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Physicians Can Manage Burnout

Julie Wei, MD

Feeling stressed out in the clinic or in medical school? You aren’t alone. Up to two-thirds of otolaryngologists have self-reported moderate to high degrees of burnout. Burnout isn’t unique to ENT physicians. Between 300 and 400 physicians commit suicide every year due to depression, feelings of hopelessness, and persistent, extreme stress. Residents and medical students also are committing suicide due to burnout.

“I was almost one of them,” said Julie Wei, MD, surgeon-in-chief and chief of otolaryngology at Nemours Children’s Hospital in Orlando, FL. “For many months in 2009 and 2010, I had rare but extreme negative thoughts, and was at times praying for cancer so that I could get out of my life as I experienced it. I was exhausted all the time, in physical pain, did not feel joy in my work, and didn’t know how I was going to be able to get up the next morning and stumble my way back onto the hamster wheel.

“My life seemed great from the outside, but I felt like I could barely hold it together. My patients didn’t suffer, but my marriage suffered, my body suffered, my young daughter suffered from having a mother who wasn’t well. I felt hopeless, but didn’t understand why.”

Dr. Wei didn’t get cancer, didn’t kill herself, and didn’t get divorced. She got help and helped herself. A few days at an AAMC Mid-Career Women Faculty Leadership Development Conference and travelling to other institutions gave her time for reflection. She rediscovered the passion that had led her into pediatric otolaryngology in the first place—and realized she was experiencing all the symptoms of burnout.

“I figured out that I didn’t have to be a victim of my own life,” she said. “And that’s what burnout is, feeling like you are the victim of your life and profession. The pressures to exceed in medical school, to get the very best grades and recommendations so you can get into one of the most selective specialties in medicine—otolaryngology—the pressure to be a super hero, the pressure to never fall behind in your electronic charting, the pressure to see more patients. It’s all designed to grind you down, to kick you into survival mode. You can manage those pressures by changing your perspective and taking control of your professional and personal life instead of letting life take control of you.”

Dr. Wei explored her own journey away from burnout on Sept. 11 during “Career Burnout: Identification and Strategies to Minimize,” a course she has given annually since 2012. She included insights from her own experiences as well as the latest research finding on managing burnout from the Mayo Clinic, Stanford Medical School, and other sources.

There is no simple solution to burnout, she emphasized. The pressures of ENT practice, declining reimbursement, electronic medical record drudgery, regulatory restrictions, expectations of perfection from all, including physicians themselves, and other pressures show no signs of changing. What can change is the way individuals perceive and react to those pressures.

One of the easiest steps is to write down your perfect day. For Dr. Wei, that meant starting every day eating breakfast with her husband and daughter.

“That one decision did two things,” she explained. “It forced me to start setting my own priorities and live with “awareness so that I am conscious about self-care and my day-to-day schedule, and what was not negotiable. I learned to create rituals that put me in control. Once you learn to set priorities in one part of your life, it is easier to set other priorities. When you stop feeling like a victim, you can manage burnout.”

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