What's at the root of your physician burnout?

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burned out matchsticks

If you’re suffering from physician burnout, do you know what’s at the root of it?

Is it too many patient hours?

All the administrative hassles?

Could anxiety be a factor?

Or is medicine simply not the right fit?

We hear the word “burnout” all the time. It affects over half of all physicians at some point in their career.

While it’s true all the changes in healthcare and the EMR have A LOT to do with the alarming burnout statistics, they are not the whole story.

In order to address your own burnout (or dissatisfaction), it can be helpful to dig down and understand which factors may be contributing in your case. Then any efforts at a solution can be targeted to the actual issues.

Do any of these factors for burnout ring true for you?

Too much of a good thing
You like being a doctor. On a good day, you enjoy your patients and being able to make a difference in their lives. But seeing patients every day, day after day, with little time for anything else, has zapped your enthusiasm. If you could cut back your schedule and be able to recharge, you would look forward to seeing patients.

Buried alive under administrative tasks
You didn’t have to take a typing test to get into medical school, but you spend more time on a keyboard than with patients. The charting keeps you up at night and there are also emails to answer, calls to make, forms to fill out, RVU’s to meet, etc. Where’s the joy? This is hardly what you pictured being a doctor would be like

No respect
You feel like you’ve lost control over how you care for patients. You are no longer in charge of your schedule or even when you (or if) you eat. Online reviews and satisfaction scores are dictating care instead of good medicine. You feel your role as a physician is being disrespected and your experience and opinions don’t matter.

Groundhog Day
It’s hard to admit that after all that training and education you’re finding yourself bored with patient care. Training was hard, but there was always something new to learn and peers to interact with. Now it seems as if every day is the same and even though the work is stressful, you’re feeling bored and asking yourself, “Is this it?”

Home is not a rest-stop
After a hard day at work, you’re not able to come home and de-stress. You may have young children to care for or elderly parents. There may be marital issues or challenges with a teen. Finances or health issues may be weighing on you. Time you would have spent exercising and having some fun is taken up by other demands. You’re running on fumes with no gas station in sight.

Anxiety’s in the driver’s seat
You worry during your off-time about certain patients. You’re afraid of missing something or having a complication. It can be hard to make treatment decisions and you find yourself asking colleagues for advice. It’s hard to enjoy work with the worry and self-doubt. You sometimes feel like an imposter and wonder if you’re cut out to be a physician.

There’s a personality mismatch
You’re an introvert. Even though you like people and 1:1 interactions, it’s exhausting to see patients every 15 minutes all day long, 5 days a week. Having to “be on” and talking a lot with people wears you out. You prefer having time to think without interruption and not talking so much. You come home drained, with little left for your family or yourself.

The shoe doesn’t fit
Although medicine seemed like a good choice – you were good at science and genuinely wanted to help people but the actual practice of medicine is not for you. You may be successful, but this career doesn’t feel like the right fit for you.

Trauma from the past
Perhaps you had a difficult childhood with a parent who was narcissistic, alcoholic, or abusive in some way. Or maybe you had experiences in medical school or residency that were traumatic. If you haven’t had the chance to work through and heal from past traumas, they can make you more susceptible to burnout. They can also sometimes show up in the present, such as working for, or with, someone who resembles an abusive parent or another challenging individual from your past.

There are, of course, many other factors that contribute to physician burnout, but I have highlighted some of the ones I see commonly.

Writing this blog brought home for me a lot of the suffering I see in the lives of my physician clients and know is there for so many.

My hope is that if you’re feeling unhappy or burned out in medicine and at a loss as to how to address this big ball of wax, having clarity on possible causes will give you a starting point for possible changes.

When I was sorting through my own desire to leave medicine, a number of these factors were at play for me. I took a lot of time while still practicing (years) to address each of them until I was left with one – the shoe doesn’t fit.

In a weird way, this echoed my life because I have a really hard time finding shoes that fit.

