Physician burnout persists even as the height of the COVID-19 crisis fades farther into the rearview mirror. The causes for the sadness, stress, and frustration among doctors vary, but the effects are universal and often debilitating: exhaustion, emotional detachment, lethargy, feeling useless, and lacking purpose.
When surveyed, physicians pointed to many systemic solutions for burnout in Medscape's Physician Burnout & Depression Report 2023, such as a need for greater compensation, more manageable workloads and schedules, and more support staff. But for many doctors, these fixes may be years if not decades away. Equally important are strategies for relieving burnout symptoms now, especially as we head into a busy holiday season.
Because not every stress-relief practice works for everyone, it's crucial to try various methods until you find something that makes a difference for you, says Christine Gibson, MD, a family physician and trauma therapist in Calgary, Canada, and author of The Modern Trauma Toolkit.
"Every person should have a toolkit of the things that bring them out of the psychological and physical distress that dysregulates their nervous system," shares Gibson.
Once you learn the personal ways to alleviate your specific brand of burnout, you can start working on systemic changes that might help the culture of medicine overall.
One or even more of these more unusual burnout prescriptions may be key to your personal emotional regulation and mental wellness.
Symptoms Speak Louder Than Words
It seems obvious, but if you aren't aware that what you're feeling is burnout, you probably aren't going to find effective steps to relieve it. Jessi Gold, MD, assistant professor and director of wellness, engagement, and outreach in the department of psychiatry, Washington University School of Medicine in St. Louis, is a psychiatrist who treats healthcare professionals, including frontline workers during the height of the pandemic. But even as a burnout expert, she admits that she misses the signs in herself.
"I was fighting constant fatigue, falling asleep the minute I got home from work every day, but I thought a B12 shot would solve all my problems. I didn't realize I was having symptoms of burnout until my own therapist told me," says Gold. "As doctors, we spend so much time focusing on other people that we don't necessarily notice very much in ourselves—usually once it starts to impact our job."
Practices like meditation and mindfulness can help you delve into your feelings and emotions and notice how you're doing. But you may also need to ask spouses, partners, and friends and family — or better yet, a mental health professional — if they notice that you seem burnt out.
Practice 'in the Moment' Relief
Sometimes, walking away at the moment of stress helps like when stepping away from a heated argument. "Step out of a frustrating staff meeting to go to the bathroom and splash your face," says Eran Magan, PhD, a psychologist at the University of Pennsylvania and founder and CEO of the suicide prevention system EarlyAlert.me. "Tell a patient you need to check something in the next room, so you have time to take a breath."
Magan recommends finding techniques that help lower acute stress while it's actually happening. First, find a way to escape or excuse yourself from the event, and when possible, stop situations that are actively upsetting or triggering in their tracks.
Next, recharge by doing something that helps you feel better, like looking at a cute video of your child or grandchild or closing your eyes and taking a deep breath. You can also try to "catch" good feelings from someone else, says Magan. Ask someone about a trip, vacation, holiday, or pleasant event. "Ask a colleague about something that makes [them] happy," he says. "Happiness can be infectious too."
Burnout Is Also in the Body
"Body psychotherapy" or somatic therapy is a treatment that focuses on how emotions appear within your body. Gibson says it's a valuable tool for addressing trauma and a mainstay in many a medical career; it's useful to help physicians learn to "befriend" their nervous system.
Somatic therapy exercises involve things like body scanning, scanning for physical sensations; conscious breathing, connecting to each inhale and exhale; grounding your weight by releasing tension through your feet, doing a total body stretch; or releasing shoulder and neck tension by consciously relaxing each of these muscle groups.
"We spend our whole day in sympathetic tone; our amygdala's are firing, telling us that we're in danger," says Gibson. "We actually have to practice getting into and spending time in our parasympathetic nervous system to restore the balance in our autonomic nervous system."
Somatic therapy includes a wide array of exercises that help reconnect you to your body through calming or activation. The movements release tension, ground you, and restore balance.
Bite-Sized Tools for Well-Being
Because of the prevalence of physician burnout, there's been a groundswell of researchers and organizations who have turned their focus toward improving the well-being in the healthcare workforce.
One such effort comes from the Duke Center for the Advancement of Well-being Science, which "camouflages" well-being tools as continuing education credits to make them accessible for busy, stressed, and overworked physicians.
"They're called bite-sized tools for well-being, and they have actual evidence behind them," says Gold. For example, she says, one tools is a text program called Three Good Things that encourages physicians to send a text listing three positive things that happened during the day. The exercise lasts 15 days, and texters have access to others' answers as well. After 3 months, participants' baseline depression, gratitude, and life satisfaction had all "significantly improved."
"It feels almost ridiculous that that could work, but it does," says Gold. "I've had patients push back and say, 'Well, isn't that toxic positivity?' But really what it is is dialectics. It's not saying there's only positive; it's just making you realize there is more than just the negative."
These and other short interventions focus on concepts such as joy, humor, awe, engagement, and self-kindness to build resilience and help physicians recover from burnout symptoms.
Cognitive Restructuring Could Work
Cognitive restructuring is a therapeutic process of learning new ways of interpreting and responding to people and situations. It helps you change the "filter" through which you interact with your environment. Gibson says it's a tool to use with care after other modes of therapy that help you understand your patterns and how they developed because of how you view and understand the world.
"The message of [cognitive-behavioral therapy] or cognitive restructuring is there's something wrong with the way you're thinking, and we need to change it or fix it, but in a traumatic system [like healthcare], you're thinking has been an adaptive process related to the harm in the environment you're in," says Gibson.
"So, if you [jump straight to cognitive restructuring before other types of therapy], then we just gaslight ourselves into believing that there's something wrong with us, that we haven't adapted sufficiently to an environment that's actually harmful."
Strive for a Few Systemic Changes
Systemic changes can be small ones within your own sphere. For example, Magan says, work toward making little tweaks to the flow of your day that will increase calm and reduce frustration.
"Make a 'bug list,' little, regular demands that drain your energy, and discuss them with your colleagues and supervisors to see if they can be improved," he says. Examples include everyday frustrations like having unsolicited visitors popping into your office, scheduling complex patients too late in the day, or having a computer freeze whenever you access patient charts.
Though not always financially feasible, affecting real change and finding relief from all these insidious bugs can improve your mental health and burnout symptoms.
"Physicians tend to work extremely hard in order to keep holding together a system that is often not inherently sustainable, like the fascia of a body under tremendous strain," says Magan. "Sometimes the brave thing to do is to refuse to continue being the lynchpin and let things break, so the system will have to start improving itself, rather than demanding more and more of the people in it."
Rachel Reiff Ellis is an Atlanta-based freelance writer and editor specializing in health and medicine. She is a regular writer for WebMD and Fortune Well, with additional work appearing in Prevention, Oprah Magazine, Women's Health and others.
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