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STRESSED OUT

“All of us have those feelings to some
frequency and some severity,” he said.
“But when they come too often and to
too severe an extent, they can begin to
undermine your effectiveness in your
work.”

“This syndrome differs from the global
impairment of depression,” he said. “It
primarily relates to your professional
spirit of life, and it primarily affects indi-
viduals whose work involves an intense
interaction with people—so professions
such as teachers, social workers, police of-
ficers, nurses and physicians.”

The survival mentality and the A strategy to examine work-life balance
physician If you’re experiencing burnout, identifying values—both person-
personality
ally and professionally—is an important factor in addressing what
“I think we all remember that survival causes burnout, Dr. Shanafelt said. One way to do that is to engage
mentality of residency,” Dr. Shanafelt in a series of questions to examine the two sides.
said. “‘I’ve just got to make it through;
things will get better when I’m done with The first set of questions:
residency.’ But what we find is that physicians perpetuate that frame- • What are the things you care about in your personal life?
work throughout their whole career.” • What does it look like for you to live in a way that demonstrates

Dr. Shanafelt said that in one study, 37 percent of physicians re- those are the things you care about?
ported looking forward to retirement as an effective wellness strat-
egy. “This is the same thing as the survival mentality … and what The second set of questions:
was notable was that it was equally common to report that strategy • What are the things you care about in your professional life?
for those under the age of 40 as those who were older,” he said. “It’s • How are you devoting and spending your time to align with those
not just those who were actually getting closer to retirement.”
things?
It’s a mentality of “work now, when I retire I’ll get to personal
life,” he said. “Physicians usually are relying on things around being a healer,
teacher, making discoveries or operating a successful practice,”
Dr. Shanafelt said that one suggestion many researchers have Dr. Shanafelt said. “The thing I can guarantee you is that your
found to be a possible cause of physician burnout is “that we are two lists are incompatible and that you cannot achieve everything
also at inherently higher risk due to what they’ve coined the ‘physi- on those lists.”
cian personality,’” he said. “Now, this is where if I wasn’t a physician
myself you would start throwing rotten fruit.” “If I think that I’m going to be a world expert in my field,” he
said, “but never miss a soccer game to be away at study section, pre-
“They say … that the characteristics that define many doctors senting at a meeting, to be writing a grant or manuscript, that’s an
are doubt, guilt and an exaggerated sense of personal responsibil- unrealistic expectation. I will miss soccer games to make a difference
ity,” he said. “But these are the qualities that make you a good
physician. They lead you to be thorough, committed, leaving no
stone unturned, to always be thinking about Mrs. Jones and what
else I could do, what am I missing? How could we do a better job
taking care of her?”

“The qualities that make people good physicians are a double-
edged sword,” he said. “It’s those who are most dedicated to their
work who are at greatest risk to be most consumed by it.”

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