Avoid Physician Burnout: Focus on Your Strengths

Avoid Physician Burnout: Focus on Your Strengths

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.

Overwhelm | A Mindfulness In Medicine Series

Overwhelm | A Mindfulness In Medicine Series

The Demystifying Physician Mindfulness Series

Does Mindfulness In Your Medical Practice Seem Unachievable?

For many of my readers, the concept of mindfulness may seem out of reach. The term evokes imagery of tranquil monks and mountain tops, existing miles away, both literally and metaphorically. I created this series to bridge this distance, and to introduce mindfulness to practicing physicians as an accessible tool to combat burnout.

Each post in this series will examine the relationship between mindfulness and a specific area of a physician’s day-to-day life. They each include a physician’s story, and how the rigors of practice hamper their ability to fully enjoy that part of their life. After detailing their situation, I provide guidance for how the physician can utilize mindfulness to gain fulfillment and mastery in that area.

With each post, I’ll give you an actionable step that will help you integrate the post topic into your daily life. I’ll also provide an exercise that you can practice in your free time that will help strengthen your resilience, calm, and fulfillment. My goal is to transform mindfulness from a daunting, unapproachable ideal into a broad toolkit that you have easy access to. Simply put, I want to help you be a happier, more productive version of yourself, at the workplace and at home.

Without further ado, the inaugural installment of Demystifying Mindfulness!

 


Today’s topic: Overwhelm

Our physician: Dr. P, is a cardiologist in a large Midwestern practice: 
“I don’t know what to do. I feel like I’m drowning in my work. Every day of my practice feels like a battle, and when I’m with patients all I can think about is getting to the end of my day. I used to be in love with my practice and I don’t know what happened. Now, my work feels meaningless, and I’m completely overwhelmed.  What can I do?”


Dear Dr. P, 
You’ve already won half the battle. You’ve noticed that you’re locked in an ineffective pattern at work, and you’re interested in strategies to improve your situation. This realization is no small thing! What I want you to start doing is focusing on your physical experience. You’ve just wrapped up with your last patient of the day, you’re late to make it home for dinner with your family, you still have a half dozen charts to complete – what does your body feel like? Is your heart rate elevated? Are your hands tense? Are you sweating? Get in tune with the physical sensations that accompany the feeling of overwhelm, and you’re well on your way to combatting it,  and feeling more in control. 
 
Physical sensations often precede feelings of overwhelm; in some ways they’re an early warning system that can help you break the vicious cycle. Once you notice these physical precursors, take a brief pause. If you can take 5 seconds in between patients to take deep breaths and ground yourself, that’s a victory. See how many of these pauses you can give yourself in a workday. While this may seem trivial, over time, mindful pauses will begin to weave together into a calmer day, and a calmer and happier life. 

In addition to your feelings of burnout, you wrote that you no longer feel connected to your work. Overwhelm and lack of passion and fulfillment often go hand in hand. Of course, it’s challenging to stay connected to work when it’s so demanding. Reducing feelings of overwhelm by mindfully pausing throughout the day will help you feel more authentically connected to your work, and may revive some of the enthusiasm you’ve experienced in the past. Reciprocally, mindfully nourishing your commitment to patients will shrink feelings of overwhelm.

At the end of every day, I encourage you to write down things that went well in your day. Focusing on what went well can reconnect you to your strengths and your sense of meaning. As doctors, we are trained to focus on what is going wrong. Give yourself structured time to focus on what is going right.

Give this mindful strategy a shot and look forward to being more present and fulfilled in your practice.

To your resilience,
Dr. Gail Gazelle


Have an idea for a future Demystifying Mindfulness post? Want Dr. Gazelle to help you tackle your problem? Write in at drgazelle@mdcanhelp.com or contact us on the website.