10 Physician Burnout Symptoms You Shouldn't Ignore
Takeaway: As a physician, you’re used to caring for others. So often, the realities of being a physician can lead to your own well-being getting put on the back burner. It’s important to keep an eye out for physician burnout symptoms. Once you're aware of burnout, you can take the necessary steps to feel like yourself again.
In this post, I share the common signs of physician burnout that I see in my practice as a clinical psychologist. I also discuss common contributing factors and the importance of addressing physician burnout.
It's no secret that practicing clinical medicine is a stressful job. As a medical provider, you experience an intense amount of pressure on a daily basis.
This is partly by design. Medical training conditions doctors to view stress and overwork as a “rite of passage.” While some stress ends after training, different stressors take their place:
A packed schedule with demanding hours
Frequent call shifts requiring you to be in two or more places at one time
Complex patients
Increasing caseload volumes
Fear of making medical errors
An unending flood of hospital bureaucratic tasks
...and so many more. It's no wonder that physicians feel stressed, overwhelmed, and burned out beyond belief.
Many physicians take pride in how much stress they can handle. Yet, chronic emotional and physical exhaustion often leads to burnout. When you're used to an intense work environment, early signs of burnout often go unnoticed.
Many physicians are also unaware of the vicarious trauma they carry from their jobs. Everyday parts of your role can be traumatizing, including:
Responding to a code
Delivering bad news
Emergency surgeries and procedures
Patients experiencing life-threatening symptoms
Ongoing exposure to traumatized patients
Traumatic patient outcomes
Patient deaths
To many, this kind of clinical work is part of their regular day in medical practice. Even in the "best" of circumstances, these events can lead to compassion fatigue. But no matter how routine they are, they are still traumatic nonetheless.
The COVID-19 pandemic brought even more stress and trauma to an already-overwhelmed workforce. Doctors on the frontlines were especially affected.
ICU physicians, ER physicians, family physicians, pulmonologists, and more faced significant pressure. You cared for critically ill patients while trying to survive a pandemic yourself. You also had the added stress of trying to protect your loved ones from your exposures at work.
All this stress and exhaustion can have costs on your personal and professional life. In my practice, I see many doctors like you struggle with burnout. The emotional and physical symptoms can take a toll on your sense of self.
It's important to keep a proactive eye on your well being. Yet, there are many systemic factors that are beyond any individual's control, including:
Burdensome use of EMRs
Pressures around medical documentation
Hospital-owned practice groups that focus on the bottom line over physician well-being
Employment in large physician groups that come with top-down pressures
Increased caseload volumes
But even with that said, there are things you can do to take charge of your life to combat your physician burnout.
The good news is that burnout isn't a life sentence. Education on the causes and symptoms of burnout is the first step. From here, you'll feel empowered to take action and get support to help yourself heal.
Everything you need to know about physician burnout
Working in healthcare can be rewarding. However, we know that it can be extremely stressful as well. Though any work environment can contribute to burnout, physicians are especially vulnerable.
Here, I define burnout and identify contributing factors for burnout amongst physicians. I also review some of the top signs that you might be burnt out.
What is burnout?
Burnout isn't a medical condition, but it can have serious negative impacts on your health.
The International Classification of Diseases (ICD-11) defines burnout as having three factors:
Emotional exhaustion
Negative feelings toward one's job
Decreased job performance
Alternative definitions include other dimensions of burnout. Increased cynicism and lowered sense of personal accomplishment are common. Existential dread, as well as reduced happiness and sense of meaning, are also common.
Burnout is more common among physicians than the general population. It impacts every type of medical provider, including:
Primary care physicians
General surgeons
Subspecialty surgeons (i.e., thoracic surgeons, otolaryngologists/ENTs, urologists, orthopedic surgeons, trauma surgeons)
Emergency physicians
Obstetrics/gynecology physicians (ob/gyns)
Hospitalists
General internal medicine residents
Family medicine physicians
…and more. Those on the "front lines" are especially at risk for developing burnout.
For many medical providers, burnout can be a confusing, anxiety-provoking, and isolating experience. Many providers experience it, though it's often not addressed in a meaningful way.
