Physicians are certainly not immune to burnout just because they have advanced education. In fact, the demands of a medical practice can be a perfect storm for stress and burnout. A recent article in the Journal of the American Medical Association noted, “Burnout is common among physicians in the United States, with an estimated 30 percent to 40 percent experiencing burnout.”

The article pointed out that many aspects of patient care may be compromised by burnout, and that physicians who have burnout are “more likely to report making recent medical errors, score lower on instruments measuring empathy, and plan to retire early and have higher job dissatisfaction, which has been associated with reduced patient satisfaction with medical care and patient adherence to treatment plans.”  

To help address this important issue, I visited Dr. Steven Berglas, one of the world’s leading experts on burnout. He is a clinical psychologist, executive coach, and consultant based in Los Angeles. Dr. Berglas spent 25 years on the faculty at Harvard Medical School, and he has written numerous books and articles on leadership and burnout including Reclaiming the Fire: How Successful People Overcome Burnout (Random House). One of his specialties is working with extremely successful people who have reached great heights in their careers and then felt miserable.

Berglas emphasizes that stress –more aptly, distress – is commonly considered a version of, or equivalent to, psychological burnout. In fact, stress and burnout are distinct disorders. If you ignore this fact and attempt to self-medicate the wrong disorder, odds are good you’ll make matters worse. For example, a three week vacation may be great to relieve stress, but it may “pour petrol on the fire” for someone experiencing burnout.

Dr. Berglas noted, “Stress is a word that is constantly misused.” He pointed out that stress is almost entirely in the eye of the beholder, and people only experience stress if they view something as posing a threat of harming them in a physical or psychological way. Berglas likes to reference Epictetus who in 40 B.C. stated, “Men are disturbed not by things but by the views that they take of them.” The real factor that dictates our feelings of stress is our “perceived control.” In a physician setting, you may be in control of your practice, but you may not have perceived control due to concerns about third party payers the government, and the ever changing landscape of medicine. 

Burnout, or as Dr. Berglas likes to call it, “Supernova Burnout” occurs when successful people begin to experience the daily requirements of their work as a “Sisyphean monotony.” He shared that, unlike the person experiencing stress, the person suffering burnout is not anxious, but instead detached from his or her work and colleagues.  People sometimes refer to this state as “going through the motions.” In this mode, people feel like they have lost all of their passion and fire for their occupation. They usually talk about just pressing on and doing their job “only for the money.”  

We often expect success to bring happiness, but most people are not prepared for “success depression,” the crippling sense of disappointment that follows the experience of huge accomplishment. Dr. Berglas provided the example of Olympic gold medal swimmer Mark Lenzi who described his post-Olympic experience as “lying in his bed…sobbing.” Once Mr. Lenzi achieved the goal that he had worked so hard to attain, depression “hit him like a brick wall.” Physicians climb a very big hill early in life. While others are beginning their careers, most physicians are continuing to toil away learning their craft.  After years of training, they set forth to go “live the good life.” If only life was that easy.

Once a physician settles into his or her practice, the realities of our modern medical system can contribute to burnout. I hear physicians who describe feeling “trapped” or “stuck in their career.”

There is such a huge investment in simply becoming a physician, and it can be very challenging to shift course.  On this point, Dr. Berglas aptly noted, “Resenting a career you feel trapped in virtually guarantees that in time you will extricate yourself from it in some maladaptive manner, making you less employable than you would have been if you’d opted earlier for a psychologically rewarding pursuit.”  When you think about how many leaders and successful people blow up their careers and families through self-destructive behaviors, the wisdom of his words ring loud and clear.

So what can you do to prevent success-induced misery? Dr. Berglas shared some practical recommendations. First, he suggests that you assess your risk.  If you describe yourself as single-minded, persevering, self-reliant, assiduous, unremitting, monomaniacal, zealous, or indefatigable then he would say you are at high risk. He also says that Baby Boomers (born between 1946 and 1964) are prone to “raging individualism” which is another risk factor for success-induced burnout.  If you are considered by others to be at the top of your field then he says, “you are more likely to wrestle with the emotional pain of continuing to use talents that have ceased to be psychologically rewarding.” 

To combat burnout, Dr. Berglas recommends nurturing satisfying connection with others including mentoring people who are the next generation of achievers. He also suggests learning something new and to find a cause in which you believe and dedicate yourself to it.  I have found that physicians who desire to “pay it forward” and take an active interest in people and causes seem genuinely happier and more engaged. As a physician, it’s important not to overlook the signs of stress and burnout, but to “heal thyself” and be proactive to take control of your own life to reclaim your passion for life and your practice.

Martin Willoughby is a serial entrepreneur, author of the book Zoom Entrepreneur, and a business consultant with Butler Snow Advisory Services, LLC. Direct questions to Martin at martin.willoughby@butlersnow.com

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