Physician Stress and Burnout: How Mindful Coaching Can Help

An earlier version of this article appeared on this website in December, 2023

Although physician burnout has probably existed for decades, it’s only recently that it has taken on the notoriety of an epidemic. A visit to PubMed.gov tells the story. In 2024 alone, 872 academic papers were published on physician burnout. Compare that to just 129 in 2011—or 4, the year I entered medical school in 1984.

Many factors have contributed to the rise in burnout, both inside and outside the institution of healthcare. Some are relatively new, such as the rapid rise of disinformation and disrespect, while others, including diminishing reimbursement for services and corporate takeover of practices, have been slowly gathering momentum. For years no one talked about it. Today burnout is out in the open, yet a clear path to meaningful prevention remains elusive.

What Burnout Really Means

The term “burnout” itself may sound a little nebulous, but there are methods to measure and define it.

The Maslach Burnout Inventory defines burnout as “a psychological syndrome” that occurs among people who work with others—particularly in high-demand environments such as healthcare.

The key symptoms?

🩻 Emotional exhaustion – feeling like you’ve got nothing left to give

🩻 Depersonalization – distancing yourself from patients, often with growing cynicism

🩻 Reduced personal accomplishment – feeling ineffective, even hopeless

Although it can give you the blues, burnout isn’t a psychiatric disorder. It’s a normal human response to an abnormal, high-stress environment.

We all have tough days, so how can you recognize burnout? One important clue is that when these symptoms become persistent and all-consuming, burnout is likely at play.

The Data Behind the Epidemic

A 2023 Mayo Clinic survey of over 7000 US physicians found that more than 45% reported symptoms of burnout. That’s down from the pandemic high of nearly 63% in 2021—but still higher than pre-pandemic levels.

Burnout rates were highest in:

🤕 Emergency Medicine

🤕 Internal Medicine

🤕 Neurology

Other studies have shown elevated burnout in

🤕Critical Care

🤕Ob-Gyn

🤕Infectious Disease

🤕Family Medicine

It was notable that in the Mayo study, subspecialty surgeons reported lower-than-average rates.

Risk factors: Not Just About Workload

The biggest contributors to burnout will sound familiar to anyone in healthcare.

⭕ Bureaucratic tasks

⭕ Lack of respect

⭕ Long hours

⭕ Lack of autonomy

These align closely with the six factors associated with workplace stress identified by the British workplace health and safety regulatory agency:

⭕High work demands

⭕Low control over workload and process

⭕Inadequate support from management and colleagues

⭕Poor workplace relationships

⭕Lack of clarity regarding professional role and responsibilities

⭕Poor management of change within the organization

Personal factors matter too. The Mayo Clinic study found that women physicians are about 30% more likely to report burnout. And those with strong support at home—often reflected in marriage status—tend to report lower burnout rates.

Why This Matters: Beyond the Statistics

Burnout doesn’t just make you miserable. It affects your confidence, your relationships, your clinical decision-making, and your ability to experience meaning at work.

And while it feels like everyone is talking about burnout, it often seems like nothing is being done about it.

Which brings us to the next question: What can we do?

Beyond Bubble Baths—Real Tools to Tackle Physician Burnout

We’re not going to yoga or om our way out of this mess. It’s a far more tangled web than that.

And let’s be clear: the responsibility to fix burnout should not rest on the shoulders of burned-out physicians. We wouldn’t expect that of our patients. The source of suffering needs to be addressed before meaningful change can happen.

To ensure sustainable and high quality care for patients, including an engaged and committed medical staff, healthcare systems must lead the charge in addressing root causes. But while we wait for structural change, there are tools that can make a meaningful difference. Among the most promising? Mindfulness and coaching.

Mindfulness: More Than a Buzzword

Mindfulness is often dismissed as fluff—but it’s more than the popular notions of deep breaths and apps.

As a certified mindfulness meditation teacher, I define mindfulness the way my mentor Sean Fargo does:

“Paying attention to the present moment with curiosity and non-judgment.”

It’s not about escaping stress, but building awareness of how we relate to it. In other words, it’s about simply being present.

This sounds nice, but how can it possibly help you overcome the powerful forces that lead to stress and burnout?

In a 2020 meta-analysis of randomized controlled trials involving medical students, mindfulness programs led to significantly lower stress scores—even months later. Techniques included:

🌻Body scans

🌻Awareness of thoughts and emotions

🌻Breathing exercises

🌻Walking and sitting meditation

🌻Group sessions and mobile apps

Most programs were once weekly group sessions, while one used a mobile app.

Mindfulness isn’t magic. You won’t suddenly be living in a blissed-out state of ease. But mindfulness can create a powerful shift in your patterns of thought and open possibilities for new and supportive ways to navigate stressful environments.

