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

From Conflict to Collaboration: Overcoming Challenges with Your Staff

As a cardiologist in practice for nearly 30 years, I was fortunate to work with a fantastic team of nurses, medical assistants, and office staff. I give much of the credit to our no-nonsense in-house nurse manager. But not all physicians are so lucky. And even one bad apple can make going to work a miserable experience.

Although medical training involves teamwork, it’s uncommon for physicians to learn managerial or business skills during medical school or residency. If you’re learning on the job, getting off on the right foot can impact your experience at work for years to come.

Until my practice was acquired by a larger organization, I served as chairman of our Human Resources (HR) committee for a number of years. So if you’re a physician dealing with challenging staff members, I’ve got some expert tips and insight to help you get to the other side of this common problem.

First, a little perspective. In years past, most physicians owned their practices. So in these situations, the physician or a trusted administrator typically did the hiring and firing. And the staff understood that keeping up good relations with their physician-employers was vital to maintaining happy employment. Now that most physicians are themselves employees, the relationships have become more muddied. And the truth is that depending on your organization, you may or may not have much say in the way the practice is run.

Be that as it may, as a physician, your leadership is crucial to maintaining a good working environment. Whether it is implicitly stated or not, your staff should understand that their job is to support the work that you do. And ultimately, that means providing optimal care and a supportive experience for your patients.

Whether you’re employed or not, your patients depend on you for your expertise and your care. Your employment status is irrelevant to them, and they view your staff as an extension and a reflection of you. That means that if the practice feels chaotic and uncomfortable, your patients are likely to feel unsafe and unwelcome.

It’s likely that most of your staff will appreciate a physician who is kind, principled, and clear. Most people who work in healthcare take pride in their jobs and care about the people they serve. But unfortunately, you can also expect to encounter some difficult folks along the way.

To maintain your sanity, your ability to provide care for your patients, and your role as a team leader, it’s important to have a clear plan for dealing with troublemakers.

Some people may be negative or disruptive, others may be passive-aggressive, and some may simply be incompetent. You may even encounter employees who delight in getting you upset. Regardless of the type of difficult staff member you are dealing with, rule number one is this: do your best to remain calm, cool, and professional at all times.

When dealing with the inevitable conflicts and other tough situations at work, here are some important things to keep in mind.

• Don’t make it personal

Although it can be tempting to let your emotions take over, the minute you make it personal, the problem becomes about you. This can be very difficult if not impossible to turn around. By keeping it professional, you have a much better chance of remaining above the fray.

• Consider involving HR:

If you have access to an HR staff member or administrator, and you feel reasonably confident that they will support you, it’s best to involve them early on in a difficult situation. This can help to protect you from accusations of harassment or favoritism.

When you try to go it alone, especially as a new physician, there’s a good chance you will end up making some important missteps. Never underestimate the power of a passive-aggressive or disgruntled employee to undermine your reputation. In the worst cases, this could mean the loss of your own job.

• Document everything

Documentation is not necessarily to get the employee in trouble. You’re documenting in order to protect yourself.

Be sure to include the specific behavior that is causing the problem, the date and time of the incident, and any steps that you have taken to address the problem. It’s a good idea to make a note of any witnesses as well.

• Try to understand the root cause of the behavior

Although your practice’s administration is likely responsible for managing the employee and their disruptive behavior, getting a handle on the behavior and its root cause may be helpful. Once you understand this, you may start to develop a plan to turn things around.

For example, if a staff member is negative and disruptive, it may be because they are feeling overwhelmed or undervalued. That doesn’t mean that you need to acquiesce to their demands or accept the behavior. But understanding what might be contributing will make it feel less personal. It may also give you insight into the path forward. And armed with this information, you may be able to work more collaboratively with your administration.

• Be direct and honest. 

If your administration takes a hands-off approach, it may be left up to you to manage the issues. This is often the case for minor procedural problems, lack of education, and misunderstandings.

When you address the problem with the staff member, be clear, calm, and truthful. Avoid being confrontational or accusatory. Instead, focus on the specific behavior or issue that is causing the problem and how it is impacting the workplace.

Consider having a trusted colleague or nurse present for the discussion. That will help to protect you from any undue accusations.

• Be prepared to offer a solution

It may be necessary to work directly with the staff member to resolve the problem. For example, if a staff member is struggling with a particular task, it may be up to you to provide them with additional training or support.

Set clear expectations and provide regular feedback. Sometimes these individuals become the most loyal employees, if they understand that you are on their side.

• Be supportive and encouraging

The process works both ways. By contributing to a work environment where your staff members feel valued and supported, you are more likely to be listened to and treated with respect.

• Be fair and consistent

Treat each of your staff members fairly and consistently. Avoid favoritism and keep your personal life separate. When you spend most of your life at work, it may be tempting to see your staff as friends. This is a pitfall that many early career physicians fall into. Over time this can create divisions and expectations that will only make things more difficult for you.

As a physician, you have the right to expect a positive and productive working environment. If a staff member is making it challenging for you and others to do your jobs, it’s critical to take the necessary steps to address the problem. Whether that means involving administration, providing additional training opportunities, or even terminating the employee, embodying a calm and professional leadership style will help to ensure a safe and supportive environment for you, your staff, and your patients.

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.