The World Health Organization defines burnout as “a syndrome resulting from chronic workplace stress that has not been successfully managed.” Physicians and other healthcare professionals are particularly at risk. A study presented in the December 2015 issue of the Mayo Clinic Proceedings showed a 10 percent rise in burnout rates among physicians to 54.4 percent from 45.5 percent from 2011 to 2014.
Clark Gaither, MD, FAAFP, is the medical director of the North Carolina Professionals Health Program (NCPHP). In a blog post for the NCPHP, Dr. Gaither described three well-known hallmarks of job-related burnout.
- Emotional Exhaustion: A feeling of being emotionally depleted to the point where you feel you can no longer give of yourself at an emotional or psychological level to your company or the people you serve. Burned-out individuals will often lament, “I have nothing left to give.” KEYWORD: Exhaustion
- Depersonalization: The development of negative and cynical feelings leading to a callous and dehumanized perception of patients which further leads to the view that they are somehow deserving of their problems and troubles. KEYWORD: Cynicism
- Lack of a Sense of Personal Accomplishment: Feeling so little reward from what you do that you tend to evaluate yourself negatively. This leads to dissatisfaction and unhappiness in your work, creating a lack of a sense of personal accomplishment. You get to a point where you feel nothing you do is making any difference. KEYWORD: Inefficacy
During a presentation at The Blanchard Institute’s recent Recovery Awareness Day, Dr. Gaither talked about his own experience with job-related burnout as a family physician in 2009. “What had once been a sense of joy, pleasure, and personal satisfaction had turned into drudgery and dread. I really didn’t understand it—in fact, I was shocked by it. I didn’t know what I was doing at the time but I made some changes that I thought would help me.”
CUTTING BACK TO FEEL BETTER
Gaither reduced his hours, working only three days a week. “It meant a significant reduction in salary but at that point, I didn’t care. Instead of paying somebody to make me feel better, I paid myself by taking time off from work.”
Dr. Gaither rested more, exercised more, and rediscovered hobbies and activities he had long neglected because of his workload. “I did all those things we asked our patients to do,” he told the Recovery Awareness Day audience with a smile. “Within weeks, I felt better.”
Only after additional research, did Gaither realize he was suffering from job-related burnout. He decided to become an expert on the phenomenon because he didn’t want “to feel that way ever again. I learned as much as I could about burnout.” He started talking to other providers and found out that many of them were burned out, too. Gaither ended up writing a book about burnout, called REIGNITE: Transform from Burned Out to On Fire and Find New Meaning in Your Career and Life.
PROFESSIONAL HAZARD
He realized that burnout was an innate hazard of the medical field. In most of the caring professions, the burnout rates are extremely high. “There are reasons for that,” Dr. Gaither said. He recalled his emotional pain when he had to help a woman deal with the death of her husband who had been killed in an automobile accident. “In medical school, they said you have to practice detached sympathy. Show empathy without taking on their emotional burden. Sounds good in theory—but in practice it’s impossible. There is an emotional cost to crying with your patients and it can add up over time.”
Exposure to the traumatic experiences of others can lead to secondary traumatization. “The chronic stress of taking in others’ trauma can lead to symptoms similar to post-traumatic stress disorder (PTSD) such as emotional exhaustion or hypervigilance,” wrote Zuri White-Gibson on PsychCentral in 2022. “Secondary trauma typically develops when hearing about someone else’s trauma, and the intense, persistent stress that can come with that is a consistent part of someone’s life.”
Secondary trauma is not the same as burnout but for medical professionals, the combination can turn into a one-two punch. “Burnout is a condition that won’t be alleviated unless you attack the underlying drivers,” Dr. Gaither told the Recovery Awareness Day audience. “The problem with most burnout mitigation strategies is that hospital employers attribute it to stress and they bring in stress management people, mindfulness people, and time management people. There’s an implicit notion of ‘you don’t know how to take care of yourself and we will show you how.’ I don’t think that’s a good strategy.”
Medical professionals don’t just face stress, Gaither explains, they are exposed to constant DISTRESS. “A little bit of stress is good—it keeps us prepared and on time. When it becomes distress with negative consequences, that’s when it becomes toxic.”
Unfortunately, the culture of the medical field and similar professions is all too often “suck it up and get it done”—an inappropriate strategy when it comes to mitigating distress and trauma both of which are major drivers of substance use disorder.
In a recent webinar, Blanchard founder and CEO Ward Blanchard presented the United States as the country with the seventh worst stress record in the world—between Sri Lanka and Uganda. And all that stress and despair translate into substance misuse and other unhealthy behaviors. “The US is the most obese, addicted, medicated, indebted adult society ever, consuming 90 percent of the world’s pain medicines,” Blanchard said.
A 2016 study on burnout and alcohol misuse among US medical students found that “burnout was strongly related to alcohol abuse/dependence among sampled medical students and increased educational debt predicted a higher risk.” A 2015 study by Oreskovich, Shanafelt, et al. concluded that “alcohol abuse or dependence is a significant problem among American physicians.”
Treating co-occurring disorders such as depression, anxiety, burnout, and trauma successfully is not always easy but with evidence-based treatment that attacks the underlying drivers, it can be accomplished. The Blanchard Institute offers a wide range of comprehensive, individualized outpatient treatment programs for substance use and mental health disorders, including outpatient detox, partial hospitalization, intensive outpatient, and outpatient treatment.
Our admissions process is discrete, confidential, and non-invasive. Call us at (704) 288-1097—our experienced admissions specialists will guide you through the process and treat you with the dignity and compassion you deserve.