Beyond the occasional generic “wellness” programs, many physicians lack constructive outlets at work. Institutional resources are often devoted to patient experience, expanding market share, and inevitably implementing policies that directly or indirectly increase physician responsibility (e.g., EMRs with patient messaging systems, etc.).
You might also worry that your colleagues will judge you for experiencing burnout. This can prevent you from being honest about how you feel.
You might commiserate (i.e. "vent") with other physicians about miserable work conditions. But this doesn't actually address the root causes of physician burnout.
Lack of control over your patient workload and administrative responsibilities is stressful. In fact, research cites loss of autonomy as a potential cause of physician burnout.
Physicians must follow many different laws, rules, regulations, and guidelines. If your personal ethics or clinical judgment conflict, you might experience stress.
The COVID-19 pandemic added to existing stressors within the field of medicine. Studies show that physician burnout rates peaked during the winter of 2021-2022.
On top of intense career demands, many physicians feel isolated. This is a classic high-stress combination that can compound the effects of burnout.
What are the causes of physician burnout?
Medicine is an inherently stressful field with its intense schedule and high demands. Yet, there is no singular cause of physician burnout. Personal, occupational, environmental, and societal causes are all contributing factors.
Most physicians are hardworking, intelligent, and compassionate people. Many have sacrificed years of personal and financial well being during their training.
This is no accident. Those who enter medical practice often feel called to help others. While this is admirable, it can also lead to overextending oneself for the greater good.
10 common symptoms of physician burnout
Most people have likely heard of burnout before. Yet it can be difficult to identify it when you're experiencing it firsthand. While burnout can look different from person to person, these are some common signs.
Emotional exhaustion
As a therapist for doctors, I see how burnout drains physicians' emotional energy. Emotional exhaustion makes it difficult to maintain a positive energy balance. Operating at constant deficit can be completely depleting.
When left untreated, emotional exhaustion often leads to physical problems. It also bleeds into other parts of physicians' personal lives. When you feel drained, there's little to nothing left in the tank to share with your loved ones.
Difficulty maintaining healthy relationships
Lack of emotional energy can lead to relationship problems as well. When you have low emotional capacity, it is difficult to connect with your loved ones in a meaningful way. It's hard to make time for personal relationships when it feels like there is no time for yourself.
Burnout can also make it hard to manage people-pleasing tendencies. Maintaining healthy boundaries is difficult when you're used to caring for others.
Divorce trends among physicians are also concerning. Female physicians experience significantly higher rates of divorce than male counterparts. Long work hours are often to blame.
Compassion fatigue
Low emotional resources and exposure to traumatic medical cases can make you feel cynical or checked out of your work. This makes it difficult to have compassion for your patients.
Many providers find this alarming since they entered the field out of a desire to help people. For many medical professionals, compassion fatigue impacts both their professional and personal identities.
Cynicism
Increased cynicism is a classic sign of physician burnout. Cynicism can make you feel disillusioned, withdrawn, grumpy, and frustrated. You might also feel detached from coworkers, patients, and even practicing medicine altogether.
You may notice getting more snarky at work or having thoughts like, "What's the point of this, anyway?". You might feel robotic, as if you're going through the motions, and impatient with those around you at work.
Many outcomes are not in your control in medicine. You may be able to direct a patient's care or treatment plan, but those plans can often get derailed. Insurance networks, lack of coverage, and patient noncompliance can all interfere.
All these stressors can feel understandably disheartening and wear on you over time. Cynicism and burnout make it hard to appreciate the value of your work. This makes it feel like despite how hard you try, it isn’t making a difference.
Loss of inspiration and curiosity
Burnout makes it hard to feel inspired and curious about your work and your life. Burnout makes it harder to meet the demands of the day, leaving little left in the tank for anything extra. You don’t get around to looking up topics or advances in areas of your practice that used to interest you.
Without time or energy to learn, you may feel frustrated by new clinical situations. Part of the joy of medicine is lifelong learning and helping advance the field of treatment. Instead, all you have time for is perfunctory CME credits.
Depression and anxiety
Society often regards physicians as “inherently” successful given how hard they have worked. As a result, many physicians struggle with stigma when facing depression and anxiety.
