What other factors increase burnout in physicians?

Diagnosis and treatment modalities are progressing rapidly and the rate of change itself is increasing over time. This is a good thing for patients, but it has serious consequences for doctors. The impact on physicians can be overwhelming when combined with patient care related stresses. Annually, there are new clinical guidelines, new diagnostic techniques, and new therapeutic regimens. It is hard to keep current with a profession that gets more complex over time.

Patients also come in to their visits with more information and opinions, often taken from the Internet. Physicians have to dispel misinformation or to justify their therapeutic decisions. It is harder to feel empathy for self-righteous or argumentative patients.

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How does the current healthcare environment contribute to burnout in general and compassion fatigue in particular?

Many, if not most physicians have gone from being in control of their practices perhaps with a few partners, to being employees of large organizations that shift and change as hospitals and health systems engage in mergers and acquisitions. As employees, they have little input in when and how they see patients, and little autonomy. Being an employee in any industry is challenging and can lead to burnout when there is bad leadership or a difficult boss. But physicians have gone from being the boss to having a boss. That is a difficult transition for doctors. These pools of 100 to 200 to 300 employed physicians in a single organization are a new phenomenon as well. We are only just beginning to learn how to lead a group of physicians of that size.

Can physicians recover from burnout?

Physicians absolutely can and do recover from burnout. Many assume that they will have to quit their positions or even leave the practice of medicine, but in my experience, 70% will recover without changing jobs, and most will never need to leave the practice of medicine.

How do you approach burnout and compassion fatigue in your clients?

I frame burnout as the depletion of three “energetic bank accounts.” It is similar to your actual bank account except these accounts hold your life energy. It’s like “the Force” in Star Wars. You have to make regular deposits in your money account at the bank if you want to make withdrawals. Similarly, if you take out more energy than you put in, you drain your account and eventually end up with a negative energy balance. Burnout happens when you continue to see patients when your energy account balances are below zero.

There are three “energetic accounts,” which correspond to the three symptoms of burnout: physical, emotional, and spiritual. (Continued…)