Burnout

In early 2020, I was in a leadership position within my department.  Just as I was settling into my new role, a pandemic was declared.

Nothing could have prepared me for what would come in the coming months.

I remember being overwhelmed with all the new information being presented daily at meetings with updated policies and guidelines.  Each day would bring a new set of questions and meeting invitations.  There were also topics that would be presented, readdressed, and updated regularly, such as visitor policies, infectious precautions, testing protocols, and personal protective equipment. 

I was in constant communication with other Department Heads, Public Health, and the rest of the leadership chain at my institution.  Meetings, emails, and phone calls were going beyond the typical business day and were extending into the early mornings and evenings.

I was working hard to keep up with relaying all the new information I gathered to my Department Members through a series of regular meetings and emails.  Each email would generate more questions and points of clarification that I was responsible to address later on.  I would also receive questions throughout the day regarding various queries which were not yet addressed by our leadership.  We were furthermore responsible for determining the function of  a myriad of services such as outpatient clinics and how we would adjust to start seeing patients virtually.  I also received questions about hypothetical situations at home, such as whether a physician should report to work if their family member were ill and awaiting test results.

Preparing for the worst, we also worked to create internal policies and procedures for what to do in case any of us got sick.  A backup system was set up to ensure that our service and patient care would be maintained.

We were told from the start that this pandemic was going to be more like a marathon rather than a sprint.  Weeks eventually turned into months, which then turned into years.

I tried my best to work hard for my colleagues and keep a positive outlook.  I felt a sense of duty and felt I was responsible for leading my group through example.  But I felt like I was losing control over my schedule and my work-life balance.  I found that I was spending hours each day answering emails, attending meetings, and addressing questions and concerns from my colleagues.  I was staying up late and waking up early to finish my administrative tasks.  This was all in addition to my clinical work.

My sleep quality suffered.  I did not have time to exercise.  I started to notice more abdominal symptoms such as nausea, vomiting and gastrointestinal upset.  My health deteriorated and I checked myself into the ER on two separate occasions for further assessment and symptom management.  Each time, the physicians did not find anything wrong on my diagnostic tests.  Furthermore, I began to feel a sense of misery at work that I never felt before.

In the past, when things were difficult or stressful, I could always count on a vacation to help reset things.  But now, travel was no longer possible due to travel restrictions . 

For the first time in my career, I realized that I was burning out.

I tried to seek guidance and assistance from some of my trusted colleagues.  Some colleagues were extremely supportive and had good insight and understanding about what I was experiencing.  But I also discovered that some of my colleagues were experiencing worse symptoms of burnout than me.

As the months turned into years, I realized that things needed to change, as I could not see myself continuing the same trajectory.  I realized that I needed to learn more about physician burnout and strategies to help myself heal.

Burnout is extremely common amongst physicians and has been linked to lower quality of care, medical errors, disruptive physician behavior, higher turnover in physicians, and suicide.  It has been estimated that one in three physicians is experiencing burnout at any given point in time.

I am feeling better now and I am grateful for the support that I received.  I feel that a greater understanding of the stressors and causes of burnout, as well as creating a support network, has helped tremendously.  I learned that there are resources for physicians experiencing symptoms of burnout and there are many colleagues who are willing to support.  I would encourage anyone experiencing symptoms of burnout to reach out and seek help.

In the literature, there is also a great emphasis placed towards institutional and system changes that are needed to help with physician burnout.  I hope that with greater engagement and recognition of this problem, we can create better strategies at a systemic or institutional level to help physicians in the future. 


Resources that have helped me:
1. Burnout and Satisfaction with work-life balance among US physicians relative to the general US population.  Arch Intern Med.  2012 Oct 8; 172 (18) 1377-85.
2. Enhancing Meaning in Work:  A prescription for preventing physician burnout and promoting patient-centered care.” JAMA 2009; 302 (12):1338-1340
3. The Impact of COVID19 on Physician Burnout Globally:  A Review.  Healthcare 2020, 8(4) 121;
4. Physician Burnout during the COVID-19 pandemic.  BCMJ 2023, 65(2) 53-57.