When people discuss physician burnout, they often reduce it to a workplace issue: long hours, endless charting, electronic health records that seem never to end, and patient loads that test the limits of human capacity. The solutions we’re offered sound deceptively simple: take a vacation, practice gratitude, do yoga, and meditate more. It’s as if wellness could be squeezed into the fifteen minutes we have left after charting at midnight. But after more than a decade in family medicine, I’ve learned that bubble baths, yoga mats, or weekend retreats don’t cure burnout.

Because burnout isn’t merely a work problem.

It’s a relationship problem.

And that’s the part no one told us.

I began exploring this truth years ago, but it wasn’t until I delivered my TEDx talk, Redefining Burnout: A Relationship Crisis, that I realized how deeply it resonated with me. Since then, I’ve received messages from physicians, teachers, entrepreneurs, and executives around the world saying, “You just described my life.” At conferences, attendees have stopped me in hallways with tears in their eyes, telling me that my Anatomy of Alignment framework finally made their burnout make sense. They had tried everything (new jobs, new schedules, and new systems) yet still felt depleted. What they were missing wasn’t another productivity hack.

It was a connection.

Burnout as a relationship crisis

So what does it mean to say burnout is a relationship crisis? Let’s begin with something simple yet profound: we live in a relationship with everything.

We relate to:

• Ourselves: Our inner dialogue, self-worth, identity, and purpose.
• Significant others: The people who love and support us, our emotional anchors.
• Work and society: The systems and structures that shape how we live, contribute, and belong.

When one or more of these relationships becomes misaligned, our stability falters. We lose our balance, emotionally, mentally, and even physically. That’s where my Three-Legged Stool Analogy comes in.

The anatomy of alignment: the three-legged stool

Imagine your well-being as a three-legged stool. Each leg represents a vital relationship.

• The relationship with self: This is the foundation, built on self-compassion, self-awareness, and a clear sense of identity. Without it, even outward success feels hollow. It’s the leg most often neglected in medicine, where our worth is tied to performance, not presence.
• The relationship with significant others: These are the people who see us beyond our professional titles, the ones who remind us that we are more than our lab coats. When these relationships suffer, we lose our emotional oxygen. Loneliness seeps in, even when surrounded by people.
• The relationship with work and society: This includes our profession, colleagues, institutions, and the cultural norms that shape our sense of duty. It’s the most visible leg, and the one most often blamed when the stool wobbles.

If one leg weakens, the stool becomes unstable. If two collapse, we fall.

Yet medicine’s typical response?

Polish the stool. Take a seminar. Get a new EMR. Attend a mindfulness workshop.

We don’t need polish. We need repair.

Why focusing solely on work fails us

Understand me: system-level reform is critical. However, when we focus solely on workplace solutions, we overlook the root cause.

Here’s the uncomfortable truth: You can work in a broken system and still maintain peace, for a time. And you can also work in a supportive system and still burn out if your internal relationships are fractured.

The problem isn’t always the charting or the call schedule.

Sometimes, the real problem is that we’ve forgotten who we are outside of work.

Relearning the relationship with self

Early in my career, I equated worth with productivity. The number of patients seen, the hours logged, the recognition earned; that was the currency of medical culture. Exhaustion was a badge of honor.

But eventually, I realized that the quiet voice whispering, “You’re running on empty,” wasn’t weakness; it was wisdom.

Reconnecting with myself meant learning to listen again, to my body’s fatigue, to my heart’s craving for connection, and to my mind’s longing for rest and creativity.

Self-relationship isn’t indulgence. It’s alignment.

It’s the ability to say, “I matter too,” without guilt or apology.

Rebuilding the relationship with others

Many physicians sacrifice personal relationships in the name of duty. We tell ourselves it’s temporary, just until residency ends, the promotion comes, or the schedule lightens. But one day, “temporary” becomes permanent.

When I began rebuilding my own relationships, I started small. Unhurried meals. Phone-free conversations. Letting people see the real me, not just the physician version.

Human connection is healing. The warmth of belonging, the safety of being seen, the courage to be vulnerable. These moments refill us in ways no conference or CME course ever could.

Reframing the relationship with work

Work is not the enemy, but our relationship with work can become toxic. Most of us entered medicine to heal, not to survive bureaucracy. Somewhere along the way, purpose was replaced by performance metrics. Reframing our relationship with work means rediscovering meaning amid chaos.

Ask yourself:

• What drew me here in the first place?
• What kind of physician, and human being, do I want to be?
• How can I practice in a way that honors my values?

I’ve met countless physicians who found peace not because they escaped medicine, but because they redefined their relationship with it.

The struts: what holds the legs together

Every stool needs struts, reinforcements that connect and stabilize its legs. In my Anatomy of Alignment, these struts are the invisible forces that sustain resilience:

• Vision: Knowing your “why.” Vision gives direction and purpose. It’s the reason you get up in the morning and push through discomfort. Without a clear “why,” even the most impressive accomplishments can feel hollow. Vision transforms effort into meaning, turning routine work into purposeful action.
• Faith: Trusting in something beyond yourself. Faith doesn’t have to be religious. It’s the belief that your struggles matter, that the pain will lead somewhere worthwhile. Faith gives you courage when logic fails, and reminds you that growth often hides within uncertainty. It’s what allows you to keep walking when the path disappears.
• Values: Your moral compass. Values anchor you when chaos hits. They remind you of who you are when life tests your integrity. Acting in alignment with your values brings peace, even in loss, because you know you’ve stayed true to yourself.

