Feature | Cultivating Habits to Keep Burnout at Bay

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There is increasing awareness of a "burnout epidemic" among physicians. Most commentators tend to advocate practical solutions to this epidemic: time with family, exercise, adequate sleep, changing workflows and electronic health record mastery. These solutions are worthy suggestions that I have embraced, and they can definitely improve one's daily grind.

However, I have observed that these solutions only barely touch some of the deeper issues that contribute to burnout – the impossibility of perfection, inevitability of disappointing others and sometimes ourselves, recognition that much of adult life has a "hamster-wheel" quality to it, and knowledge that our time is much more limited than we once thought.

Almost all adults either face (or actively avoid) these realizations at some point, and we find encounters with these ideas across art, literature, philosophy and religion.

During the past three years since completing fellowship, I have increasingly looked to these disciplines while trying to cultivate three habits to keep burnout at bay.


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Many of us physicians were the children who loved to read. I was one of them. Years of medical education and residency, career-building, and recently child-raising and housework diminished the time left for nonmedical reading. My own disposition is also to blame, for my concentration has waned from too much internet and smartphone use.

Yet with a bit of effort, reading still opens up unseen vistas and tints the world in brighter colors. Over the past three years, I have slowly and fitfully read novels, history, classics and religious works. I have also listened to long-form podcasts and even university courses on my way to work or during my work outs.

Most reading and listening have been diversions, some of which are fun, stretch my mind or exercise my imagination. However, I have also occasionally gained an insight that helps ease a challenging workday.


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In the Jewish tradition, prayer has many forms and functions – gratitude, petition, submission and communion. The traditional liturgy is ancient, and yet much of it still speaks to the heart.

Prayer allows (or sometimes forces) me, even if just for a few minutes, to put my life in perspective. It also has connected me to a larger community of Jewish friends and family in my adopted city of Albany. For those who are not of a religious bent, I suggest meditation, music or even a meaningful conversation.


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One of the challenges of being a physician is that it often feels like we are constantly being asked to give ourselves. However, this is true of many other types of work that are not nearly as well paid (i.e. customer service, the military, teachers and home-care workers). Consequently, physicians have traditionally been expected to be pillars of their communities by giving money and time to schools, arts, religious institutions and the needy.

I have only started to embrace this role, but when I have done so, it has instilled a sense of purpose that provides a significant inoculation against burnout. Giving can take the form of buying a toy for a needy child, generously tipping your waiter, serving on a school board, volunteering at a food pantry, contributing to a favorite charity or endowing a scholarship at your community college.

In my experience, giving locally feels especially meaningful. Just as important, be prolific in giving praise and thanks to those around you.

Modern burnout has its roots in the timeless challenges faced by humans, but it is also accelerated by our technological "always-on" society. I sense that confronting burnout will be a constant challenge in our careers.

The most common approaches – demarcating time with family, exercise, sleep, limiting your smartphone use, financial literacy and workplace improvements – are important. However, I also encourage you to think of cultivating habits that address some of the deeper roots of the problem.

Just like all virtuous habits, it will take time for these efforts to bear fruit. But I am convinced that they will help reignite life's brightness.

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This article was authored by Joshua Schulman-Marcus, MD, FACC, cardiologist at Albany Medical Center in Albany, NY.

Keywords: Clinician Well-Being; Work Life Balance; Burnout;