So You Want to Be a Doctor?

Overcoming the Burnout Blowup

Doctors and other health care workers should look in, then out, to clear career exhaustion.

By Benjamin Cassidy September 6, 2021 Published in the Fall 2021 issue of Seattle Met

Before anyone ever knew about Covid-19, a different affliction had already taken root in those who’d have to stem the virus—one that wasn’t a disease or illness, technically. “We were in the midst of, really, an epidemic of career burnout among practicing physicians and other health care workers in the U.S.,” says Dr. Chris Bundy, executive medical director at the Washington Physicians Health Program.

For a brief period at the outset of the coronavirus pandemic, the brain drain relented, Bundy thinks, as doctors shed bureaucratic headaches and traded elbow taps for their response to the crisis. But eventually the motivational problems that give rise to burnout would resurface at the Seattle-based nonprofit that has helped rehabilitate doctors since 1986. In 2020, 62 percent of its referrals were for non-substance-related health conditions, with a significant chunk tied to burnout.

Which is not a catch-all term for workplace dissatisfaction. The World Health Organization officially recognized burnout in 2019 as a state of exhaustion precipitated by “chronic workplace stress that has not been managed.” Bundy breaks it down into three domains: emotional exhaustion, when “the thought of going in and spending one more day at work just seems unbearable, unmanageable.” Depersonalization, when someone develops “callousness and cynicism about the work.” And a loss of efficacy, when “you’re showing up every day to do a job with a mission that’s important to you, and you feel consistently thwarted in that mission.”

To combat these feelings, treatment at the physicians health program addresses the pillars of internal motivation: autonomy, competence, and connectedness. While cutting back on work hours might boost productivity, coaching or therapy helps identify what first drew health care workers to medicine in order to truly alleviate burnout. Bundy would like to see opt-out therapy and counseling programs introduced in medical schools and residencies. “Therapy’s not just for mental illness, but kind of like massage,” he says of the concept. “You can get massage because you have an injury, or you can get massage because it feels good, because you like it, because it helps you reduce stress.”

He also emphasizes the need for more ingrained peer support in the health care system. In the past, he notes, a doctors’ lounge was a place where physicians could break bread together and discuss cases and connect. “In today’s modern health care environment,” he says, “that’s been lost.”

To reclaim a burnout remedy, then, doctors don’t have to look far, just beyond their own “perfectitude,” as Bundy calls it. “The power of shared experience cannot be overstated in terms of mitigating the stress and demands of the profession.”

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