Spit If You Think You Have Burnout!

But let me duck first!

Your saliva may predict whether or not you might be at high risk for burnout, according to researchers in Montreal, as reported in Psychoneuroendocrinology.

By analyzing a sample of spit, abnormally low levels of the stress hormone cortisol can be detected – a red flag for impending burnout.

Dr. Robert-Paul Juster, one of the investigators said, “This could have very strong implications in terms of helping to prevent burnout.”

Under acute stress, elevated levels of cortisol can be detected in the saliva. However, during chronic stress, which can precipitate burnout, cortisol levels actually drop significantly.

And what if you are confused about whether you have depression or burnout?

Cortisol tends to be high in those with depression, and low in individuals suffering from burnout. The saliva test may help to differentiate these two conditions, which can have overlapping symptoms.

If an individual with burnout is treated with antidepressants, this can be a therapeutic mistake, Juster said, since one of the effects of antidepressants is to lower cortisol levels.

“Great!” You may be thinking. “A test to predict those at risk for burnout. Use that for medical students; I’m already burned out.”

I find that a lot of doctors feel burned out, but have not been given much, if any, information on burnout and what can be done. Because burnout occurs in stages, and has a variety of symptoms and causes, there are no simple “one-size fits all” explanations or pat remedies.

But there are some fundamentals we can begin with.

In a nutshell, burnout is the experience of long-term exhaustion and diminished interest.

Burnout has 3 main components:

Emotional Exhaustion – those in the helping professions who deal with illness and death are especially at risk. No surprises here.
Depersonalization – people are seen more as objects; cynicism develops, and there is a tendency to isolate.
Decreased Personal Accomplishment – work becomes less satisfying; there is joyless striving.

If you are feeling emotionally drained, have difficulty being empathetic towards your patients, and dread going to work, you may be on the road to burnout.

Dr. Tait Shanafelt, director of Mayo Clinic’s Physician Well-Being program, has reported that at any given time, 1 in 3 physicians is experiencing burnout.

Do you feel like you might be that 1 in 3 with burnout? Here is a 1 minute online survey you can take to assess your degree of burnout. Please note that this is a non-validated assessment. The gold standard for assessing burnout is the Maslach Burnout Inventory, which is used in most of the studies on burnout.

In my next blog I will be discussing some of the causes of burnout. Feel free to post a comment on your own experience with burnout.

Latest Posts

Episode #207: Breaking Free from Comparitis: How to Stop Comparing and Start Thriving

Finding My True Self at the Dump: A Cardiologist’s Coming-of-Age Story – By Dr. Michelle Grenier, Pediatric Cardiologist

Episode #206: When Being a Caregiver Means You’re Neglecting Yourself: Key Advice From A Palliative Medicine Physician

Find what you're looking for:

Popular Categories:

Career Change | Career Enhancement | Job Search | Personal Development

Posted in personal development

Heather Fork

2 Comments

Michelle on March 25, 2018 at 11:54 am

Hello, my psychologist says antidepressants don’t help with my level of burnout. My GP savoys that he is not wanting to put me on any again as he has tried everything except lithium and I am antidepressant resistant. I’m feeling beyond being able to be helped. Since I was on antidepressants for many years – which stopped working so I stopped taking them and felt a lot better for a time – I am wondering if antidepressants won’t help me. If I were not previously depressed and I now have burnout then I would think depression is part of the process, however, I was previously depressed. I am struggling to see another day. It is so deep at the moment that my previous psychologist (I’ve moved towns) is worried I won’t make it. Can you advise on if you think I should try antidepressants now, in my state?

Reply
- Heather Fork on March 25, 2018 at 2:42 pm
  
  Hello Michelle, I am so sorry that you are experiencing such a difficult time and there is confusion about what is the best approach to your burnout and depression. I do apologize that I am not able to advise you on whether or not you should try antidepressants this time. I would recommend seeing someone who is an expert in this area, preferably a practitioner with a lot of experience in burnout and depression. Sometimes it is hard tell which is primary, but reducing one’s work responsibilities if possible can be helpful in teasing apart how much is burnout and how much is pure depression. Without fully knowing all the details of your situation it is impossible to tell. Are you currently practicing medicine? Please try to find the best professional to help you whom you trust and feel understands what you are dealing with. I’ll be thinking of you and hoping for some positive changes. Please feel free to keep us posted.
  
