May 03, 2016
3 min read

Recognizing and addressing professional burnout

Everyday stressors that build up over time can lead to varying levels of burnout in ophthalmologists.

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“I have a theory that burnout is about resentment. And you beat it by knowing what it is you’re giving up that makes you resentful.”
– Marissa Mayer

“It is impossible to control outcomes or results, although most of us have been programmed from a very young age to believe otherwise. The idea that we can perform actual ‘magic’ causes tremendous dysfunction, unnecessary suffering and prevents the development of emotional resilience.”
– Christopher Dines

Radiation film badges were first developed in the early 1940s during the Manhattan Project, which ushered in the atomic age, led to the first nuclear weapon and, parenthetically, employed my first boss when he was just a graduate student.

Today, specialists who work around radioactive material — whether they are dental assistants, X-ray techs or nuclear scientists — wear a radiation badge to assure that they have not received a dangerous level of exposure to ionizing radiation.

I would like to invent a similar “dangerous exposure” badge for ophthalmologists. But instead of measuring radiation, this new badge would measure the approach of burnout that comes from undue stress, impossible tradeoffs and excess workloads. After nearly 40 years as an “ophthalmologistologist,” I can report the following examples from extensive field observation:

  • The surgeon who arrives at work later and later, avoiding the start of the clinic day.
  • The doctor with a once-cheerful and socially generous disposition who others report as now being, “Not herself, withdrawn, rarely complimentary of others.”
  • The ophthalmologist who asks staff to open clinic and surgery slots, and then bites their heads off a month later for “overbooking.”
  • The practice partner who once made brisk, intelligent business decisions, but who is now frozen even with smaller matters before the board.
  • And especially, the doctor whose lifestyle costs are growing faster than practice profits, squeezing him into an impossible and unsustainable position.

This happens at different workloads, and with differing levels of superimposed general life stressors, for different ophthalmologists.

It is hard to become an eye surgeon without a degree of obsession and workaholism, of course. But shifting from 40 patients a day to 60 (to cover rising costs) while simultaneously undergoing partner stresses or a personal health crisis can put even the most resilient surgeon over the top.

My colleague Craig Piso, PhD, presents in the sidebar accompanying this column a recap of 10 burnout cures. Each of these, individually or in combination, with or without outside professional support, can help an overly crispy eye surgeon walk back from the edge of burnout. But none of these are likely to be undertaken without recognizing that you are flying a bit too close to the sun.

Like too many X-rays, exposure to too much work can sneak up on a surgeon. Years of slow accommodation to more and more work and stress can pass without being recognized until a breaking point is reached. Let’s make this simple. If you notice any of the following six ophthalmically centered markers in yourself, you may be at or beyond the point of burnout:

  • You don’t start most days (both clinical and surgical) with a sense of positive anticipation regarding the people you will help and work with, and the livelihood you will be making.
  • You have no financial wiggle room. Your personal expenses consume 100% of your paycheck, savings are scant, and you cannot conceive of a way that you could increase income or decrease expenses.
  • You literally (or at least figuratively) flinch every time a staffer enters your office, thinking to yourself, “Oh no, what now?”
  • When new, common problems are thrown at you, everything from federal regulations to a surgical complication or an unexpected repair bill, your shoulders slump as if under a blow.
  • When new opportunities arise (a new procedure to learn, a new service to provide), your first instinct is to say, “Impossible, not one more thing.”
  • You don’t end most days with a pleasant fatigue, a sense of accomplishment and gratitude for having found your way to ophthalmology.

Whether you have a case of full-blown burnout or are just crispy around the edges with a subclinical case of “brownout,” think about the issues raised briefly in this month’s column, recognize what is at risk both personally and organizationally, and intervene with vigor, just as you would for any patient you serve.