Apr 2000 Table of Contents

Balancing Act

Preventing Burnout

The personality traits that make you a good doctor may also make you a target for burnout.

Fam Pract Manag. 2000 Apr;7(4):70.

When I was a kid, my brothers and I would play a game of catch we called “burnout.” We'd begin by standing close together, tossing a baseball between us. With each successive toss, we'd throw harder and move further apart. The object of the game was to throw the ball so hard that the opponent couldn't bear the pain of catching it and would call it quits. Today I see some of my colleagues engaging in a form of this childhood game. They throw themselves harder and harder into their profession, ignoring their health and distancing themselves from their loved ones, until the pain becomes so unbearable that they consider quitting medicine or, even worse, life.

The cause

Consider these statistics: Physician insurers have seen disability claims from doctors climb by more than 60 percent since 1990;1 85 percent of physicians say their family life often or sometimes suffers from the emotional demands of their profession and 30 percent say they would change their profession today if they could.2

What causes burnout? Wayne M. Sotile, PhD, a psychologist who has treated more than 700 physicians in the past 20 years, has found that physicians who burn out don't necessarily work longer hours or have more managed-care headaches, but they do have more conflict in their relationships, both personally and professionally. This conflict is often rooted in the very personality traits that define us as physicians and usually work in our favor, such as our exacting nature, our work ethic and our strong sense of responsibility. But in their darker form, these traits, combined with our penchant for independence, create the perfect medium for burnout to flourish.

Relief and renewal

As family physicians, we pride ourselves on practicing preventive medicine. We can help ourselves and our colleagues avoid burnout by recognizing the preventive measures that are available to us. Avoiding burnout is analogous to riding a bicycle. Both take balance and require that you shift gears to negotiate the constantly changing terrain. Consider the following three ways to downshift from the pressure of being a family physician:

Education. Find an area of medicine to explore in more depth, or develop an interest in something outside of medicine. I have been challenged and renewed by becoming certified in addiction medicine, medical management and hospice care. Medicine aside, I also belong to a book club and have pursued a career in professional speaking. Taking classes in computers, photography or martial arts may provide you with the release you need to survive the rigors of practicing medicine. And who knows? You may even discover a second career.

Exercise. You've heard it before: Moderate activity creates an increased sense of well-being. My octogenarian patient once put it best: “Doc,” he said, “I walk three miles a day. The first two are for my heart, and the third is my mile for thinking.” The key, as we all tell our patients, is to find an activity you enjoy and then make it a priority. You may say you don't have time to exercise, but you do. One of my very busy colleagues schedules her exercise time in her appointment book. I ride my bicycle four days a week, often with a group of friends. Other times I ride alone and use that time for solitude and reflection.

Networking. As physicians, our autonomous nature often compels us to try to work out our problems on our own even though sharing with others can ease our stress. According to Diane Kale, a practice management consultant, synergy and teamwork don't come naturally to physicians; however, if we embrace them, we may find an effective antidote for the stress we feel.

Relationships with peers and colleagues are important, but I also strongly recommend developing a network of friends outside of medicine. My circle of friends includes teachers, a poet, coaches, furniture salesmen, lawyers, pilots and artists. My friendships with them have given me valuable new perspectives.

Life isn't going to stop throwing fastballs, so don't kid yourself. We all have the potential to be drawn into the downward spiral of stress. Whether we succumb to it is our choice. We can either keep trying to catch those fastballs despite the pain, or we can find ways to pace ourselves so that we can stay in the game for the full nine innings.

Dr. Davis is a family physician practicing in Conroe, Texas.

1. Henry S. Stressed out. Hippocrates. September 1998:47–52.

2. Can you care too much? Hippocrates. April 1994:32–33.

Editor's note: For more information on burnout, see “Overcoming Compassion Fatigue.”

 

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