These inaccurate and harmful beliefs around successful people can make spotting symptoms difficult. Some common symptoms of mental health issues include:
Sadness
Lack of interest
Loss of meaning and purpose in life
Feelings of hopelessness and worthlessness
Sleep and eating disturbances
Since society holds physicians to such high standards, it can be hard to reach out for help. This can delay treatment, which can make the problem worse over time.
In fact, many physicians fear professional repercussions when seeking care. Confidentiality concerns lead many physicians to pay for care without using health insurance. In my practice as a clinical psychologist, I emphasize the utmost confidentiality.
Low sense of personal accomplishment
Reduced sense of personal accomplishment is one of the hallmark indicators of burnout. It can be difficult to get through the day when you feel like your work is unsatisfying or meaningless. This is especially true if your work is a central part of your identity.
Loss of interest in hobbies or activities
As you know, anhedonia is a loss of interest or pleasure in activities you used to enjoy. This is a common sign of both burnout and depression.
Exhaustion associated with burnout can also deplete your energy. This makes it difficult to find energy for activities outside of work.
Misplaced frustration
Emotions have a way of making themselves known, even when you try to suppress or avoid them. Acknowledging the stress and frustration you feel from work can be difficult. This makes it bubble up in unexpected ways.
For example, you might experience road rage or pick a fight with a loved one. You might also get more upset about smaller stressors that may not usually bother you.
Physical signs of burnout
Besides the mental and emotional toll of burnout, there are many physical manifestations. Muscle tension, headaches, and changes in sleep habits are a few health impacts of burnout.
As you know, exhaustion, sleep loss, and chronic stress suppress the immune system. This makes a person even more prone to illness. This can be especially prevalent for physicians working on a shift schedule.
As a physician, you counsel patients on the importance of healthy lifestyle choices. You devote all your time and energy to getting through the day or night shift. However, this can often compel you to make less-than-optimal choices around your own health.
Systemic implications of burnout
Physician burnout can have systemic impacts as well. In fact, neglecting burnout can lead to lower patient satisfaction.
One study of physicians in an internal medicine residency program demonstrates this. Researchers used the Maslach Burnout Inventory to measure symptoms. Physicians who met the criteria for burnout reported suboptimal patient care more often.
Major medical errors are strongly correlated to a physician’s level of burnout. So, addressing burnout may help reduce medical errors and lead to better outcomes for patients.
Studies also link low job satisfaction to higher levels of burnout. Future research should focus on burnout prevention. Research should also focus on physician job satisfaction and provider mental health.
Medical education programs must also provide more burnout awareness, education, and prevention. Many physicians didn't receive information or validation around burnout in their medical education.
If anything, medical school and residency training already laid the ground for burnout. It's essential that physicians are taught life balance skills in training. This can be a powerful way to prevent physician burnout.
I'm experiencing physician burnout. Now what?
You might expect me to lay out a list of coping strategies to address burnout. However, I would imagine that any physician reading this has already seen tons of lists like this.
These lists might become yet another "thing" that you're "supposed to do." If you don't, you might feel like it's your fault-and still feel burnt out.
You might have even already tried all the coping skills you can find. For one valid reason or another, these strategies fail to address burnout in a meaningful way.
At best, your attempts at implementing these coping strategies may have helped temporarily. Usually, many physicians feel they are impossible to implement. After all, they require time and energy to use long-term.
These simplistic coping strategies are not a solution to physician burnout. Receiving this messaging can increase frustration, overwhelm, hopelessness, and cynicism. Over time, this further reinforces physician burnout.
Yes, these coping strategies can be valuable and necessary. But, they are insufficient alone for reducing physician burnout. We should not confuse "self care strategies" with combatting physician burnout. Yes, self care may be a part of addressing your physician burnout, but it is almost never the full story.
Physician burnout is complex and individual
Unfortunately, there is no one size fits all solution for treating physician burnout. Many healthcare professionals experience similar stressors. Yet, each provider has different values, needs, and preferences. This makes their burnout recovery journey unique. It's critical to find what works for you.
I'm a clinical psychologist who specializes in treating physician burnout, so I see firsthand how burnout is a deeper, individualized phenomenon. In my work with clients, we address two core tenets to support burnout recovery: inner happiness and meaning-making in one's life.
