After being a coach for a couple of years now, there is an immediate danger I see right now. Many of you are doing too much. Unsustainable, dangerous amounts of work. Dangerous to yourself and dangerous to others, which makes it dangerous for you, too. I’m not trying to be overdramatic, but I am shocked by how much overworking we are accepting. Everyone’s definition of “overwork” will vary. And the hustle culture and “just suck it up” mentality have been ingrained into especially surgeons for generations. But that doesn’t mean it is OK, and it doesn’t mean we have to continue. And in fact, we cannot. Why do we do it? There are many reasons. We think we must. Not for the money, but because of short staffing, higher acuity of patients, and higher volumes of patients prevalent, especially since COVID. We are not usually in charge of resources or getting people on the job, and there is the underlying idea that it will be fine because we will just handle it. And we do, from fear of what will happen if we don’t. Our patients won’t get treatment; we feel responsible for what happens to them. There may not be someone else available or willing to accept the signout in many short-staffed and rural locations. Often, we are unwilling to ask for fear of looking like we are lazy. But what happens when we overwork? Many are already a little crispy around the edges (I know I was a couple of weeks ago). Some are more than crispy — some of you are charred and parts are flaking away to where you wonder if anything will be left. It’s not OK. It’s not reasonable. Something must be done. We are in an epidemic of gaslighting in medicine. The best definition I heard of gaslighting is transferring your authority on yourself from you to someone else. We give up our authority on ourselves to everyone else but ourselves. We leave our feelings of work ethic to our current culture: we are lazy if we don’t step in line and do everything asked of us. We are told we aren’t worth our salaries as physicians are replaced with less expensive nurse practitioners and physician assistants. We are told our education is not important as the public ignores our expertise, and the judicial and legislative system tells us they know better for our patients. And it is somehow our fault, or at least we are left to deal with it. Show up and work hard to pay outrageous student loans gathered in pursuit of the cause. I don’t know the right answer for all of this. But I do know where we need to start. We are the authority on ourselves. And when we own the authority, then we insist on change. We know it is absolutely necessary. We are ultimately responsible for our happiness, our feelings of support, and when too much is too much. And the problem with burnout is that we lost that authority. Then we make mistakes and further erode our belief in ourselves. We dig a big, bottomless hole, and our actions only involve digging in the hole, which just drags us deeper. How do you find that authority when it seems lost? There is a coaching revolution in medicine, and it’s catching on because it works. The best coaches will not gaslight you and tell you what to do. The goal is to give you back your authority by letting you know you had it all along and finding the limiting thoughts that are holding you back. Coaches show you how to find your authority and use it to learn what you need and help you strategize on how to get it. But one thing that you can do right now is to start building in growth days. This might be one of the most important articles I have written. I share this article whenever and wherever I can. And encourage my colleagues and coworkers to take them. Let’s spread that idea and give everyone permission to do it. Take time, just for yourself. First to recover, and then to thrive. It’s time to stop overworking. Source
