Physician burnout and the question science cannot answer

I left Nepal to train in a country I barely knew, carrying the kind of ambition that doesn’t leave room for doubt. Internal medicine residency, then a rheumatology fellowship at the National Institutes of Health (NIH). I pictured a career built in clinical research, publishing, discovering. That was the plan, and for years I didn’t question it.

The turning point

Then our daughter was born, and everything about that plan stopped making sense. Her medical needs were complex from the start, the kind that reorganize a family overnight. I remember the specific disorientation of that period, not just the exhaustion, but the deeper uncertainty of not knowing which direction was even right anymore. The research path I had built my identity around no longer fit the life in front of me, and I had no map for what came next.

Building something new

What came next was a shift I didn’t plan and couldn’t have designed on purpose. I moved from an employed physician position toward building my own practice, Empowered Arthritis and Rheumatology Center. I didn’t build it because I had a five-year plan. I built it for two reasons. The employed position wasn’t giving me what I needed either, no real growth, no sense that I was creating anything beyond seeing the next patient on the schedule. And it was the only structure flexible enough to hold everything that mattered to me at once, our daughter’s needs, our son growing up watching how his parents handled hard things, my wife’s own work building something to help other mothers through complicated pregnancies and postpartum periods, and a clinical practice I could actually shape instead of just work inside of.

Where faith came from

I did not walk through any of that certain I was making the right call. What carried me through it was faith. Not a tidy, confident faith. A faith that showed up mostly as the willingness to keep going when I could not see the outcome, and to trust that the effort itself had meaning even when the results were nowhere in sight yet.

That’s not where I started. My father was deeply religious, and for a long stretch of my early life I rebelled against that so completely that I called myself an atheist, mostly to prove I could think for myself. Life has a way of correcting overcorrections. Somewhere in the middle of raising a medically complex child, building a practice from nothing, and trying to be present for a marriage and two kids at the same time, I became a genuine believer again, not out of inherited habit this time, but because I needed something bigger than my own control to hold onto, and it held.

There was another piece to it too. Our daughter was born into a family of two doctors, and even with all our training and access to good specialists, her medical complexity was still beyond anything medicine alone could fully explain or fix. Around that time I came across Dr. Francis Collins, who was leading the NIH while I trained there. I started reading his work and listening to him speak, and one question kept surfacing for me: Does science explain everything that happens in our lives? The honest answer, even from inside a career built on science, was no. That’s where faith found its opening. Science explains how things work. Faith explains why they work, and why they happen to us at all.

Faith as a tool, not a doctrine

I’m telling you this because I don’t think my experience is unusual among physicians, even if we rarely say it out loud. We are trained to trust data, protocols, and our own competence. We are not trained to talk about faith, and many of us quietly worry it sounds unscientific to bring it up in a clinical or professional context. But the research doesn’t support that worry. A review in Frontiers in Psychology found that religiosity, spirituality, and a sense of meaning are consistently associated with lower burnout and greater well-being among health care workers. A scoping review of medical students found that higher spirituality correlated with greater resilience, empathy, and life satisfaction, not less rigor or less capability.

I want to be precise about what I mean by faith, because I’m not asking every reader to adopt my specific beliefs. I mean faith in the broader sense: trust that your effort matters even when you cannot control or see the outcome. That definition holds whether you pray the way I do, hold a different faith entirely, or simply trust in something beyond yourself, the resilience of the human body, the slow arc of medicine across generations, the idea that meaning exists in the work even on the days the data doesn’t cooperate.

An idea older than medicine

There’s a reason this idea shows up in very different traditions saying nearly the same thing. The Bhagavad Gita, one of the most revered Hindu scriptures, teaches “nishkama karma” (selfless action, without attachment to the result). John D. Rockefeller, one of the most successful businessmen in history, captured a strikingly similar idea near the end of his life, in a poem he wrote about his own philosophy of work:

“I was early taught to work as well as play,
My life has been one long, happy holiday;
Full of work and full of play-
I dropped the worry on the way-
And God was good to me every day.”

Full engagement in the work, deliberately released from anxiety about the outcome, with the good that came of it credited to something larger than himself.

An ancient text and an American industrialist landing on the same mechanism, centuries apart, is not a coincidence. It’s a pattern in how sustainable effort actually works.

What this means for you

For those of us in medicine, this has a specific shape. Burnout deepens when the emotional weight of caring outpaces any sense that the caring is going somewhere, when we start believing every outcome is a referendum on us alone. Faith, in the functional sense I’m describing, doesn’t ask you to care less. It asks you to stop carrying what was never yours to carry by yourself.

I still don’t know, most days, whether every decision I’ve made since our daughter’s birth was the right one. What I know is that the practice I built instead of the research career I planned has given me something I’m not sure the original path would have: a life where the work, the family, and the faith all point the same direction. That’s not a research finding. It’s just true, and it’s the reason I think faith deserves a real place in how we talk about sustaining ourselves in this profession, not as a footnote, but as a legitimate tool, available to every clinician regardless of what they believe.

So here is my question back to you. What does faith mean to you, in your own life, in your own words? You don’t need my definition or anyone else’s. Take a moment this week, maybe on your drive home or in the quiet minute before you walk into the next room, and actually look for the deeper meaning in what you do every day. Not the schedule, not the metrics, the reason underneath them. That search itself is a form of faith, and in my experience, it’s one of the most practical tools we have against burnout, and maybe even against it taking hold in the first place.

Ananta Subedi is a rheumatologist.