As a physician, you may ruminate over an interaction with a patient or worry about a complicated procedure that didn’t go as expected. You work through lunch, see patients after hours, handle numerous emergencies, and plow through endless paperwork and red tape. In short: factors related to practicing medicine can put enormous stress on physicians.
In the Medscape Physician Burnout & Depression Report 2023, 53% of physicians consider themselves burned out, an 11% rise since the pre-COVID-19 survey of 2018. Causes range from too much bureaucracy and time spent on electronic health records to feeling overworked and underappreciated to a lack of autonomy and too much governmental oversight.
“When stress becomes unhealthy, you might notice sleep problems, such as going many days with poor-quality sleep, or being up in bed worrying about what you have to do the next day,” says Jonathan DePierro, PhD, associate professor of clinical psychology at Mount Sinai and associate director of the Center for Stress, Resilience, and Personal Growth at Mount Sinai.
“Being particularly irritable or on edge is a sign that stress has sunk in its claws,” he says. You may feel tense a lot of the time and have trouble enjoying things in life.
“In the field of medicine, there is so much pressure to not only be a caretaker but to always be the expert, to always have all the answers,” says Laura Putnam, founder and CEO of Motion Infusion, a thought leadership company who provides workplace wellness support to organizations like Kaiser Permanente and the American Heart Association. She is the author of Workplace Wellness That Works. “There’s this enormous amount of pressure around demonstrating competency that’s competing against the need to be vulnerable.”
Isn’t Being a Physician Just a Stressful Job?
Yes and no. “Gallup research shows that the top five drivers of burnout in the workplace have nothing to do with the individual but have everything to do with the workplace itself: things like work overload, toxicity, and perceptions of unfairness,” Putnam says. “It’s important for physicians to be able to understand there are a lot of headwinds they’re up against that makes it really hard not to be burned out.”
In addition, research by the Agency for Healthcare and Research Quality has pointed to measures such as staff surveys, flexible schedules, a better work-home balance as well as help with EHR entry as steps practices can employ to help offset some of this stress. However, these are primarily organization-level changes that require a top-down approach.
In the Medscape report, 29% of physicians reduced their work hours to relieve stress, 25% used meditation, 22% changed their workflow or staffing, and 21% changed jobs altogether.
But the onus isn’t on physicians individually to self-care their way to a less stressful workday. In fact, that belief can further stress physicians, says Putnam.
Instead, you can adopt some small steps on the job as you see patients, manage admin work, and navigate interpersonal conflict to help mitigate the stress of practicing medicine and keep burnout at bay.
Talk About It
It’s time for physicians who are stressed to move toward a more supportive environment, says Daniel Selling, PsyD, psychologist and founder and CEO of Williamsburg Therapy Group.
“Talk about your stress,” he says. “Open up about it and normalize it and discuss the struggles that that 53% of the people around you are also experiencing.“
If you’re part of a large healthcare system, resources may be readily available to you. Mount Sinai’s Center for Stress, Resilience, and Personal Growth came about as an on-the-ground resource for the entire healthcare system.
“Our mission is explicitly to improve the resilience of our healthcare workers and address mental health concerns, like depression and anxiety,” says DePierro. “We do lots of workshops focused on the science and practice of resilience, we train teams and leaders together, and we also provide immediately accessible confidential behavioral healthcare.”
Manage Time and Energy Differently
“I think that is a worthwhile experiment for anyone to play around with,” DePierro says. “People get in a rut or a cultural expectation that their job has to be performed in a certain way and the hours have to look a certain way, and if you step outside of that, you’re a problem.”
You can also reconsider how you spend your time during a single workday. Perhaps you can space out patients differently, so you have different break patterns, suggests DePierro. And work in some restarts, too: If possible, take a 5-minute walk outside or leave the office space for a change of environment when you feel stressed.
Practice Gratitude
Research backs the benefits of spending a few minutes daily thinking about what you’re grateful for. “Studies show that it improves cardiovascular health, it boosts our mental health, it increases our resilience to stress, and that it seems to have particular benefits for health professionals,” says Putnam. “Gratitude helps us cope with stressful experiences by reminding us of what is positive in our lives in the midst of, or even as a result of, suffering.”
Flag Your Wins
“So much time in medicine is focused on things that went wrong, things that could go better, and things that need to be corrected,” DePierro says. “If we don’t flag the wins, then when something bad happens again, it feels like everything is bad. Calling out the successes, even to yourself, helps you put a pin in them, so they’re more easily recalled later.”
Nurture Social Connections
Identify one or two people at work you can lean on. “Having at least one other person in the trenches with you that you can close the door to the office and vent with or that can emotionally support you goes a really long way,” says DePierro.
“And not just for burnout as a construct but for things like depression and anxiety and even symptoms of PTSD.” He says, if you have somebody validating your perspective and saying that they understand what you’re going through and are in your corner no matter what, you’re at decreased risk of developing mental health symptoms after stressful events or ongoing stress.
Selling says the changes you make to reduce your stress don’t have to be sweeping. Instead, change starts with one step down a path. For example, if you’ve never taken a lunch break before, don’t start with an hour. Find 10 or 15 minutes. Or start even smaller: Set a reminder on your phone every 2 hours to take a 5-minute break.
Remind yourself: “I deserve to not feel so stressed or burnt out. I’m doing something I love, helping people’s lives. So how do I help myself in the process?”
Rachel Reiff Ellis is an Atlanta-based freelance writer and editor specializing in health and medicine. She is a regular writer for WebMD and Fortune Well, and her work has appeared in Prevention, Oprah Magazine, Women’s Health, and others.
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