But the good news is I found a great pair that I’ve been wearing for the past 10 years since I started The Doctor’s Crossing.

Every step I walk in them is a step I walk for you – to give you back that spring in your step where you’re walking towards what excites and fulfills you.

If there’s a way I can help you, that’s what I’m here for. You can comment on the post or reach me directly at heatherfork@gmail.com

‘Til next time,

Heather

If you would like recommendations for burnout based on your Enneagram Personality Type, you can read them here

Note- the blog is now being sent out on Thursday mornings ( instead of Wednesdays). 

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6 Comments

  1. Anonymous on August 25, 2019 at 7:32 pm

    Anonymous Comment from a physician who asked not to be identified.

    Watching the blowfly crawl over the glass, I’m relieved it’s silent, at least for now. That incessant buzzing and banging about. It grates. For me it began with irritation, about the little things. Like the sound of that fly, I ignored it. An insignificant distraction. So I thought. Time proved otherwise. Medicine. A privilege, a challenge, a responsibility. First, wonder, hope and fear, soon fatigue, apprehension, disillusionment. The long hours, yes, and, sadly, the boys club. The endless striving, silent endurance, repetition, constant proving. MD, MPH, PhD. Mountain climbing, it’s exhausting. Somewhere in there my humanity slipped its moorings. Then the guilt began. Shame and a sense of failure quickly followed. I’d lost something, something important. My patients and their stories kept me going. And a work ethic that only knew 5th gear. The buzzing got louder. Soon it was me banging against the glass. A bewildered insect in a huge jar, repeatedly seeking a way out. I began to notice the same behavior in a number of my colleagues. Each of us trying for surreptitiousness, none of us succeeding. A furtive look here, a knowing glance there. But no words. To speak the feeling felt dangerous. A betrayal. Membership of the medical club is hotly contested. And revered. To want out? Heresy. A sign of a flaw within the self, not the system. Survival, and silent adherence, a badge of honor. But at what cost? First step, stop flapping so hard. Next, breathe. From there, It didn’t necessarily get easier but, slowly, it did become more possible.

    • MMiller on August 27, 2019 at 4:10 am

      To “Anonymous”:
      Wow!
      This is the most beautiful and accurate description of the journey through my medical career. Thank you for your comment!

      • Heather Fork on August 27, 2019 at 3:12 pm

        I know! I totally agree. This eloquent writer has a true gift for metaphor and has captured her own experience in a way that transcends the personal and speaks for so physicians trying to figure it out and find their way.

    • Heather Fork on August 27, 2019 at 3:14 pm

      Thank you Anonymous for your incredibly beautiful comment and imagery that so aptly captures the struggles of so many other physicians. If you ever write a book, it will be a gift to all lucky enough to read your poetic and powerful prose.

  2. Tim Owolabi on September 21, 2019 at 3:39 pm

    Thanks for the relatable post Heather. As I have given myself permission not to accept burnout, I’m loving my new shoes 🙂 I echo the sentiments about the post from Anonymous. The imagery captures a feeling many of us unfortunately know well.

    • Heather Fork on September 22, 2019 at 2:31 am

      You’re most welcome Tim! Thank you for reading and commenting. Kudos to you for being proactive and changing your trajectory from burnout to loving what you do. We as physicians do not need to be victims of our circumstances. Anonymous did do a beautiful job at capturing the trap.. and she is also finding her way out. We are only trapped if we believe ourselves to be. Enjoy your new shoes and the dance as well.

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modupe

"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
Tim O

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
Lynette Charity

“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
Gail Miller

“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
Steve

“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
Sue Zimmermann

“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
Devki Patel

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
Jay Macregor

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
LI

“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
Amie

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
KB Karen Barnard Photo

"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
IMG_05-22-2021_9-11-9

"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
Camille Gardner-Beasley

"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
Anna testimonial

"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

Abbey

"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
Maria

"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
1

"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.

Reshma

"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

unnamed

"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