When these struts are strong, even a wobbly stool can bear great weight. When they weaken, collapse is inevitable.

What conferences, coaching, and conversations have shown me

Since my TEDx talk, I’ve shared this framework with physicians, leaders, and entrepreneurs across North America. I’ve seen tears, nods, and, most importantly, the spark of recognition.

At one event, a physician told me, “I thought I had a work problem. But after hearing you, I realized I had a relationship problem, with myself.”

That moment changed everything for her.

In my coaching practice, I’ve watched professionals rebuild confidence, joy, and creativity. Not because their workloads vanished, but because their alignment returned. They stopped outsourcing their self-worth to institutions and began living from the inside out.

Medicine’s culture problem

Let’s be honest: Medicine has a culture problem. It’s a culture steeped in perfectionism, martyrdom, and quiet suffering. We glorify endurance and pathologize rest. We call self-care “selfish” and label vulnerability as weakness.

The reality? Many of us were never taught how to maintain healthy relationships, with ourselves or others. We learned how to diagnose disease, not disconnection.

Until we redefine success as wholeness, burnout will remain endemic.

This is why redefining burnout as a relationship crisis isn’t a metaphor; it’s a survival strategy.

The cost of ignoring alignment

When alignment breaks down, the consequences ripple outward.

• Physicians often lose their marriages, meaning, and sometimes their lives.
• Patients lose trusted care.
• Communities lose healers.

But when we restore alignment, when we strengthen those legs and struts, we rediscover meaning. We practice medicine from a state of fullness, not depletion. And we become living proof that wellness and compassion can coexist.

What you can do right now

If you’re nodding along, here’s the good news: You don’t need to quit medicine to reclaim yourself. And you don’t have to wait for the system to fix itself.

You can start today:

• Conduct an alignment audit: Which leg of your stool is weakest? Which strut needs reinforcement?
• Set micro-boundaries: Protect small, sacred blocks of time that are yours alone.
• Practice radical honesty: Name your exhaustion. Admit your frustration. Truth-telling is the first act of healing.
• Seek support, not permission: Coaching, therapy, and peer circles aren’t luxuries; they’re lifelines.
• Reclaim joy: Schedule joy like a clinical procedure. Joy is medicine.

Victims or victors? The choice is ours

The health care system is flawed, but surrendering to hopelessness doesn’t heal us. We are not victims of medicine; we are stewards of its evolution. We can’t fix everything overnight, but we can start by repairing what’s within our control: our relationships, our alignment, and our humanity. When we strengthen those three legs and their struts, we don’t just survive medicine; we transform it.

A call to reimagine wellness

Wellness isn’t the absence of illness. It’s the presence of alignment.

Too many good physicians have burned out, not because they were weak, but because they were disconnected. It’s time we stop treating disconnection with downtime and start rebuilding the relationships that make us whole.

The path forward

Burnout may never disappear completely, but its grip loosens when we understand its anatomy.

We need:

• Medical systems that prioritize human connection.
• Leaders who value emotional intelligence as much as clinical excellence.
• Peers who remind us that vulnerability is strength.
• And most of all, we need each other, not as competitors, but as collaborators in healing.

As I often tell audiences: “You can’t pour from an empty cup, but you can refill it through connection.”

The world needs your mind, your compassion, your humanity.

But before you keep giving, pause and rebuild your relationship with yourself.

So, take a deep breath.

Check your stool.

And start realigning: one leg, one strut, and one relationship at a time.

Tomi Mitchell is a board-certified family physician and certified health and wellness coach with extensive experience in clinical practice and holistic well-being. She is also an acclaimed international keynote speaker and a passionate advocate for mental health and physician well-being. She leverages over a decade of private practice experience to drive meaningful change.

Dr. Mitchell is the founder of Holistic Wellness Strategies, where she empowers individuals through comprehensive, evidence-based approaches to well-being. Her career is dedicated to transforming lives by addressing personal challenges and enhancing relationships with practical, holistic strategies.

Her commitment to mental health and burnout prevention is evident through her role as the host of The Mental Health & Wellness Show podcast. Through her podcast, Dr. Mitchell explores topics related to mental fitness and stress reduction, helping audiences achieve sustainable productivity while avoiding burnout.

Dr. Mitchell is also an author. Her book, The Soul-Sucking, Energy-Draining Life of a Physician: How to Live a Life of Service Without Losing Yourself, addresses the unique challenges faced by health care professionals and provides actionable solutions for maintaining personal well-being in demanding careers.

Dr. Mitchell’s expertise and advocacy have been recognized in her role as an executive contributor to USA Today, Thrive Global magazine, KevinMD, OK! Magazine, and Brainz Magazine, as well as across various television and radio platforms, where she continues to champion holistic wellness and mental health on a global scale.

Connect with her on Facebook, Instagram, and LinkedIn, and book a discovery call to explore how she can support your wellness journey. For those interested in purchasing her book, please click here for the payment link. Check out her YouTube channel for more insights and valuable content on mental health and well-being.