in healthcare today, you have probably heard of Dr. Kevin Pho and his KevinMD podcast and website.
Not only does he offer a curated selection of articles tailored to physicians and others in healthcare, Dr. Pho also hosts a podcast for thought leaders in the medical field. I was honored to be invited back as a guest.
In this episode, which originally aired in October 2023, we talk about the epidemic of disrespect faced by physicians today, and clear steps you can take to advocate for yourself and reclaim your dignity.
This is a topic I wrote about in Preventing Physician Burnout: Reclaiming Your Dignity. An earlier version of the article also appeared on the KevinMD website.
When physicians and others in healthcare are treated respectfully, the practice of medicine becomes more sustainable and more inclusive.
Navigating Burnout: My Podcast Appearance on KevinMD
Burnout is a symptom of a system that is not working for you. In many ways it’s a form of grief. It’s not your fault. But that doesn’t mean there’s no way out. In my interview with Kevin MD, I discussed the factors that contribute to burnout as well as some actionable steps you can take to improve your life as a physician and to combat the effects of today’s stressful environment.
If you’re a physician, or anyone active in healthcare today, you have probably heard of Dr. Kevin Pho and his KevinMD podcast and website.
Kevin posts interviews and articles daily, and I was thrilled to be a recent guest. In the episode, we discussed the burnout epidemic, and why it’s not the same as compassion fatigue.
Burnout is a symptom of a system that is not working for you. In many ways, it’s a form of grief. It’s not your fault. But that doesn’t mean there’s no way out. In the interview, I went over actionable steps you can take to improve your life as a physician and to combat the effects of today’s stressful environment.