Physicians are a symbol of health, wellbeing and reliability. In addition to being trained in an environment of self-reliance, the need to maintain perfect self-images encourages physicians to hide weaknesses and struggles, landing them on a path to burnout.

Dr Lim Boon Leng, a psychiatrist at Gleneagles Medical Centre, says burnout from work should not be taken lightly. “It can deteriorate to full blown depressive or anxiety disorders, with severe symptoms such as feelings of hopelessness and suicidal thoughts.”

Here are 5 insidious ways physicians get burnout:

1. High-stress work environment

Moving up the hierarchal ladder in medicine means accepting increasingly higher levels of responsibility. However, like most things in medicine, doctors do not always have full control over outcomes of their patients. Physicians serving in the front line of care such as emergency care physicians also bear higher stress loads. Increasing medico-legal cases further add to a hostile environment, where doctors start to see each patient as a potential lawsuit.

“The more developed a country becomes, the more stress a doctor has to deal with. This is simply because of the fact that the population is more educated, demanding, do not respect the doctor as much as the older generations, high litigation rate and reducing income with higher debt,” says Dr Pagalavan Letchumanan, a consultant rheumatologist.

2. Doctors are emotional sponges

On the most part, the hospital is a draining environment. A physician’s day is typically filled with encounters of sick, hurting, scared, and emotional people.

“Often, the doctor acts as an emotional buffer. We will buffer the patient from our own stressful environment until we can’t take it anymore,” said Dr Mark Linzer, who has studied physician burnout since 1996. Furthermore, physicians lack training in how to create and maintain boundaries with their patients.

3. What work-life balance?

Physicians have little to no breaks in their schedule, and in the limited time away from work physicians are expected to keep themselves updated with medical advances and study for exams. With that said, quality time with loved ones is pushed aside, and according to Dr Linzer, this can impact patient care.

“When they can’t do those things, it’s all they think about during the day and the patient suffers,” he said. Dr MH left the medical profession after 14 months of training at a Klang Valley hospital. "I was on call every other day and I realised that even after becoming a medical officer or specialist, the schedule would still be heavy. I didn't want that kind of lifestyle."

4. Conflict with leader’s values and leadership

Every physician has differing visions and values in their practice, but not seeing eye to eye with their leader’s values in patient care is a constant source of demotivation for physicians. This can also be a more challenging sign to identify early, but it is “necessary to prevent burnout,” Dr. Linzer said. Whether at a large hospital or private practice, doctors will feel their motivation gradually dissipate unless they feel that the people leading them also share their values for medicine and patient care.

5. Struggling to keep things exciting

Decades later, things eventually get stale for some physicians as they struggle to keep the job exciting. Some physicians lose the passion and enthusiasm for medicine, reducing the job to a mindless daily routine.

“During my last several years of practice, each day seemed like a monumental struggle. I tried simply to survive each overscheduled, jam-packed clinical day, a fruitless exercise because I would just have to go through the same ordeal the next day and the day after that,” said Dr Thomas Murphy.

Physicians finding themselves in the early stages of burnout can initiate coping strategies to prevent a downward spiral. “Burnout doesn’t have to be highly expensive to fix,” Dr. Linzer said.

“Preventing burnout can actually save money in the long run on recruiting and training new practice staff.” MIMS

Read more:
Burning brightly, or burning out? A mismatch between unconscious needs and job demands
Managing stress helps prevent physician burnout
Healthcare professionals: Tips on supporting a struggling colleague
4 ways to manage empathy burnout
Healthcare professionals: 5 job hazards you should look out for