Family doc Dike Drummond hit the wall at age 40. He was burned out. It led him to walk away from his successful small town family practice and, after five years of working locums, to hang up his stethoscope for good.
Burned-out doctors everywhere should be glad this happened because Dike has taken his experience with burnout and parlayed it into a successful physician burnout coaching practice. But more important than that, he has developed a ton of resources for physicians facing burnout, most of which are available for free on his website, The Happy MD. These tools are based not only what he has learned from his own burnout, but also upon learnings from thousands of hours of one-on-one coaching with physicians.
Now, he has captured what he has learned in his recently published book, “Stop Physician Burnout, What to Do when Working Harder Isn’t Working.” Dike wrote the book to help the 1 in 3 physicians confronting burnout at any given time understand what is happening to them and begin to take action to get their lives back.
Why is burnout such a big deal?
- Lower quality of care
- Lower patient satisfaction
- Higher rate of medical errors
- Higher malpractice risk
- More frequent disruptive physician behavior
- Higher turnover of physicians and other staff
- Higher rates of physician divorce
- Substance abuse
Just about every aspect of care is impacted when a physician gets burned out.
What are three symptoms of burnout?
There are three main symptoms of burnout:
- Exhaustion: feeling very tired and unable to recover even after taking time off
- De-personalization or “compassion fatigue”: not being able to empathize or relate to patients
- Lack of efficacy: feeling like there is no purpose to your work or doubting the quality of your work
Interestingly, male docs have a different pattern of symptoms than female docs. Whereas women experience the symptoms in the order listed above, men will first experience cynicism and compassion fatigue and then become exhausted. According to Dike, “it is rare for a male physician to doubt the meaning or quality of his work.” Another difference between men and women physicians is that women will usually confide in someone or ask for help. Most men do not. That is probably why 85% of Dr. Drummond’s coaching clients are women.
The four root causes of burnout
I am going to list these in a different order than in the book. First of all, one important cause is the conditioning of our pre-med and medical education. All those years, we are heads down with the following well-defined goals: get into medical school (a good one preferably), get the MD, get the residency (also a good one preferably), pass the boards, do a fellowship, and get a job (again, a good one preferably).
In pursuit of these sequential single-minded goals, we are able to push everything else we might want to do to the very bottom of the pile. You know the list: socialize with friends, read a good book, nurture a relationship, bum around Europe, spend (quality) time with your family. Those things, we say, can wait until after, right? But sometimes they can’t…we have all heard the story of the surgery resident who doesn’t realize his wife and kids have left him until weeks after the fact.
The other three root causes are (2) the practice of medicine itself. It is stressful. The hours are long, the responsibility huge. And then there are (3) the stresses of the specific job—whether it is the financial challenges of solo private practice or the politics of academics or the perceived powerlessness of being an employed physician. And finally, there is the burnout related to (4) trying to have a life in the face of burnout causes 1-3.
The ideal practice description
Dike says this is the blueprint for change. Docs are so used to taking whatever is thrown at them (night shifts, brutal call schedules, working holidays, missing the kid’s soccer game), that they probably have never thought about exactly what it is they want their practice to be. He encourages his clients and readers to write down, in detail, a description of their ideal practice. DO NOT SKIP THIS STEP, he warns. Without your ideal practice description, you will not take the next steps in the process of building your new life and your new practice.
The book provides guidance for how to develop the description and how to develop a Master List of changes you want to make on your journey to go from where you are now to where you want to be in the future—step-by-step.
Dike tells me he has compiled a list of 117 “field tested and doctor approved” tools. They are all available on his website, The HappyMD. He suggests you start by downloading the Burnout Prevention Matrix to get an orientation to the tools. They can be lumped into one of four buckets:
- Personal Stress Relief
- Personal Recharge
- Organizational Stress Relief
- Organizational Recharge
I will not list the individual tools here but will say that they provide specific instructions to help you practice another way of doing things (for example, getting over your hatred of your EMR, hacking your schedule or your weekly bucket list). You don’t have to speed through all of these like you are studying for Boards, rather prioritize and work through the ones that really matter to you—one step and one tool at a time.
The radio interview
I had a chance to chat with Dike on my weekly radio show, The Doctor Weighs In on Radio. If you haven’t had a chance to experience his passion about helping docs avoid or overcome burnout, this is a good place to start. And be sure to go to www.thehappymd.com/book and order a copy of the book. For a limited time, if you enter the code breathe, you will get $10 off the price (such a deal!)