What is burnout?
I was working with a client this week. He has a busy Practice, but he feels constantly overwhelmed. Overwhelmed by the patient load, administrative challenges and feeling rudderless when it comes to marketing his Practice. He came to me because he was feeling increasingly despondent and resentful about the role he found himself in.
In short (and wearing my past psychiatrist’s hat), it was obvious that he was circling the drain of burnout.
The Society of Occupation Medicine estimates that ‘between 30% and 40% of UK doctors, including trainee and junior doctors, are experiencing burnout and work-related stress, with GPs reported to be most at risk’. Ouch.
Twice in my career, I’ve experienced burnout. Both events were lengthy and were whilst I was working full time in the NHS.
Needing to get a better work-life balance was one of the reasons I moved into Private Practice, and it eventually enabled me to leave the NHS completely, and do something I really love in the private sector – Sports Medicine.
Make no mistake, burnout isn’t confined to those working purely in the NHS.
It’s important to understand that increasing your working hours by adding three evenings and a Saturday morning of Private Practice to your full-time NHS gig can also a recipe for burnout.
What are the warning signs of burnout?
1. Feeling like the patient is the enemy.
Ever noticed how the mood you are in can significantly determine how you respond to the patient in the room?
If you’re regularly finding yourself feeling ‘snidey’, cynical (or even resenting the fact that the patient is breathing), chances are you’ve got burnout.
Perhaps you’re beginning to think that what you do is meaningless, and you’ve totally lost sight of why you became a doctor in the first place? Yep, that’s a sign of burn out too.
2. Never making enough time for friends and family.
At the end of the day, do you feel you have given you all to your patients, and you’re left drained and empty like a discarded Slush Puppie?
Is there is no love left in the tank for your special peeps?
3. Do you feel trapped in survival mode, and dread going into work on a Monday?
Are you finding that you’re losing your sense of humour, distancing yourself from your colleagues and are never able to lighten-up?
If this sounds like you, it’s probably time to get help. The clinicians amongst us who are most at risk are those of us who consider that we cope well under stress, are deeply conscientious, and have continually pushed aside any idea of help..
What puts us at risk of burnout?
Why is it at we can work in the same role for years and be happy in our Doctoring, and yet the next year we fall foul of burnout?
There’s no doubt that being a Doctor is draining. It is mentally and physically taxing completing long days and nights at work.
Provided we have supportive colleagues, a place and space to recharge, and we look after ourselves in terms of sleep, exercise and nutrition, we’ll bounce back OK.
The problem comes when one of those things breaks down.
If you used to join friends for a spin class and glass of wine, but now you’ve a screaming two-year-old or you’re going through a divorce, you no longer have that after-work solace.
If your cherished work colleague commits suicide, your line manager is a sadistic troll, or HR is turning a blind eye to the institutionalised bullying in your department, your working world becomes hell.
Combine either of those with an average of five hours or less sleep per night and an over-reliance on Pinot Noir, and voila! Burnout city.
There isn’t a strict diagnostic set of criteria for burnout, but the BMA has a useful tool to help you discover if you might be at risk:
So, what’s the remedy?
Sometimes we need some professional help. If you’re in crisis, please, please, go promptly to see your GP.
Dr Kate Little has a really useful resource page – https://physicianburnout.co.uk/need-help-what-help-do-i-need/
If you’ve (thankfully) not reached that stage, how can you galvanise yourself from burnout?
Stop and take stock of what’s happening.
It’s important to realise that it’s not going to get better, just by ‘giving it some more time’.
It’s very helpful to take a few days off, if possible, to get some perspective.
You can get back to doing what you want to do, by doing less of what stresses you, taking more care of yourself, and getting more support from colleagues. In other words, it’s about decreasing stress in our work and home lives, and increasing what nurtures and restores us in our working and home lives.
This sounds obvious, but trimming off a patient of two off the end of a clinic and instead, going for a run, can make all the difference in the world between surviving and thriving.
Learn to reinstate boundaries
Recognise that your energy is a finite resource. Try making exercise a transition from work to home life, so you can blow off steam. Make sure that you actively build in small 10 or 15 minute breaks into your Private Practice clinic timings, so that your patients aren’t back to back all day.
Reconnect with non-medical friends and set up hobby or sports dates, so you can do something different. Something that ain’t medicine. Rigorously defend time for these activities, and don’t be tempted to squeeze it that one ‘little extra’ patient (just because you like to please your secretary).
Make time for meditation, reflection and headspace. Journaling (try a gratitude journal) and running have been my salvation.
Define your ideal working week.
Busier isn’t always better, so you might want to consider looking at areas of your week when the clinics might be quieter. Could you get away with holding a shorter clinic on that day, or completely taking the day off?
When was the last time you took a proper holiday? Like for two weeks or more?
Delegate and outsource wherever possible.
Ask yourself, what tasks could you possibly hire a VA to do in your absence?
To enable yourself to digitally disconnect, could you get secretarial support for patient email filtering?
What can you automate in your practice in terms of billing, dictation and report writing that would mean that you get to leave the office, without taking it home with you?
Make sleep a priority.
It’s all too easy to start a day, already exhausted with a depleted energy tank. Switch off Netflix, and get to bed before 10.30pm. You know it makes sense.
Be kind to yourself.
Remember that compassion and empathy ‘thing’ Doctors are supposed to do?
Guess what? That starts with you. Give yourself a break. You’re human.
Forget any ideas about needing to be strong and perfect, and ditch the shame about reaching out for assistance – you wouldn’t hesitate to get help if you thought you had cancer.
It’s absolutely ok to discuss how you’re feeling with (nice) colleagues. They may be also be feeling similar work pressures, and as a collective, you might even make some proper changes in the ‘system’.
If you need help to regain control over your blossoming Private Practice get in touch…. firstname.lastname@example.org