  Reply

"Heather’s approach was great! She would listen to me and helped me appreciate who I am."

I remember when she said ‘do your resume before our next meeting’, I was about to push back but she gently nudged me along and I’m glad I did exactly what she wanted me to do. We also did interview prep via Zoom and I was offered a great job in UM. She has continued to follow up even after I was offered this job, helping me with pointers about negotiating. I will totally recommend the Doctors Crossing and Heather to anyone feeling stuck like me and looking for a great coach! Thank you Heather!

- Modupe Oladeinde, MD

Family Medicine

“The coaching I have had with you has been life changing."

You helped me find the courage to seek out leadership positions and become a medical director as well as a physician advisor. I am grateful we crossed paths and am a different person because of it. You have inspired me to "believe" in spite of my inner skeptic. I consider you one of my most important mentors and am proud to also call you a friend. This says a lot given the apprehension I felt when I took a chance with our first coaching session. Even though I have already made a successful transition, I still value your ongoing mentorship and can enthusiastically attest that the value of your services is tremendous!

- Tim Owolabi, MD

Family Medicine

“I was at a crossroads in my medical career. I asked myself, "Do I stay or do I go?"

I met Heather at the SEAK conference. She and I revisited this question. Did I want to quit being medicine completely? She helped me to identify my needs, wants, and my vision for my FUTURE, not just in medicine, but in life!!!

She was able to listen to my "ramblings" about becoming a stand-up comic, lounge singer and voice-over actor and translate them into action steps. I chose to become a composite of all of these. Now I am a more confident, healthier, happier person. I credit this in its entirety to the tutelage I have received and continue to receive from Heather. She cares. She listens. She was there for ME. She will be there for YOU!

- Lynette Charity, MD

Anesthesiologist

“I am forever grateful to Heather for helping me to recognize, I am more than just my M.D."

Heather helped me understand that I am more than just a doctor and that my experiences in clinical medicine are valuable in so many arenas. As a result I realized that there are other ways to use my background, still be able to help people and continue to challenge myself and grow. To that end I discovered coaching - specifically health coaching. I am on my journey becoming a health coach and truly loving it!

- Gail Miller, MD

OB/Gyn physician

“Thank you, Heather, for helping me transform my career, my faith and my life."

What started out as an initial thirty-minute consultation call turned into an amazing four-year journey that transformed my life, personally, spiritually and professionally.

Heather helped me to discover my passions...by doing so, I discovered I still had a calling for medicine but it now came from a place of truth...

Today...my wife and I are opening our first concierge medicine clinic in a community we love. I’m actually excited to have the opportunity to practice medicine the way I believe it’s meant to be, with a focus on the doctor-patient relationship and an emphasis on faith. I know if I had not reached out to Dr. Fork, my life would not be where it is at today.

- Steve Lapke, MD

Papillion, NE

“Heather gave me the confidence to create a new livelihood by following my heart."

She is incredibly knowledgeable about the range of careers available to physicians and provided me with advice and connections which I would not have found on my own. From the start she encouraged me to step out of my comfort zone and try different things. I was laid off unexpectedly in early 2017, and Heather gave me the confidence to create a new livelihood by following my heart and making decisions based on trust, not fear. Now I am enjoying working part-time in a clinical setting in addition to teaching and writing.

- Sue Zimmermann, MD

Orthopedic Surgeon

“After months of struggling to find a non-clinical career that matched my values and passion, I stumbled upon Heather's website which truly changed my life."

Heather's insightful and personalized approach to career coaching made me think outside the box since she took the time to evaluate my personality, values, interests, and preferred lifestyle.

Through her encouragement, practical advice, and professional connections, I was able to find a non-clinical position at a state Medicaid agency that aligned with my passion for population health and serving low-income communities. In addition to her coaching sessions, Heather has built a community of like-minded physicians through her blog, and I feel honored to recommend her to friends and colleagues who seek to make positive changes in their professional and personal lives.

