Over 56% of doctors are burned out now more than ever. However, Burnout is preventable and reversible, and I’m going to explain why.
For those who want the unabridged version of this discussion, you can read about my journey from burnout to bliss in my memoir, Right Brain Rescue.
Burnout has seeped into every career. It’s not just the obvious: doctors, nurses, PAs, paramedics, teachers. Every industry is suffering from burnout. Although we may feel like it happens all of a sudden (like it in the pandemic), burnout happens insidiously.
If we continue this conversation openly and become aware of early signs and symptoms, we can hope to combat this global epidemic.
Burnout is a state of mind that is not only psychological behavioral, but also neurochemical.
Depersonalization is that feeling when you are so far removed from whatever your company’s mission or goal is. You’ve lost the original intention of the career you signed up for. Now, it feels like you don’t have any personal voice; your opinion doesn’t matter. You’ve suggested ways to improve your company’s systems, you’ve sat in committee meetings and focus groups, and yet…. you’ve watched nothing change to make your daily grind less….grindy. As a result, you feel a deep sense of loss of agency and autonomy.
This is straightforward. Ask any parent of a newborn and they’ll know what emotional exhaustion feels like. Emotional exhaustion is when you feel depleted. You’re running on empty. In the case of burnout with your job, you feel the Sunday night dread creep into Sunday afternoon. You rue the idea of getting up for work the next morning because it’s another week of pouring from an empty cup without any more drops to give.
Maslow’s hierarchy of needs states that Self-Actualization is the drive for most humankind. Seeking new horizons might not be everyone’s goal, but most of us want some personal stake in what we’ve contributed on this earth. Low perceived personal achievement means that no matter what you do or how much harder you work, it is not making any measurable difference. You don’t feel like you’re contributing and you don’t feel like you’re achieving anything. Basically, you feel disconnected from your life’s purpose.
When our worth is measured in metrics that don’t align with our values, it’s the perfect recipe for burnout. We aren’t allowed to be unique in medicine. Instead, we are asked to increase speed, efficiency, and patient volume. When I was a second year medical student, the attending physicians didn’t have to explain the latest Google search or compete with extra decisions thrust in their workday.
Before the availability of internet medical knowledge and electronic medical records, I remember watching physicians in awe because they were moving effortlessly throughout their day. They knew their patients well, they understood the family that they were serving. Each clinic team member worked within their role as one cohesive unit: the nurses, doctors, and front staff anticipated the needs of the other.
What I was witnessing was daily flow state.
We’re more likely to get into a flow state when we have high value tasks. Tasks that we are trained to do that are unique to whatever our job is. These are things like making medical decisions on which tests to order, what antibiotics to prescribe, how to deliver unfortunate news to patients. It aligns with the core values and the mission of WHY we’re doing our job. And that gets us into flow!
Low value tasks are things that don’t, they’re just busy work. These are things like entering orders in by hand, clicking a dozen boxes, bouncing messages back and forth, etc. In medical careers, we’re taught that you do the busy work to get to this flow state. You’re a lowly medical student running labs to the basement, then you’re an intern doing pre-rounds before the resident at 5am, etc. Eventually, your reward was supposed to be as The Attending, master of all. And yet, we are masters of none.
A modern day as a primary care doctor is filled with low value tasks. We go to work, we open our computer. Perhaps there’s a new electronic medical upgrade that we have to then reorient our old pattern of clicking through boxes. Our team members aren’t allowed to sign refills, accept verbal orders, or help in other ways to grease the flow wheels of a doctor’s day. There’s no flow in medicine. Instead, our clinic days are fragmented and so compartmentalized that the physician is required to oversee nearly twelve EMR categories (between messages, cosigns, referrals, etc) to get their work completed. And many never finish. Instead, they leave their flow-less job in a burned out state to continue clicking and typing on their EMR at home.
The clues are there, but we may not always connect the dots, which is why I’m so passionate about speaking at conferences, hospitals and other industries just to explain what burnout feels like. Once we learn how to recognize it, and how to tap into flow state again, then we can brainstorm solutions to change the culture of healthcare and industries beyond.
Burnout is not the result of a poor work ethic, a bad boss, the fact that you’re not resilient, you didn’t do as many yoga downward dogs, or didn’t sip enough wine. None of that is going to cure burnout.
Burnout is loss of autonomy. You have no agency, no personal achievement, emotional exhaustion and a complete disconnect from your mission. The core root of burnout is loss of flow. The antidote to burnout is Creative Flow State.
Creative Flow State is a neurochemical state in your brain when all five neurochemicals of happiness are produced:
Some examples are downhill skiing, playing violin or performing surgery. But you can also get into flow state from balancing a checkbook or playing Sudoku.
Every career gets into flow state! It’s similar to an autopilot sensation where you feel like you’re just in that zone and it’s motivating. It’s any time that you’re using all your senses and you’re engaged in an activity that feels equally matched to your skills.
The best part is that these neurochemicals feel good and their effect is long lasting even after that activity has ceased. The goal for every career is to sharpen your skills enough to drop you into flow as soon as possible. Your brain doesn’t have to “think” so hard at the daily tasks of your job, so you can allow some fluid improvisation. You are able to “play” with variations within your day.
You know you’re successful when you are enjoying the day, just for enjoyment’s sake. Flow state is an autotelic state; the actual event is motivating enough to keep doing it. The activity is the reward.
Part of leveraging your ability to dip into flow state is understanding the deeper neurochemistry of our brain. We need to prune back activities that don’t serve us. Those mundane, low value tasks. This includes both work and personal life. When we eliminate these meaningless tasks, we unlock new levels of energy to carry out our daily activities at higher levels.
Healthcare professionals need to reclaim higher value tasks that are involved in the daily delivery of medical care. They must find ways for the doctors, nurses, etc. to do what they are trained to do. Maybe then we can teach our students, our residents and our attendings how to dip back into flow state and do the beautiful, creative healing that is our purpose.
Watch a replay of Episode 02 of Right Brain Recess! Don’t forget to watch LIVE on Facebook, Instagram, YouTube or LinkedIn at 8:00AM CST on Mondays.
My goal is to transform medical education by incorporating this self-preservation education. I want to teach our healers how they can learn to access their creative flow state to bring that back in medicine and have more autonomy, more joy, and less stress.
This is why I enrolled in Steven Kotler’s Flow Genome Institute as a flow trainer. It’s an intense 18-week course to learn the research behind neurochemistry so I can incorporate this in my teachings, in my speaking and in my mentorship for other colleagues.
You can join me in learning as I post on Facebook, Instagram and YouTube. And if you’re a medical professional, please join my Facebook group, Creative Medical Professionals. It’s a playground for those interested in bringing art back into the healing arts.
I am a Functional Medicine Physician, Speaker, Author and Mentor located in Monroe, WI.
This episode also addresses the challenge of measuring transformation in functional medicine, where data is not always the best indicator of success.
Dr. Salyer and Jill explore themes of personal growth, the enduring bond of friendship, and the courage to pursue one’s passions.
Dr. Mushtaq sheds light on the epidemic of “busy brain syndrome”—a cluster of symptoms including difficulty focusing, anxiety, and insomnia, which she attributes to chronic stress and neuroinflammation.
