Two hours of administrative tasks for every hour with patients. A proliferation of non-physician administrators deciding how the day is going to run. Little in our training about how to cope with uncertainty and change. It’s no surprise that burnout rates are approaching 60%. Despite being so common, when we see a colleague struggling with physician burnout, we may not know what to say. Responding appropriately can bring someone back from burnout and may even save a life. Here are some tips:
Approach the situation with compassion
Burnout is often referred to as erosion of the soul, and for good reason. With it comes a great sense of despair, hopelessness, and isolation. We lose our perspective.
Often there is no better remedy than the kindness of a colleague, someone who has walked in our shoes and knows what we’re experiencing. Approach the colleague with the empathetic aim of letting them know that you care about them, you’ve noticed that they are struggling, and you’re there for them. Afraid of saying the wrong thing? Here are some ways to convey your concern.
“I can see you’ve had a rough week.”
“I’m concerned about you.”
“I get why you’re feeling this way.”
“I don’t have answers but I want you to know I’m here and I care about you.”
“You deserve to feel better.”
“I know these feelings will pass.”
Normalize the experience
With burnout comes a sense of personal inadequacy. Everyone else seems to be coping with all the stress. What’s wrong with me? Tell your colleague that what they’re experiencing is normal and that many physicians are having the same feelings. Let them know there’s nothing wrong with them. Make it clear that these harsh feelings do not mean that they are a failure. And, no matter what they’re thinking, that experiencing burnout is a normal response to the stressors of modern practice and doesn’t mean they’re in the wrong career.
Don’t problem solve or give advice
As physicians, we’re conditioned to fix whatever problem the person in front of us has. It is quite literally what we are trained to do. But with burnout, we need to suspend our desire to problem-solve. Instead of doing something, we need to focus on simply being present with a colleague’s suffering.
On that same note, we also need to avoid giving advice. Giving advice sends an implicit message that the person doesn’t have the inner resources to solve their problem. Not only that, but the last thing someone wants to hear when they’re low on energy, overwhelmed by demands, and disconnected from any sense of meaning is “I know how to solve your problem, here’s what you should do.” Simply listening without suggesting any action can help someone in burnout begin the critical step of gaining perspective on their situation.
Help them connect with their accomplishments
When we’re in burnout, we’re focused on everything that’s wrong, with the workplace and with ourselves. We’re disconnected from meaning and purpose. Positives slide off us like Teflon and negatives stick as if attached by Velcro. Whatever our strengths and accomplishments may be, we believe we have none. It’s critical to find a way to reconnect with the things we are accomplishing.
Ask your colleague if they’d consider keeping a running list of three things they accomplish every day. This simple exercise can provide ballast against the pull to inadequacy and negativity.
Let them know seeking help is not a sign of weakness
We learn early in training that seeking help is a sign of weakness. We’re the head of the team and we’re supposed to have all the answers. Yet, we can’t solve every problem by ourselves (no one can.) Reassure your colleague that asking for help is a sign of health, not weakness. Recommend that they speak to loved ones and other colleagues. Encourage them to seek coaching or other professional help.
While you can’t change the external landscape, know that applying these tips can make a big difference in a colleague’s ability to see a way forward. In summary, remind yourself to listen compassionately. Normalize their experience. Avoid the temptation to give advice or problem-solve. Help them see their strengths and accomplishments. Let them know that seeking help is often vital and is not a sign of weakness. Reassure that they can find a way to meet the intense demands of practice with much less anguish.
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With the election season just behind us, many people are experiencing emotional overwhelm. The uncertainty afoot can elicit a deep sense of fear and ill ease. Fear, like all emotions, has its place. We need to recognize this feeling and take time to tend to it. As the election demonstrates, when fear becomes the major driver, however, it can take us (and whole nations) to a dark place. Fight or flight is vital when we need to take rapid and immediate action for safety or for survival. When we don’t, fear can be paralyzing, leaving us feeling powerless, hopeless, and stuck. Fear breeds hostility, rigidity, and takes us to a place of reactivity as opposed to one of thoughtful and mindful activity. When we’re in fear, we move out of compassion for ourselves and for others.
To stay grounded and focused, we need to assess. What’s being triggered? Is it my safety and security? My sense of well-being? In this moment, am I facing a real threat? Or is my fear related to something that hasn’t even occurred, and may or may not occur in the future? This discernment is critical so that you can mobilize resources to cope with whatever it is that’s right in front of you, and build reserve to face future challenges as they unfold.
Check in with yourself right now. How resourceful are you when you’re in a place of fear? When you look back on decisions you’ve made based on fear, do you believe that you’ve made the best decision? Have you seen others make wise decisions? Now ask yourself the following question: when you’re at your best, are you letting fear steer your course or are you able to notice your fear, center yourself, and move forward from a constructive place? What would be different if your focus shifted from fear to calm and equanimity?
Once you’ve righted yourself, you can decide what action is the right next step. In the face of fear, small actions are best. You can set a daily intention to tune in to yourself and notice when fear is nipping at your heels.
Gandhi said “The enemy is fear. We think it is hate; but, it is fear.” His words ring true in the current political environment. Managing one’s fear could never be more important. Like anything, this requires practice. It’s well worth it, though, so that we can live with a sense of peace and contentment. So we can make decisions that we don’t later regret. So we can mobilize resources to be our best with all people we meet.