- Devki Patel, MD

Pathologist

“Working with Heather ultimately helped me leave my job in corporate healthcare and find a path that was much more fulfilling."

My career was going reasonably well but I couldn’t shake this nagging feeling I could do better; or at least find a better long-term career fit.

I was able to find a surgery job that better aligned with my goals and professional interests. Additionally, Heather helped me start a consulting business which has allowed me to pursue a true passion: helping medical students, residents, and attendings surgeons navigate the challenges of high-stakes standardized exams.

If you are reading this as a “Type A” surgeon who doesn’t think coaching is for you, I would encourage you to give Heather a shot. I’m very glad I did!

- Jay MacGregor, MD

Colorectal Surgeon

“I gained the confidence in myself to develop an action plan that blended the best parts of my experiences and interests into a cohesive career."

Through our work, I learned to trust myself to make good decisions for my own future – something I hadn’t realized I was struggling with because as an emergency physician, I make life-changing decisions with patients every day.

By feeding my creativity and interests in other realms of my professional life, I’ve found renewed compassion for my patients and myself, making every shift an opportunity to actually care for people. Thank you Heather. I really couldn’t have made these changes without your help!

- Liz McMurtry, DO

Emergency Medicine Physician

“The simple truth is - Heather Fork totally helped me change my life."

I never would have had the courage to make the changes I’ve made without her unwavering support, wealth of knowledge and commitment.

When I first started working with Heather, I was downtrodden...I’d been practicing medicine for 20+ years and yet had never quite found my place. During the first year I worked with Heather, I left the practice I’d been working at, and recreated an entirely new professional purpose.

I’m now an executive and leadership coach, a university professor, and a Brené Brown Daring Way facilitator, and I have never looked back. I love what I am doing more than at any other time in my professional life and I credit Heather with seeing in me what I was never able to see in myself, until now.

Don’t hesitate, don’t doubt yourself, schedule your time with Heather as soon as possible- she can help you reconnect to your purpose and reinvent your life.

- Amie Langbein, DO

Family Physician

"After 30 years in academic medicine, I wanted a career change but had no idea where to start. Medicine was all I knew."

I signed up for coaching with Heather and it transformed my life. She helped me get clear on what I wanted my life to look like. We reviewed my skills, values, and strengths. She instilled hope in me that change IS possible after 50 years!

The outcome is that I have created a life I love! I practice endocrinology part-time and own a life coaching business! Coaching with Heather is one of the best investments I have made in my life.

- Karen Barnard, MBBCh, MPH

Endocrinologist and Life Coach

"Heather was my source of hope during a time when I felt stuck and confused. She gave me the permission and confidence to reach higher than I believed I could."

After graduating from residency and starting a family, I lost sight of why I became a physician. I struggled to convince myself to stay in a career that was clearly the wrong fit for me and my family. My anxiety about work was at an all-time high when I reached out to Heather. She provided something that my mentors, friends, and family could not – rather than just offering career advice, she changed the way I think about my life so that I could understand how my career would fit into it. I realized I wasn’t ready to give up on medicine and eventually found a job in academic medicine. I finally feel that excitement for medicine that I used to feel when I was in training. More importantly, I feel like I can be the role model to my young daughter who may one day also face similar challenges between career and family. Thank you, Heather, for all your kindness, support, and skillful coaching! The experience was life-changing!

- Yuri Shindo, MD

Internal Medicine Physician

"As a Physician, your personal and even professional needs are often overlooked. I learned how to prioritize my career goals by working with Dr. Heather Fork."

She taught me how to put into practice what I knew in theory, that taking care of myself was a priority. I learned to give myself permission to make the career choices that would give me the work-life balance I desperately craved and needed. The process of confronting fears and insecurities was a bit scary, but well worth it in the end. I am now a happier version of myself with a non-clinical job that I truly enjoy!

- Camille Gardner-Beasley, MD

Family Medicine

"After 10 years in outpatient family medicine I felt stuck and knew I needed a change but I didn’t know where to begin. Thankfully I found Heather and she guided me every step of the way."

