Medical school and residency taught you how to grind it out. While the grittiness it takes to make it through both certainly serves you well as a physician — especially during a pandemic — it also can be a double-edged sword. Ignore physiological and psychological distress for too long, and you may end up with a bad case of burnout that could derail or end your career (or worse). Stress is inseparable from the practice of medicine. One of the keys to a long, happy career is learning how to manage that stress before it metastasizes into burnout. Here are some effective burnout-management strategies you may want to implement. Get a coach Working with a career or professional coach is a sound way to manage burnout, burnout onset, and burnout symptoms, according to a 2019 review published in Cureus. Authors argued that physician employers should provide coaches, especially to residents; however, you can work independently with a coach if you choose. Coaches teach physicians to tap into their internal sense of control, the researchers wrote, helping doctors realize that their decisions and actions have more of an effect on their lives than external factors. The researchers note that other studies have shown that having an internal locus of control has an inverse correlation with burnout. A good physician coach will teach you this, as well as meta-cognitive techniques. Meta-cognition is essentially thinking about the way you think. While this may seem convoluted, developing meta-cognitive skills will enhance your rational abilities and keep you more emotionally balanced. Mindful moments Mindfulness is a buzzword. What does it actually mean? According to the UCSD Center for Mindfulness, mindfulness is any such activity that “seek(s) to develop and nourish present moment awareness. (It) encourage(s) paying attention in a way so as to be more aware in the present moment of all that is here, and of the constantly changing nature of what is here.” Mindfulness practices fall into two categories, according to the Mayo Clinic: structured and unstructured. We tend to recommend the structured practices because they’re easier to do consistently. For example, how do you practice “accepting yourself?” It’s much easier to schedule and do a traditional sitting meditation, body-scan meditation, or walking meditation. Click here for the how-tos. We know mindfulness limits physician burnout. According to the Cureus review, an 8-week mindfulness meditation program reduced burnout and boosted empathy skills among physicians. Start by scheduling a short daily session (about 5-10 minutes), and build up to longer sessions as you feel comfortable. Use your vacation time You have paid time off and you need to use it. According to a 2018 Clinical Gastroenterology and Hepatology review, studies have shown that productivity increases when employees return from vacation. To enhance the effect, the authors recommend disconnecting from work completely (if possible). That means staying off of email (unless it’s essential), not taking patient calls, avoiding glances at your schedule, and staying out of patient records. Delegate, the authors say. Make sure someone you trust is covering for you and put up that out-of-office message. If you’re a new physician, or your contract soon will be up for negotiation, remember that paid time off is also a form of compensation. We tend to fixate on the dollar amount, but opting to take time over dollars may be a way to build more burnout mitigation into your life and lifestyle. A word of caution on the vacation front, however. Don’t expect it to be a silver bullet. According to a 2018 American Psychological Association (APA) survey, two in three adults said the post-vacation bliss wore off immediately or in a few days. The APA researchers noted that this may hinge on the employing organization’s culture. Work with a therapist The Cureus review recommends cognitive behavioral therapy (CBT) to combat burnout. The authors highlight previous research, which demonstrated that weekly CBT sessions reduced emotional exhaustion for physicians. This may be due to the fact that CBT trains people to examine thoughts, perceptions, and beliefs that arise automatically. Once a CBT user masters this skill, they begin to improve their ability to differentiate between interpretations, assumptions, and facts. Therapy is yet another area in which telehealth may benefit physicians. Many mental-health clinicians have embraced telehealth in the wake of COVID-19. While working with a counselor over live video feed isn’t the same as having a face-to-face conversation, it does lighten the time burden of therapy. Now, any room with a comfortable seat and an internet connection can become a space for mental development and healing. Take advantage of this opportunity. According to the Association of American Medical Colleges, about 60% of physicians have reported feelings of burnout during the pandemic. Despite this, only 13% of those surveyed said they’ve sought mental-health support. Source
