Doctor burnout: 5 ways to know you're running out of energy

Burnout harms workers in all fields, but evidence indicates that incidence is higher in healthcare professionals. According to a review published in Local and Regional Anesthesia in 2020, an estimated one in three doctors is experiencing burnout at any given time—and studies have found that rates of burnout are as much as 10% higher in physicians compared with the general population.^[] Roughly 43% of physicians show symptoms, which include exhaustion, depersonalization, and diminished efficacy.

Physicians on the front lines of care, such as family medicine, internal medicine, and emergency medicine, tend to be at the greatest risk, wrote the authors. However, as noted in an article published in the American Journal of Medicine, “some believe the condition to manifest at some level in nearly all physicians.”[2]^[]

Indeed, doctor burnout is an ever-growing concern, with reports published annually on the most burned-out specialties. And then there’s burnout’s equally dangerous cousin: compassion fatigue.

Studies have shown that burnout is associated with an increased risk of major medical errors, as well as health risks for doctors. The condition has been linked to depression and increased risk of diabetes and coronary events.

Signs of burnout

A study published in the Journal of Clinical Psychiatry examined high rates of burnout among frontline caregivers responding to COVID-19, and found a number of symptoms that strongly predicted the condition.^[] Researchers concluded that fatigue, irritability, anxiety, and feeling “on edge” were most commonly associated with physicians who were burned out.

Researchers also identified symptoms that appeared to be related to specific burnout outcomes. For example, irritability and trouble concentrating best-predicted difficulties at work. On the other hand, negative expectations about oneself or the world, or feelings of self-loathing, best-predicted effects on personal relationships.

These signs may seem benign or like a part of everyday life, but if they persist, they can eventually lead to burnout.

The Local and Regional Anesthesia review notes that emotional exhaustion, depersonalization, and a sense of low personal accomplishment are also symptoms. Physicians can become exhausted and appear to stop caring about patients. Cognitive performance and motivation may also decline.

Authors of the review provided a five-stage model that illustrates the burnout progression:

1. It begins with a period of enthusiasm, known as the “Honeymoon Phase.” The physician may feel an increased commitment to work, but this inevitably leads to added stress as the physician gets worn out.

2. Without coping strategies, burnout leads to a sense of stagnation, followed by the onset of stress. Some days may begin to feel more difficult than others. Work becomes all-consuming and personal boundaries may become porous, leading to an erosion of social and familial relationships. Physical and emotional symptoms of stress and depression begin to emerge.

3. After a while, chronic stress morphs into frustration. Physicians may develop feelings of failure, incompetence, or inadequacy.

4. An apathy stage follows. The physician’s world becomes clouded with disillusionment and despair. They may believe that there is no way to resolve the situation and become distant and resigned.

5. And finally, when the physical and emotional symptoms overwhelm the physician, they enter a phase of habitual burnout.

The key is to identify some of these red flags before you—or your colleagues—become overwhelmed. Mitchel Schwindt, MD, described some of these red flags in a KevinMD.com article, which details his experiences with burnout.^[] He ignored many symptoms at the time, including unexplained anxiety or nausea, feelings of dread days before a shift, and decision fatigue.