She helped me carefully assess my interests, strengths and passions while also providing me with constructive changes to implement in my job search and resume. With Heather’s help, I just landed a fully remote UM position and I am also exploring coaching as well. Now I feel like the possibilities are endless and I’m excited for this next chapter in the nonclinical world! Thank you Heather for changing my life for the better.

- Ana Jacobellis, DO

"I'm truly thankful to have had the opportunity to be coached by Heather, she is not only a resourceful mentor but a wise and supportive friend. I'm honored to recommend Heather to all my friends and colleagues."

I had been a practicing Internist for 20 years when I reached a point when I needed to make a serious change in my career path. While I enjoyed seeing patients, I was not satisfied with my life-work balance. My job was taking me away from my family and left me little time and energy to do other things that are important and meaningful to me. I came across Dr. Fork's podcast; The Doctor's Crossing Carpe Diem Podcast, it is such an informative and enjoyable podcast for any physician who wants to do more with their career and life in general. Then I had the pleasure to get career coaching from Heather, it was truly an amazing experience. Heather has broad knowledge of all the different career paths that are available for physicians, she is so insightful and very easy to talk to. She helped me clarify my goals, examine my own mindset and definition of success. Together we developed a clear plan and actionable steps to reach these goals. I eventually made a career transition to a remote non-clinical position that allows me to do meaningful work which aligns with my personal and professional goals and priorities.

- Abbey Awad, MD

Internal Medicine

"There have been a handful of people who have come into my life and changed it, and Heather is one of those people."

From the very first interaction with Heather, it became abundantly clear that she possessed a systematic approach and a methodology firmly rooted in my focusing on my goals and aspirations. Heather's coaching sessions helped me dismantle limiting beliefs and unearth the capable woman, mother, and physician within me. Under Heather's guidance, I began to dream again. I rediscovered my passion for writing, found the courage to share my stories, and even launched my own coaching practice. Today, I specialize in helping others conquer imposter syndrome and overcome burnout, empowering them to lead meaningful and fulfilling lives. Working with Heather fundamentally shifted my perspective and allowed me to show up authentically in every facet of my life, resulting in a profound sense of fulfillment.

I am deeply grateful that I can continue my work in the emergency department and serve my community as a physician as well as a coach. Working with Heather was a transformative gift that enabled me to rediscover my true self, find clarity in my life's purpose, and unlock my full potential. Through her guidance, I not only reignited the powerful, confident, and bold version of myself I had lost sight of but also realized the boundless possibilities that lay ahead.

- Maria Dominguez

Emergency physician and coach

"I'm so glad that I worked with Heather last year."

Making a career shift can be a lonely time, and Heather was there every step of the way with encouraging words. She helped me gain a better understanding of the breadth of careers available to physicians, as well as giving me the tools to make that leap possible. My life is better than I ever thought possible. I'm happier, healthier and doing work that I love. My only regret is that I didn't do this sooner.

Caitlin M.

"Heather provided invaluable insight during our one-time consultation."

She quickly helped me recognize an area where I was limiting myself and encouraged me to explore new possibilities. Her sound and supportive guidance empowered me to take the next steps in launching my parent coaching services. I’m grateful for her support and highly recommend her expertise!

Reshma Shah MD, MPH

"Heather taught me that 'the truth will set you free'."

I sought Heather’s guidance after practicing outpatient internal medicine for many years, as it was getting difficult to balance my role as a clinician while meeting my needs and those of my family. After our first consultation, I felt like I was seen and heard for the first time in my career. Working with Heather helped me identify my strengths, weaknesses, fears, and goals, and ultimately guided me to a non-clinical role that better aligned with my needs and aspirations. I am deeply indebted to Heather for the impact she has had on my personal and professional development. She is one of the most influential people in my life and I continue to seek her guidance years after our initial encounter. She once said that “we are happiest and most successful when we are using our skills and abilities at their highest level.” Heather will help you discover your truth. Thank you for your incredible work and friendship!

Megan Leivant, MD

Internal Medicine