It took me almost two decades to look back and try to understand the reasons I left medicine. Leaving was an incredibly painful decision and the residual shame I carried made me want to look the other way—until I learned about burnout. Before, I thought it was me, that I was the problem. It was freeing to learn the truth: burnout is a psychological response to stress that has defined symptoms: emotional exhaustion, depersonalization, and inefficacy. Its triggers are well-understood, including those that affect physicians.
In 2013 I finally mustered the courage to write about my personal experience with burnout and leaving practice. I was shocked when the article went viral. Clearly my story struck a nerve. Since then I have made it my mission to learn all I can about physician burnout—its underlying causes, its consequences, and potential fixes.
In the course of my work I’ve interviewed dozens of physicians, researchers, health care leaders, and experts in burnout. I’ve learned that it’s a big problem for many physicians (actually it’s a big problem for many other health care providers, but what I know best is its effects on physicians). I’ve learned that understanding the root causes of physician burnout requires that you untangle the underlying flaws in our health care system. I’ve learned that burnout is not about the “weakness” or sensitivity of individuals and it can’t be prevented through individual wellness solutions alone.
I don’t have firsthand knowledge about the current pressures of practice. Some of the factors that led me to leave are probably different than those causing the burnout epidemic today—but more than likely, many are the same, because they reflect underlying problems that exist in health care. Problems like what’s paid for (procedures and testing) and what’s not (time for communication, compassion, relationship-building), broken communication processes, lack of reliable safety routines, a flawed malpractice system, and many others.
Along my journey of discovery, I’ve learned about some really innovative ideas to prevent burnout and fix the underlying problems in health care. In these posts I’ll share what I’ve discovered in the hopes that these cool ideas will spread. Imagine a scenario in which physicians care for patients in settings where “things work,” where care providers and other staff are respected by and collaborate with administration, where physicians can see a sustainable career ahead, and where physicians can find the joy in practice they envisioned when they first applied to medical school. I think these ideas could help make this dream a reality.