Coaching: A Practical, Personalized Intervention

Coaching offers another evidence-based path forward—one that’s personalized, practical, and action-oriented.

In a 2019 randomized trial from the Mayo Clinic, physicians who received six coaching sessions by phone experienced:

📞17% drop in burnout (vs. an increase in controls)

📞20% drop in emotional exhaustion

📞Improvements in job satisfaction, engagement, and meaning at work

Other studies, including one from Duke University, have shown benefits for physicians at all stages—from residents to senior leaders.

Coaching gives you a supportive structure to clarify your values, reset your goals, and regain agency. Sometimes, that means discovering a way to achieve a better balance in your current role. Other times, it means exploring new positions. For some, it means leaving clinical practice altogether.

Mindful Coaching: Where Awareness Meets Action

When mindfulness and coaching intersect, physicians get the best of both worlds:

❇️ Awareness of what's depleting your energy

❇️ Clarity around what matters most

❇️ Practical tools for taking aligned, meaningful action

This is not about telling physicians to fix themselves. It’s about providing a safe space to reflect, reset, and reconnect with purpose..

A Call for Change

Although mindful coaching can help you rediscover your own strengths, burnout is not a failure of individual resilience. It is a consequence of a system that demands too much and gives too little. But within that system, you can still reclaim clarity, agency, and connection through personalized support that connects with your own value system and aspirations.

Systemic change is essential, but it begins with the individual. When you advocate for your own well-being, you’re also shaping a more humane and sustainable future for healthcare.

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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

Berg, S. (2021). Q&A: Clearing up confusion on physician burnout and depression. American Medical Association

Christensen, A. J. et al. (2023). Addressing Burnout in the Primary Care Setting: The Impact of an Evidence-Based Mindfulness Toolkit. Military medicine, 189(Suppl 1), 64–70. https://doi.org/10.1093/milmed/usad277

“Death by 1000 Cuts”: Medscape National Physician Burnout & Suicide Report 2021. (n.d.). Medscape. https://www.medscape.com/slideshow/2021-lifestyle-burnout-6013456#3

Drybye, L.N. et al. (2019). Effect of a professional coaching intervention on the well-being and distress of physicians: a pilot randomized clinical trial. Journal of the American Medical Association Internal Medicine

Garcia, C. L. et al. (2019). Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Medicina

Hathaisaard, C. et al. (2022). Mindfulness-based interventions reducing and preventing stress and burnout in medical students: a systematic review and meta-analysis. Asian Journal of Psychiatry

Health and Safety Executive. (2019). Tackling work-related stress using the management standards approach

Kane, L. (2022). Physician burnout and depression report 2022: stress, anxiety, and anger. Medscape

Maslach, C. et al. (1997). The Maslach Burnout Inventory Manual

Schneider, S. et al. (2014). Physician coaching to enhance well-being: a qualitative analysis of a pilot intervention. Explore

Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Wang, H., Carlasare, L. E., & Dyrbye, L. N. (n.d.). Changes in burnout and satisfaction with Work–Life integration in physicians and the general US working population between 2011 and 2023. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2024.11.031

Making Peace with Your Inner Critic: A Guide for Physicians

Your inner critic is that harsh internal voice muttering in the shadows of your thoughts, constantly critiquing, second-guessing, and comparing. It may take form as the voice of a family member, a tough or challenging attending from your years in training, or a demanding patient. It might even arrive in the guise of your own voice. It’s not surprising that most physicians have their own version of the inner critic.   

No one likes the inner critic, but here’s what you might not realize: Despite its harsh and heckling tone, constantly telling you that you’re not good enough, the inner critic may actually believe that it’s on your side. It may be trying to protect you from what it senses as impending harm or shame.

Of course, sometimes the inner critic is intentionally cruel. That’s a voice that needs to be locked in a box and put out with the trash. It does not deserve your attention or respect. If it is especially powerful, therapy can be life changing.

But your inner critic often emerges from an authentic drive for self-improvement and accountability. Although its intentions may be well-meaning, if left unchecked, this inner critic inevitably creates an unhealthy cycle of self-doubt, perfectionism, and burnout.

In this article, you’ll learn how to recognize the inner critic as a voice rather than a truth. And you’ll see how you can harness its intentions, putting it to work to develop a more compassionate self-dialogue that allows you to thrive and grow.

Noticing the Inner Critic

Your inner critic might say things designed to make you question yourself, such as:

• "You should have caught that diagnosis sooner."

• "What if you made a mistake during that procedure?"

• "You’re not smart enough to keep up with your colleagues."

The inner critic thrives on echoing your deepest fears, drawing strength from your attention. The more you engage with it, the more amplified and persistent it becomes. That’s why it’s crucial to recognize its influence and take steps to quiet its power.

