How to Practice Medicine Without Burning Out
Have you ever met a physician who loves what they do and seems to do it effortlessly? I have, and in the depths of my burnout it was almost upsetting to see someone living their best life in my profession. What secret did this person have that made medicine a fulfilling and sustainable career path for them, and why was no one letting me in on this secret? I discovered the answer for myself through a lot of trial and error, and now looking back I can see many of the same features in the lives of the thriving clinicians I’ve met throughout my years in practice. Today, I want to share these secrets with you.
Variety in Clinical Work
If you’re seeing patients in the same clinic for 10 half-days each week and can’t imagine life any other way, I love that for you. But this arrangement doesn’t work for many of us. Often, the happy clinicians I’ve met have some degree of variety in their patient care. One of my colleagues who works at a federally qualified health center once told me his enviable schedule that included a few half days per week of his regular primary care clinic, a half day of pediatrics, and a half day of healthcare for unhoused patients, among some other rotations. A mixture of inpatient and outpatient work can also provide variety, particularly if your inpatient work is rotation-based, i.e. one week on/ two weeks off, rather than rounding in the morning and still seeing patients in clinic every day.
Even if you’re highly specialized, having a day of the week where you focus on a particular condition within your specialty, a dedicated procedure clinic, or group medical appointments can help break up the monotony. Speaking for my colleagues in primary care, examples of half day clinics that I’ve seen include HIV/ hepatitis management, ultrasound, GYN procedures, skin procedures, and addiction medicine, and that’s just a sampling. Use some creativity and find a niche that you’re interested in pursuing. Sometimes it’s not just the act of doing something different from day to day, but the act of learning something new that provides the mental stimulation you need to stay excited and engaged.
Non-Clinical Work
Another way I see clinicians making their work more sustainable is through removing some half days of clinical work in order to add some roles that don’t involve direct patient care. Please note I said that some clinical time needs to be given up in order to make this an effective burnout prevention strategy - piling additional responsibilities on top of full-time clinic is only going to make things worse. This mixture of clinical and non-clinical is common and often straightforward to do in academia, where under your same job description you may have opportunities to teach, do research, or perform administrative duties like clinic operations. Think about which of these types of opportunities would help address what you’re lacking in your clinical work - if you find yourself craving more opportunities to interact with others and provide mentorship then teaching might be a good fit, whereas if you like having more time to think and consider systems-level issues then research could be a great option.
Non-clinical work isn’t limited to those in academia - you can also find leadership roles within private practices and non-profits. If you’re more entrepreneurially minded, you can do consulting work for pharmaceuticals or healthcare startups. Your non-clinical work doesn’t even have to be related to medicine. Perhaps you’re an accomplished musician, and you decide to cut back to part-time clinical work in order to teach piano and work on fulfilling your lifelong dream of recording an album of your compositions. Or you work part-time in clinic while coaching physicians on burnout, and you spend a lot of your time writing, speaking, and creating content for your business. If you say it’s not possible, then it won’t be. You have to have an attitude of how can I make this work if you want to create the version of this that’s right for you.
Boundaries
Work can easily expand to take over your life if you don’t have boundaries. I like to think of boundaries in two main parts: boundaries for work and boundaries outside of work. For your work boundaries, this might mean having limits with patients - not accepting late arrivals and setting an agenda at the beginning of the visit with an understanding that most hand-on-doorknob questions will have to be handled at the next visit. This might also mean having limits on the depths to which you’ll address questions within a portal message; at some point, it reaches a level of complexity that requires an office visit. Lastly, consider leaving work at work by completing your notes before you leave whenever possible. I used to spend an hour or two on notes at home each evening, and now I try to complete them between visits. A note that used to take 15 minutes to write at home now takes only 3 minutes because it’s fresh in my mind and I have the time pressure of the next patient waiting for me. Think of one small change that would help create a better system for you.
Having boundaries outside of work can also drastically improve your work-life balance. This can include ways that you ask for support and ways that you say no to additional work, especially uncompensated work. Asking for support might look like requesting that your partner handle dinner preparation on your clinic days, even if that means they just pick up takeout and have it on the table when you get home so that you can stay a little later to finish up your notes. Saying no to additional work might mean letting your family members know that they need to direct their medical questions to their own physician and that you’re not available for impromptu consultations. Boundaries usually have to be reinforced over time, but it’s well worth the effort.
Conclusion
The intention of this article is to give you an idea of which areas of your work and life can support your balance and satisfaction in medicine. For the items that don’t resonate with you, notice that sense of your own internal compass and ask yourself “what is it for me instead?” A burnout-free practice doesn’t just happen overnight - it takes incremental changes, reassessments, and ongoing investment. Take out your journal or start a document on your computer if you don’t have a journal and write out what you’re curious about after reading this article. Even the act of jotting down a few notes will raise your awareness in your day-to-day life and allow you to hone in on what you need.
Do you want to build your own version of a balanced and meaningful work life? Sign up for a free consultation today to start identifying and creating the change you want to see, or join our EmpoweredMD community to stay informed about future posts and events.