Physician Burnout: Symptoms, Causes, & Prevention

What Is Physician Burnout?

Burnout is a state of chronic stress and exhaustion. Physicians can experience burnout due to the demanding nature of their job. When stress becomes chronic and keeps piling on without a chance to recharge, reset, and return to baseline, burnout is the result. This accumulation of toxic stress and burnout can result in mental exhaustion, feelings of ineffectiveness, loss of purpose, and increased negativity.

The COVID-19 pandemic has put an enormous strain on healthcare providers around the world. Physician burnout was already a concern before the pandemic. Now, it is even more of a concern. It is important for physicians to notice the warning signs of chronic stress and make changes before it turns into full-blown burnout.¹

Signs of Physician Burnout

The early warning signs of burnout include increased cynicism, negativity, and detachment. Physicians may start to have trouble sleeping, become overwhelmed with stress, or start dreading or missing work. They may notice that they are not only physically exhausted, but also mentally fatigued and emotionally drained.

Signs of physician burnout can include:

• Physical and emotional exhaustion
• Mental fatigue, distraction, fogginess
• Sleep issues
• Fatigue
• Self-doubt
• Loss of inspiration
• Loss of meaning and purpose
• Mental exhaustion
• Feeling emotionally drained
• Appetite and weight issues
• Feeling ineffective as a physician
• Cynicism about their job
• Depression
• Depersonalization, a feeling of being detached from one’s own body or mind¹
• Anxiety
• Compassion fatigue

Causes of Physician Burnout

There are many factors that contribute to physician burnout, including personality traits, pre-existing mental health conditions, increased workload and responsibilities, and systemic stressors.

Potential causes of physician burnout include:

• Driven personality: Often, people who are attracted to the competitive and rigorous field of medicine are more likely to be driven, competitive, or perfectionistic. These personality traits can put someone at a higher risk for burnout.²
• Healthcare worker shortages: Since the beginning of the COVID-19 pandemic, worker shortages are prevalent in most fields and medicine is no exception. This can put physicians at risk for higher patient loads, additional clerical or administrative duty, and long hours.
• Too many patients: COVID surges presented physicians with ever-increasing patient loads, stressors, and limited resources.
• A challenging work environment: In addition to patient care, physicians are also faced with interpersonal challenges at work, ineffective systems, and bureaucracy. These can lead to feelings of ineffectiveness, self-doubt, and overwhelm.
• Financial stress: Physicians are often faced with financial stress from enormous student loans and may find themselves in low-paying jobs, especially during residency and at the beginning of their careers. This can contribute to the chronic stress that leads to burnout.
• Dealing with patients: Physicians work with patients who are often scared, anxious, and overwhelmed. They may come off as demanding or combative. Physicians have to navigate this complex emotional landscape while providing quality healthcare.
• Lack of respect for physicians: Physicians may find themselves feeling disrespected by their healthcare team, staff, and patients. This can increase the feelings of ineffectiveness that lead to burnout.
• Feeling like their efforts aren’t appreciated: Physicians can also feel taken for granted and feel like their hard work, effort, and contributions are not appreciated. Feeling undervalued and unappreciated in the workplace is a significant cause of burnout.
• Inefficient systems: Inefficient workplace systems, bureaucratic and administrative headaches, and supply-chain problems can create additional workload and stress for physicians.²
• Clerical burdens: In addition to patient care, physicians are also responsible for administrative tasks like charting, coordinating with other providers, replying to phone and email messages, and researching and planning treatment. All of these tasks can add up to very long hours, working during time off, and feeling overburdened and overscheduled.³
• Physician burnout can be overlooked due to a belief that physicians are impervious to it: Physicians sometimes feel that they are seen as superhuman. Others may forget that they are affected by chronic stress and burnout too. For these reasons, physicians and their colleagues may miss the early warning signs of burnout.⁴
• Pre-existing anxiety or depression: Studies show that people with pre-existing mental health conditions like anxiety or depression are at higher risk for burnout.⁵

Physician Burnout Prevention & Management

Prevention of physician burnout includes practicing self-care, taking time off, getting support, and dealing with the feelings of overwhelm that can come with chronic stress. In addition to recovering from the physical effects of chronic stress and burnout, it is also important to prevent emotional burnout and manage stress.

Here are nine ways to prevent physician burnout:

1. Physical Self-Care

The mind and body are inextricably linked. In order to prevent burnout, it is important for physicians to take good care of their physical health. Things like drinking enough water, stepping outside for fresh air, spending time in nature, or taking a minute to stretch can do wonders.

2. Emotional Self-Care

Being a physician can be a tough job emotionally. Emotional self-care refers to taking care of one’s inner world: thoughts, feelings, and emotions. Some ways to do this are by listening to upbeat music or watching an uplifting show, journaling, or spending time with a friend.

3. Make the Most of Your Time Off

In order to stay sharp and avoid burnout, physicians need to be able to really take time off. This means no checking email or voicemail. This can be tough with on-call duties and high-need patients. However, it’s important for physicians to set boundaries around their time and energy so they can truly unplug when possible.

4. Talk to Your Boss About Possible Schedule or Workload Adjustments

Sometimes, burnout is the result of systems, processes, and workplace culture that are out of your control. Explore whether any adjustments can be made to lighten or change the workload or responsibilities.

5. Talk it Out With a Friend

It can be helpful to process job stressors with a trusted friend. Sometimes, just talking about it out loud can uncover solutions or coping skills. It’s important to remember that the purpose of this is not just to complain, but to talk through thoughts and feelings in a way that brings clarity.

6. Get Enough Sleep

Studies show that insufficient sleep contributes to burnout among physicians. Allowing time to relax and unwind before bed, practicing good sleep hygiene, and avoiding caffeine can help. If a sleep disorder is present, getting proper treatment is shown to reduce burnout.⁶

7. Exercise

The link between exercise and good mental health is well established. Exercise can reduce stress, release endorphins, and even increase serotonin and dopamine. Exercise is also shown to help reduce symptoms of depression.

8. Try Mindfulness

Mindfulness is more than just meditation; it includes being present throughout the whole day. Mindfulness can decrease stress and improve mood. Try taking a walk and tuning in to all of the senses: sight, sound, smell, taste, and touch.

9. Learn New Skills

When burnout starts creeping in, it may be time to seek out opportunities for growth, knowledge, and new skills at work. Learning new skills or making changes can increase competence, confidence, and excitement for the work.

Physician Burnout Treatment

Physician burnout treatment may be required. Signs that burnout may be leading to a more serious mental health condition like depression or anxiety include difficulty sleeping or sleeping too much, changes to appetite or weight, anxiety, panic attacks, and thoughts of death or suicide. If any of these symptoms arise, a mental health professional can help.⁷

Physicians who work with trauma can also develop secondary or vicarious trauma. Symptoms include being easily startled, intrusive thoughts, memories or dreams about traumatic events, and avoidance of things that trigger those memories.

Helpful types of physician burnout treatment and therapy include cognitive behavioral therapy (CBT), internal family systems, and eye movement desensitization and reprocessing (EMDR). Find compassionate, skilled therapists through an online therapist directory. It’s important to find the right therapist who is a good fit for your needs so that you can begin the process of healing.

Final Thoughts

Physician burnout is difficult to overcome but there are ways to move forward, heal, and rediscover passion for the work. Physicians give so much to others; they deserve to feel healthy, be energized, and live without burnout.