When I experienced burnout as a young primary care physician, I thought it was my fault. Actually, I didn’t know it was burnout; I had never heard the word. But I believed whatever was causing the deep exhaustion, lack of empathy, and feelings of uselessness were surely due to a flaw or weakness in me.

Eventually, I stumbled across the definition of professional burnout. I was so curious to understand what had happened to me that I co-authored a book on the topic. In our 15 months of research, we heard over and over again that physician burnout is driven by system issues: problems like lack of resources, understaffing, inefficient work processes, and the burden associated with documentation in the electronic health record.

I was fully invested in believing that health care organizations and the larger U.S. health care system were solely responsible. What a relief to learn it wasn’t me.

The systemic causes of burnout

I started advocating for system change through writing and talks. Turns out, the problems are much more complicated and interwoven than you would think. And change at this level takes time and is really hard.

Then, I learned of a successful physician burnout prevention program that acknowledged the system issues that doctors face and guided physicians to take the steps to improve their own well-being. When a critical mass had completed the program, it began to improve the whole health system.

Today, I believe that taming the physician burnout epidemic calls for a “both-and” solution.

The power of micro changes

We absolutely need to advocate for system change at the national, state, and organizational levels. At the same time, my clients have proven to me time and again the immense power of micro changes. By making small, strategic changes one at a time, they recover from burnout, rekindle passion for their work, and build sustainable careers, while having a life outside of medicine.

They have the bandwidth to advocate effectively for system change, take on leadership roles with decision-making power, and model for others what a thriving professional life looks like.

Moving beyond fault

Whose fault is physician burnout?

Perhaps finding fault is not so important. What is important is having the courage to do what you can where you can to improve your work experience and your own well-being.

Diane W. Shannon is an internal medicine physician and physician coach.