How to address physician burnout
The antidote to burnout is not self-care strategies alone. Yes, they may be necessary, but they aren't enough.
Physicians place an incredible amount of weight on their medical careers. It's often their primary source of meaning, purpose, fulfillment and self worth. This is an ideal recipe for staying in a burned-out state!
The true antidote to physician burnout is enriching your life beyond medicine.
Taking an active interest in your own life outside of medicine is not simple. It's almost always difficult and oftentimes painful work.
This is especially true for physicians. You have been so used to tying your self worth and identity to your medical career. This makes it difficult to focus on your own needs.
It requires deeper introspection, inner work, and more fundamental personal changes that no institutional or organizational efforts can provide, which usually only target symptoms at best (as we’ve already seen—reference back to all the coping strategy lists you've likely already gotten worksheets and handouts for at physician wellness grand rounds or CME talks!).
In fact, these institutional efforts can often come with harmful implicit messages. You hear that you should be more "resilient" and “efficient" in the face of increasing workload.
The bottom line is that you need more time and energy for yourself to combat burnout. Everything else ripples out from there. Ultimately, no organization or employer is going to do this work for you.
You have to take interest and initiative in your own life, and that requires personal work.
Importance of happiness and meaning in reducing burnout
Addressing burnout in a more fundamental and meaningful way often requires deep personal work. It's essential to implement changes to increase happiness and meaning in your life. In fact, you can find true well-being at the intersection of happiness and meaning.
Both are necessary—and one without the other is insufficient. It can be helpful to illustrate what one without the other looks and feels like.
Happiness without meaning is the in-the-moment, feel-good stuff. Think binge-watching Netflix or eating a tub of ice cream in front of the TV.
These activities masquerade as self care. They might feel good in the moment (and, yes, no one thing is "bad"), making a habit of these things can hurt us in the long-term.
On the other side of the coin, you have meaning without happiness. This can look like many things, but one huge example is caregiving at the expense of prioritizing self-care.. This is something that parents often describe struggling with.
Meaning without happiness has a direct analog to the physician experience. Medicine tends to attract compassionate people with a deep sense of career-related purpose. But for so many physicians who experience burnout, this can come at the expense of one’s own well-being and life.
In fact, meaning without happiness often exemplifies the experience of physician burnout. It can also serve as further rationalization for staying in a burned out state. When you derive meaning from your job above all else but feel continually unhappy, you stay burnt out.
You've spent so much time and energy dedicated to your medical career. This can make you feel like you've lost permission to take interest in your own life.
Sometimes when you have free time, you might even feel like you don't know "what to do” with it. This can be a two-way relationship–you might avoid carving our free time unless you've done the deep work to unpack this all.
Creating a deeper foundation of meaning and purpose outside of medicine is vital. In fact, building emotional awareness and emotional intelligence can have direct impacts on increasing your well-being. From here, you can focus on time, relationships, and freedom within and beyond medicine. Therapy to address your physician burnout can help with this.
Physician counseling can help you heal from burnout
Burnout can make it feel impossible to devote time and energy toward your own well-being. Yet, it's essential for your recovery process.
Burnout is unique to each individual, despite many commonalities among people’s experiences. Everyone's job is different. Everyone's life is different. Everyone's relationships and past experiences are different. No checklist is going to address the unique aspects of your life.
Burnout is a serious issue, and it requires time and effort to address. This time and effort is necessary to acknowledge what is unique in your life and to you as a whole human being.
Yes, systematic change is necessary to fundamentally prevent and treat physician burnout. However, addressing your own burnout is still a priority. It is fixable and improvable.
Counseling for physicians helps you discover your personal patterns that contribute to burnout. It can also empower you to advocate for yourself (both in your personal and professional life).
As a clinical psychologist specializing in physician burnout, I tailor my approach to each individual. I take your unique struggles, strengths, experiences, and realities into account.
Interested in learning more? I encourage you to reach out to schedule a free consultation. Burnout doesn't have to be your default way of living anymore. Together, we can make real, lasting change and help you find more meaning and fulfillment in your personal and professional life.