Please leave your comments and suggestions below so others can learn from your experience.
New Year’s resolutions are a longstanding tradition around the world, dating back to ancient Babylonian and Roman customs. In modern times, New Year’s resolutions have become popular in western culture, typically revolving around self-improvement goals, such as better eating, exercising more, and spending less. Unfortunately, the tradition is typically unsuccessful. There’s no firm data, but a 2007 study reported on the site Quirkology revealed that 88% of 3,000 adults who set New Year’s resolutions failed, despite the fact that 52% were confident of success at the beginning. This highlights how modern culture leads us to focus more on goal-setting than goal completion.
Here are 10 tips to achieve your New Year’s resolutions in 2015:
- Start small.
Taking on a large goal is tempting, but it’s also the most sure-fired way to fail. If the goal is too much of a stretch, it can fuel a downward cycle: lack of achievement, decreased motivation, and self-criticism. By starting small, you increase the likelihood of taking the vital action steps, and each “win” helps build your belief that you can achieve your goals. This creates an upward spiral of confidence, motivation, optimism, and competence: all key ingredients of self-efficacy and success. Gary Hamel, author of the 2007Amazon best business book of the year, The Future of Management, defines the key to success as “win small, win early, win often.”
Pamela Rutledge/Via http://athinklab.com/
Envision a day in the future where you’ve accomplished your resolution. Close your eyes and sit for a few minutes, letting yourself bask in the experience of having reached your goal. Experiencing this wonderful state is much more motivating than berating yourself over something you weren’t able to accomplish. It can help you shift your focus to self-motivating questions such as “what small step can I take TODAY to help me get to this feeling?” and “what is a new way of thinking about my goal that will help me experience more of this feeling?”
- Let go of old goals.
If you haven’t moved forward on a goal year after year, it’s time to think about what’s holding you back. Putting something on the list after years of not succeeding can start the year off with a sense of shame and disappointment. One option here is to include a resolution to forgive yourself for things you didn’t accomplish and start taking credit for all that you do achieve.
- Keep your list short.
Would you rather succeed at three out of three resolutions or one out of ten? It’s much easier to focus on a small number of goals than a long list. And think of the satisfaction you’ll have checking each one off!
- Focus on “wants” instead of “shoulds.”
Focus on what you truly want to achieve, rather than on things you believe you “should” be achieving. To be successful at any life change, you have to really want it. It pays to take the time to consider what it is that you truly want, teasing out the things others have said you should do or stop doing. Similarly, Ryan and Deci’s theory of self-determination tells us that intrinsic motivation is much more powerful than that generated by external forces.
- Resolve to “be” instead of “do.”
Make sure to include resolutions that involve “being” and not just ones that require “doing.” For example, a resolution could be: “This year, I will have more moments of being present with my family, times where I’m not focusing on all the work I have to get done.” “Being” resolutions are ones that you can achieve at any time. Even if you stray on a “being” resolution, you can accomplish the goal the next day… or even in the next hour.
Start every day off by planning one small step you’ll take to get closer to your goal. This method of breaking down the larger goal into more feasible parts is a great way to make incremental change. It also reminds you that you, truly, are in charge of your fate.
- Find an accountability partner.
Whether it’s your spouse, a friend, a coworker, or a coach, it’s much easier to follow through on goals if you have a buddy. In the best-case scenario, you’ll hold one another accountable. Tell your partner to go big on the cheerleading and championing as it’s much easier to succeed when there’s someone rooting for you and shouting, “I know you can do it!”
- Don’t use your resolutions as a means for beating yourself up.
This is an area where many people falter. If you’re like most people (myself included!), you probably have enough inner critics badgering you as it is. You don’t need your New Year’s resolutions to provide them yet another stomping ground.
- Don’t let a sense of failure stop you.
It’s all too easy to swing from the high of “this is the year I’ll accomplish X” to the low of “I just did the opposite of X; I’ll never achieve my goal.” In reality, every day represents a new opportunity to move toward your goals, so go ahead and be sure to seize an opportunity. This is true for New Year’s resolutions and true for any goal in your life. If failure presents a major hurdle for you, you can always think back to #6 and try to “be” instead of “do.” You might be surprised at how a change in perspective—viewing failure as a platform for growth instead of sinking—can help you achieve different aspects of your goals.
Following these steps can’t guarantee that you’ll achieve your resolutions, but it might be the way to pull yourself out of the 88%. Go forth and decide what steps you’ll take today. Even if you falter from the path, every moment of your life can be used to institute change. Self-improvement is always within your reach.
Coaching can help with a number of issues physicians and physician leaders commonly face. Here are some of the top ones:
• You feel stuck somewhere in your life and/or career and you need help figuring out and taking the next steps
• There’s a gap in skills, confidence, or resources needed to achieve professional success—as defined by you
• You have been told that you would benefit from coaching
• Loss of sense of purpose
• You want to advance your career and you’re not sure how to do so
• Anger, detachment, or other signs of burnout
• Assistance with negotiating terms of employment
• You are successful, but success is problematic or scary, or comes with unwanted expectations
• Improved work-life balance
• You want to enhance your emotional awareness and intelligence
• Identification of your core strengths and how best to leverage them in all areas of your life
Physician coaching provides a supportive and non-judgmental ally to assist you in overcoming whatever challenges you face. Give it a try… you’ll likely be pleasantly surprised.