Photo by Andreas Fidler on Unsplash

It’s difficult to avoid physician burnout when the demands keep increasing and it feels like the system is against you. For some, burnout becomes the norm, and it takes a big toll. In case you’re unsure, here are the three components of burnout:

  1. Emotional exhaustion and depletion
  2. Cynicism, depersonalization, and withdrawal from your work
  3. Inability to connect with your strengths and your accomplishments

These run together, creating a downward cycle. Looking at the last one, however, we see how a focus on one’s weaknesses can set the stage for burnout. As physicians, we are often our own harshest critics, saying things to ourselves that we wouldn’t say to others. Among the hundreds of physicians I’ve coached, I’ve seen many hyper-focused on their perceived inadequacies. Perhaps you can relate to this? Here are a few questions to help you see if you’re leaning in this direction:

Do you tend to see your strengths or your weaknesses?
Do you pay attention to what you’ve accomplished or what you haven’t?
Do you notice what’s going well or what isn’t?

If you answered yes, know that you probably come by these patterns honestly. They’re the result of our education, our workplace environments, and the broader culture we live in. Changing these habits takes some practice, but it’s a sure way to reverse the cycle of burnout.

Roadblocks to Seeing Our Strengths

Medical training tends to be deficit-based. In residency, our noses were often rubbed in any mistake we made. An Internal Medicine resident recently told me, “On my Onc rotation, the attending kept focusing on how few of the chemo regimens I was up on. On my Cards rotation, the fellow kept at my not being up on the latest STEMI trials. No one seems to notice when I do know something. It’s been so long since I’ve gotten any positive feedback, I’m not even sure if I have any strengths at all.” These types of hypercritical experiences of belittlement create stress, worsen physical and mental health, and can even lead to suicidal thoughts.

Most physicians have stories from their residency about being “pimped,” asked question after question by an attending, just so they’d finally get to the inevitable embarrassment of not knowing the answer. This pattern can leave us focused on our weaknesses.

Experiences like these are pervasive in our training and, for some, may be reminiscent of messages we received earlier in life. Whatever the origin, these self-defeating messages can fuel the downward spiral of burnout.

Physician Burnout and Negative Self-Talk

Let me share with you an example of just how deep this goes. When I give talks on resilience to physicians, I ask:

What’s your typical ratio of self-promoting to self-defeating messages?

And do you know their typical response?

What is a self-promoting message?

Physicians are so used to the self-defeating voices that it’s difficult to identify with the concept of positive self-talk.

In addition to what we learn in our training, this also may result from perfectionism. Many physicians consider perfectionism an asset. And, while it may have served us in taking tests, perfectionism can hold us back today.

Physician Burnout and Perfectionism

Here’s one way of thinking about perfectionism:

  • Holding out for a barely attainable standard and then berate yourself for not achieving it.
  • Procrastinating to avoid facing self-criticism.
  • Believing that berating yourself will improve your performance.
  • Ruminating and experiencing anxiety about your performance.
  • Experiencing a lack of confidence.

Bottom line: Difficulty appreciating your strengths and successes.

A different frame to consider is: Have I done my very best? Can that be good enough?

Physician Burnout and a Strengths-Based Approach

If this resonates and you notice that the negatives dominate your thought processes, practice giving more attention to your positives. As discussed in a previous post, a strengths-based approach tends to be more motivating than whipping ourselves about our deficits. Here are some practical ways for you to shift focus to your strengths.

  • Notice when you get stuck focusing on your weaknesses.
  • Push yourself to shift attention to what’s going well.
  • Notice the “bright spots” in each day—times when something good happens; when you utilize your strengths.

When you find yourself back in the cycle of self-defeating thoughts, ask yourself:

  • What’s right about me?
  • What am I doing well?
  • What are the three things I’ve accomplished today?

Develop the habit of noticing what’s going well. Celebrate doing your best and practice letting “good enough” be enough. You may just find that this frees up your energy, replacing physician burnout with physician resilience.