Before the pandemic, we had an epidemic of physician burnout, with many physicians caught in a cycle of exhaustion, cynicism, and loss of purpose. All the change and uncertainty the virus has brought certainly doesn’t help! It’s now more imperative than ever that physicians build resilience to all the pressures and stress of our careers.

In the decade I’ve worked as a physician coach, I’ve seen seven habits, thought patterns, and practices that distinguish those who can thrive despite pressure, and those who cannot. These seven are the difference between a fulfilling and purposeful career and burnout.

1. Resilient physicians remember that life is short. Last I heard, death is inevitable. Illness too. Thanks to the pandemic, this is more in the forefront than ever before. But how often do we lose sight of these truths and delude ourselves that death and aging affect others but not us?

The costs of this delusion are twofold. Firstly, ignoring the impermanence of life means we can spend our days sleepwalking and biding time that won’t be there forever. We can spend hours on charts, and then come home and scroll on Facebook and LinkedIn, instead of taking in the goodness of those we love.

Secondly, thinking that we and our families won’t experience pain, sickness, and tragedy, leads to much suffering when difficulty inevitably arises. We can feel like life has been unfair to us – or that we deserve better.

Resilient clinicians recognize that the misfortunes of life happen to everyone – and they react with strength, compassion, and wisdom when they do.

2. Resilient physicians let go of perfectionism. If you’re a perfectionist, you definitely aren’t alone. It’s a trait that helped us get into and survive our training, but it’s also a trait that gets in our way as we progress in our lives and careers.

We can find ourselves overly focused on writing the perfect note, having the perfect home, and getting every one of actions perfect. This creates intense pressure for us and creates anxiety around everything we do- whether it’s charting, spending time with our kids, or starting a new hobby. Perfectionism is exhausting!

Resilient clinicians recognize that perfection is unattainable – and they realize that doing their best is the way to go.

3. Resilient clinicians lean into gratitude. We’re told that gratitude is good for us, but resilient physicians know this deep in their bones. They spend time appreciating what they have and try not to focus on what they don’t. They count their blessings, and they do so regularly.

The research-proven benefits of gratitude are legion– increasing empathy, decreasing depression, improving sleep, decreasing aches and pains. Gratitude enhances the strength of meaningful relationships and increases our sense of well-being.

The more we focus on the blessings that we have in our lives, the more happy and fulfilled we become. The more we focus on what we do not have, the more miserable, exhausted, and grumpy we become.

Leaning into gratitude is not about an artificial Pollyanna stance! It is about taking time to appreciate what’s going well. The fact that you are employed, that your health is good, that your loved ones don’t have COVID. Small or large, beginning grounded in gratitude builds our resilience to the stresses we face.

4. Resilient clinicians know which thoughts to believe. We all have filters that obscure how we view ourselves and our world. These filters lead to cognitive distortions – ways of seeing ourselves and the world around us that are inaccurate and untrue.

Resilient clinicians recognize which thought patterns are serving them and which aren’t. They understand that thoughts are simply thoughts, mental events generated by the mind. They are curious and discerning, and develop the habit of observing, rather than engaging with each and every thought.

Questioning our thoughts is at the heart of mindfulness.  With mindfulness, we heighten our awareness of what the mind is up to and see the narratives we’re caught in. Stepping out of mental stories is key to building our resilience.

5. Resilient clinicians move past the imposter syndrome. Many physicians suffer from imposter syndrome, that belief that what we know is minuscule and what our peers know is massive, and that it’s only a matter of time until we’re found out as a fraud. But we don’t stop there. No, our mind is often busy fueling a host of self-defeating messages.

Resilient clinicians are aware of this, and work to be more gentle with themselves. They are able to view their own accomplishments objectively, and they compare themselves to others less, knowing that they are on their own path.

6. Resilient clinicians let go of what they can’t control. With all the dysfunction in the American health care system, there is much that is beyond our control. The push to see more patients in less time, having to deal with difficult non-clinical administrators, insufficient PPE. Yet, how often do we find ourselves railing against some problem or other? Banging our fist, literally or figuratively, and wanting to scream, “How can this be?”

Resilient clinicians know that all that railing just dissipates their energy. They know that energy conservation is key to avoiding burnout. They ask themselves: Is this something I can change? If yes, they think about how best to intervene. If no, they remind themselves that the thing they always have control over is themselves.

7. Resilient clinicians have a growth mindset. In order to weather the difficulties in our work, we have to believe that we can shift our own behaviors, improve, and grow.

Think about your own thought processes as you read this piece. Are you open to trying new behaviors? Are there things that you can incrementally improve upon?

Resilient clinicians take a gradual approach and are gentle with themselves throughout the process. They know that self-kindness is more motivating that self-bullying. They know that resilience is built by being patient with themselves as they learn and grow.

Resilience is something that lies within each and every one of us, but we don’t always realize this. Pick one of these strategies and grow yours this week.

Gail Gazelle is an internal medicine physician and the author of Everyday Resilience: A Practical Guide to Build Inner Strength and Weather Life’s Challenges.

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