You might visualize your inner critic as an annoying and unwelcome distant relation, tagging along for the ride. But instead of sitting quietly like a polite passenger, or offering constructive advice, this protective character goes into overdrive, grabbing the steering wheel and becoming harsh and punitive when it senses danger ahead. It might believe that it is trying to protect you. But instead of helping you discover your own route, the inner critic may actually run you off the road and into a ditch.

To create some distance, it can help to give your inner critic a name. Take away its sting by making it something ridiculous or silly.

No matter how you conceptualize it, keep an eye out for this dangerous character. By tuning in to the patterns and triggers of the inner critic, you can begin the process of disarming it.

Facing Down the Inner Critic

Identify Patterns

When does the inner critic tend to appear? Does it strike at a specific time of day, day of the week, or month? Do you notice it when you are doing certain types of tasks?  Or does it show up when you’re exhausted and unable to block out its annoying chatter?

Understanding the recurring patterns can provide insights into the core issues your inner critic is amplifying.

Voices in Your Head

Delve into the narratives your inner critic spins. Recognize its dramatic and querulous nature. When your inner critic surfaces, pay attention to the specific phrases and statements it uses. These may include self-defeating remarks, doubts about your abilities, or a barrage of negative predictions.

Tap into the self-talk your inner critic stirs up and ask yourself if there might be a different way to see things. For instance, if your inner critic says, “You’ll never get this right,” counter it by recalling times you’ve successfully navigated similar challenges. Reframe its negativity into constructive, empowering thoughts. By turning its drama into dialogue, you’ll regain control.

Emotional Impact

Explore how your inner critic drives your emotions. Does it trigger self-doubt, frustration, or a sense of being overwhelmed? What are the underlying fears it amplifies? Can you seek out the root causes? Perhaps there’s a different way to tackle these issues.

For instance, if fear is present, can you dissect it into its parts? What are you afraid of, and what's the worst-case scenario? What skills and knowledge do you already possess? How might you target areas for improvement in knowledge or skillset that might disarm the fear?

Physical Sensation

Consider the physical manifestations caused by the inner critic. Do you notice increased stress, tension, or even physical discomfort? Recognizing your physiological responses can serve as an early warning sign when the inner critic is near.

This is a perfect time to integrate mindfulness techniques like focused breathing or even a brief walking meditation. Just a minute or two can break the spell. When you feel the inner critic approaching, remind yourself to be present in the here and now, avoiding the temptation to ruminate over the past or over-analyze what’s to come.

Excessive Restraint

Pinpoint the actions your inner critic prevents you from taking.  Evaluate how the inner critic seeps into your decision-making process. Does it hinder your ability to take calculated risks or make decisions with confidence? Is it fear or is there something you need in order to gain confidence? Acknowledge the limitations, if they are real, but then make a plan.

Are these limitations that you want to overcome? Envision them as roadblocks and strategize how you might get over, around, or through. You don’t need to go it alone. Perhaps a coach or a therapist would be valuable, depending on the type of obstacle that you’re facing.

Transforming the Inner Critic

Imagine your world without the inner critic. If nothing was holding you back, what are three small actions you'd take immediately in your medical practice or your life? How might that improve your well-being, or your capacity to practice your profession at a level you aspire to?

While it may not be possible to squelch the inner critic completely, there are several important ways that you can disarm it, turning it into an ally instead of a fiend.

Acknowledge Its Intentions

When your inner critic pipes up, pause and ask, “What is this voice trying to protect me from?” Naming the underlying fear—like avoiding a mistake or preserving your reputation—can reduce its intensity while offering a tool for reflection and positive action.

Reframe the Dialogue

Instead of letting the critic dominate, respond with curiosity and self-compassion. For example, “I hear you’re worried I missed something, but I reviewed everything thoroughly.” This turns self-judgment into a productive conversation.

Redirect Its Energy

Channel the inner critic’s vigilance into positive actions. This might include creating a checklist for complex tasks, learning new skills, or seeking feedback from a trusted mentor to grow your expertise.

Balance with Self-Compassion

Remind yourself that mistakes can happen even under the best circumstances. Failure doesn’t always mean that you did something wrong. Learn from less-than-ideal outcomes and move forward. Your patients, family, and community need you.

Why Taming the Inner Critic Matters

What’s your inner critic trying to protect you from? Next time it speaks up, take a moment to listen with curiosity, not judgment. You don’t need to hand over control, but you might be surprised at how much it’s been trying to help.

By recognizing the inner critic as a well-meaning—if sometimes misguided— ally, you can reclaim your confidence, stay motivated to grow, and expertly care for your patients. At the same time, you’ll cultivate the self-compassion you so readily give to others. When needed, a coach or a therapist can be a valuable ally. In the end, taming the inner critic is about becoming the best version of yourself.

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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.