Every day, I see and hear physicians sharing and complaining about how burned out they are. However, I am struck by the fact that while we coach our patients to get help when they are suffering, sick, depressed or in a state of hopelessness, we refuse to follow our own advice. Furthermore as physicians, when presented with potential avenues to alleviate our pain and suffering, we find reasons to be cynical and skeptical rather than looking at it as a valid possibility.
What’s more disappointing to me is to see influential physician voices highlight the suffering of doctors while simultaneously shooting down the possibilities of burnout recovery and prevention? How does keeping physicians in a victim role empower them? It doesn’t’! And If our community is so burned out — if 50 percent of doctors are really experiencing burnout — then why don’t we take advantage of the help when it’s offered? I decided to take a very informal poll of my peers in various groups and communities. Here are some of the responses I received:
1. They are afraid of consequences of reaching out. Not only can there be stigma in the workplace for admitting that we are feeling burned out (more on that later). But if you acquire a mental health diagnosis, it can have an impact the process of licensing (or renewal) because as we all know, mental health diagnoses in physicians lead to increased scrutiny by the state licensing boards.
2. They don’t know who to ask. Since there are no “research-proven” programs for physician burnout, doctors are often confused about where they need to go even when they would like to reach out for help. While there are many pilots being explored and various options outside of academia (peer coaching and physician coaching programs for example), physicians often look for hard evidence of efficacy before trying anything new. Unfortunately, hard evidence often takes years (sometimes decades) and is frequently biased.
3. They are nervous about confidentiality. For the institutions that offer options, physicians often feel conflicted about taking advantage of internal resources for two main reasons: The reason mentioned above (stigma) and second, confidentiality. Who’s to say, in their eyes, that their information won’t be shared with superiors who will later use that against them? If physicians don’t feel safe, they won’t reach out.
4. They don’t see the value in “non-medical” approaches. To our earlier point, physicians often go for the solutions that are proven with mounds of research studies. Since physician burnout prevention and recovery is such a young conversational issue, there is little research. Therefore things, like life coaching, seem underwhelming and to some even feel like “quackery” despite its clear effectiveness in other industries and worldwide.
5. They think they should be able to handle it on their own. So many physicians that I speak to on a regular basis considering my services as a coach often either say this or respond affirmatively when I articulate it: “I am a physician, I should be able to handle this on my own … it’s what I do for a living. Maybe there is something wrong with me.” The shame and guilt associated with feeling like you should be able to fix yourself because it’s your job to fix everyone else, can make a doctor feel crazy and deepen the downward spiral. The missing link that physicians often miss is that everyone had blind spots, and by the mere definition of it, we cannot see our own. Putting down our egos and realizing this could save countless lives (patients and our own).
6. They downplay their suffering. This is the “I see much worse on a daily basis, so I have no reason to complain” syndrome. Once again, there’s a guilt associated with living a seemingly “good life” yet feeling dead on the inside especially when you see so much illness, suffering, death and dying day in and day out. Downplaying our suffering does physicians such a disservice and contributes further to the downward spiral because we are not acknowledging our true feelings about our current circumstances.
7. They don’t want to look weak. This is part of our conditioning. In medical school, we are overtly and subliminally given the message that those who ask for help are weak. Over the years, we take this on in a deep unconscious level. Beginning to recognize this conditioning is the access to undoing it. It takes courage to admit when you need professional support. Ultimately, it not only benefits you, but it also benefits your patients, staff, colleagues, your spouse, and your children. When you take a courageous step such as reaching out for professional support, you model for others that it’s OK.
8. They just don’t think there is any “program” that will work. Embedded in our conditioning is skepticism. Healthy skepticism is necessary, however, at its extreme, it becomes resignation and cynicism. Cynicism is the killer of possibility. If there are going to be any solutions to this growing perplexity of burnout, we need to balance our skepticism with openness to new possibilities. As such, we may find some alignment in creating strategies to ultimately win the battle of burnout that is taking many of our physicians out.
Given these responses, it’s no wonder that physicians experiencing burnout don’t reach out more often for any support. However, if we never take the risk, we will never reap the rewards. There is no real solution because it’s an ongoing perplexity, but continuing to raise awareness of our own thought processes and conditioning will allow for more effective strategies and programs to be created both institutionally and independently.
Maiysha Clairborne is an integrative medicine physician and can be reached at The Stress Free Mom MD. She is the author of The Wellness Blueprint: The Complete Mind/Body Approach to Reclaiming Your Health & Wellness.
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