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10 replaceable thoughts (and 15 books) to help you survive burnout

Dawn Sears, MD
Physician
May 20, 2021
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Physicians are leaving the broken medical system at unprecedented rates. We continue through a war with an uncertain liberation day, and we are exhausted. Meanwhile, the only battlefront in which we have control is that of our mind. We have not been taught how to tame this beast. If we hope to thrive in medicine, we need to “capture our thoughts” and redirect how these result in feelings, actions, and outcomes.

Here are 10 common incorrect thoughts you might take the time and energy to explore:

1. “I have to do it all.”  When you think and believe this, you create a self-fulfilling prophecy. Consider replacing this with “I am blessed to have resources and helpers” as well as “good enough is good enough.” Review Carol Dweck’s Mindset. Similar results can be found in as little as one hour of working with a life coach.

2. “I hate my job.” Really? Do you hate preventing cancer, relieving suffering, or filling a deep need? Review Simon Sinek’s Start with Why. Pull out Rachel Naomi Remen, MD’s Kitchen Table Wisdom. Get The One Thing (by Gary Keller) you hate done first thing in the morning, so it no longer haunts you. Put a “do not disturb” note on your door or not allow Netflix or Facebook until you get that “one thing” completed. Chose joy — not dread.

3. “I feel so alone.” Loneliness was already a major health crisis. Then the government and CDC literally mandated we go into deeper isolation. The reframe can be “Who can I meet today?” When I adopted this survival technique, the result was an amazing collage of colleagues by my side. The courage to build these relationships is born of Self-Compassion (Kristin Neff, PhD’s book of the same title). If you are too tired to reach out, that’s OK. Acknowledge if someone else was brave enough to reach out to you and consider connecting.

4. “Everyone takes advantage of me.” Is it true? Is it absolutely true? What if the opposite was just as true? (Thank you, Katie Byron and The Work) I knowingly recall the meme of the angry Italian mother in the kitchen — “No one ever helps me!” —son offers to help, she declines and grumbles, “No one ever helps me!”

Today, email three people who helped you during the pandemic (molecular biology, supply chain, nursing, family member, etc.). Send a text to three people who helped you last week. Imagine your source of support receiving a hand-addressed note in their mailbox of you expressing your appreciation for them.

Brene Brown believes gratitude is the secret to joy (The Gifts of Imperfection is a great start).

5. “I feel unappreciated.” Of course, you do — as my life coach says: “It’s not your job’s job to make you happy. Your job’s job is to give you work and a paycheck.”

After a difficult task is complete, reward yourself with a chocolate kiss. After a considerable victory, plan a vacation. In the meantime, download Cloud and Townsend’s Boundaries and re-listen to it today!

6. “I don’t have enough time in the day.” Download James Clear’s Atomic Habits. This will change your life in simple ways by gaining 1 percent regularly — change cue, craving, response, and reward. With this model, you can eliminate bad habits (remove the cue, make it unattractive, make it difficult and unsatisfying) or add a new habit (make it obvious, attractive, easy, and satisfying) without guilt, mental effort, or frustration. These techniques can be easily shared with patients and family.

7. “No one is helping me.” This is a constant complaint of women physicians. We (socialization) are part of the problem. Babcock and Laschever’s Women Don’t Ask is painfully true. The reframe can be “I have not communicated my needs well.” I challenge you to ask for four things today: a glass of water from your partner, a friend to pick something up from the store, ask the child to bring dirty clothes to the laundry room, ask your boss to take a “walk and talk” with you. Expect only to receive 50 percent of your asks. Tomorrow you will ask again.

8. “I am too exhausted to think.” Absolutely truth! Take Restquiz.com to see which of the seven types of rest you are not getting: physical, mental, spiritual, emotional, sensory, social, and creative. Download Saundra Dalton-Smith, MD’s hypnotic reading of Sacred Rest.

Then, consider utilizing Headspace to learn to meditate, take “time outs” in your closet, embrace the quiet and watch the productive thoughts start to form (or give yourself permission to simply “be”).

9. “My brain is overwhelmed.” Yes, and you can use Norman Doidge, MD’s The Brain That Changes Itself to rewire the circuits to non-overwhelmed. You start by bringing your brain back into your body. This can be done by three cleansing breaths prior to a meeting, “massaging” your hands while pre-washing prior to stressful patient encounters, learning “tapping,” blowing bubbles, and countless other strategies to remind us that we are not robots.

10. “I have no control.” False. You always have a choice. Edith Eger and Viktor Frankl share these profound truths through their experiences at Auschwitz in Man’s Search for Meaning, The Choice and The Gift. If Edith Eger can be found lying in the yard, knowing that cannibalism is occurring, yet think “I can eat this blade of grass or that blade of grass,” then we have to realize that we, free and not starving, are not trapped, and we always have a choice.

If you don’t ask for something you want, then you have already accepted the answer of no. Go ahead and ask for what you want and need. You may not get it this time but ask again in the future.

We will change health care eventually. In the meantime, you can change your thoughts today. Reach out if I can help. Reach out to many resources on the internet, Facebook, your community. You are not alone.

Dawn Sears is a board-certified gastroenterologist and hepatologist, a clinical professor at UT Southwestern, and the founder of GutGirlMD Consulting. She currently serves in the gastroenterology division at the North Texas Veterans Administration, where she works as an instructor, gastroenterologist, and coach.

Much of her career and research has focused on the well-being of her colleagues, with a stated goal of stopping the loss of women physicians from health care. She spearheaded the Women Leaders in Medicine program, serving more than 300 women physicians and moving the needle on engagement, retention, and burnout, and she hosts the ACE and Emerge women physician empowerment conferences. As an ICF Certified Executive Coach, she works regularly with both private and institutionally based physicians. She has served as chief of well-being, program director, and chief of gastroenterology at multiple institutions, and has sat on boards of directors. Her work has been recognized with grants and awards from the American Medical Association, the American Medical Women’s Association, the Texas Medical Association, and the Physicians Foundation.

She has authored numerous peer-reviewed publications spanning physician burnout, women in medicine, hepatitis screening, and gastrointestinal disease, with work appearing in PLOS One, Clinical Gastroenterology and Hepatology, Gastroenterology, and The Lancet Gastroenterology and Hepatology. She shares updates on LinkedIn, Facebook, X, and YouTube.

Image credit: Shutterstock.com

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