Kyle: What are the causes or the origins of provider burnout?
Dr. Judy: Well, the causes are very insidious. It’s not really one thing. It’s multiple things and you kind of just ignore them. They’re unaddressed. And I think this can happen a lot with providers because you’re used to ignoring your own needs and putting the patient’s needs first. At least that’s how we were all trained.
And it’s a very good attribute to have as a provider. People congratulate you and reinforce you for that. Wow, you always put the patient’s needs first. That’s awesome.
Well, sometimes we need to take care of ourselves before we can take care of other people well. And unfortunately, burnout happens because over time, you’ve just stopped addressing the things that come up for you, thinking, I’m just going to soldier on and keep pushing through it. Well, eventually, you can’t push through it.
And if you don’t address those signs of burnout, then full-scale depression can occur, possibly other consequences that we talked about, like alcohol and substance abuse. I mean, all of these things are possible.
Kyle: If someone’s working very hard at their job at the hospital, but then at home they’re having some marital problems, let’s say, or their kids are acting out and it’s causing this stress and they bring that stress into their job, which leads them to have provider burnout…we can’t call it provider burnout though, right? Because the cause came from the family and not the job.
Dr. Judy: Yeah, I think that that’s obviously a delineation that really separates burnout as a result of occupational hazard as opposed to, yeah, I feel burned out at work, but it’s really because like the rest of my life is kind of crumbling in various ways.
So that’s a little bit different. That’s sort of just obviously there’s significant life stressors that you need to deal with, but really when we talk about burnout, we’re talking about the kind of burnout that comes specifically from work. The majority of stress comes from work, but of course it impacts the rest of your life. It impacts your relationships. It impacts how you can engage with your family and your health. It impacts how good you are to yourself.
People stop working out. They start eating poorly. I always think that it’s a warning sign, not just the occasional stressful day. But really, it’s like every day after work – “I’m so stressed, I need to have a drink right now.” That’s one sign that says something about work is making you want to reach for the bottle literally the minute that you get off work.
Kyle: Right. But what do they do when they have to work? And I don’t even mean have to work financially. I mean, you have to go to work because your patients depend on you…
Dr. Judy: Yeah. And I think that is exactly why people don’t catch it until it’s too late many times. Because there’s a little bit of a God complex, in a good way right that a lot of providers have. Like, no, but I’m so important. My job is super crucial. Well, you can’t do your job if you’re dead. So let’s make sure that you fix the problem before you get really, really sick.
Burnout vs. Stress
Kyle: What are the signs that someone is burnt out and not just stressed?
Dr. Judy: So the signs of burnout are oftentimes very much overlapping with signs that are associated with depression. But I think some of the ones that really stand out to me are just a real sense of negativity and cynicism about everything.
Like, you no longer think that the world is a good place. You kind of just expect bad things to happen. And it’s hard for you to see the world through rose-colored glasses at all. You can never see the glass as half full again. Everything is all about the negative side. You become more of a naysayer.
Somebody proposes a change at work that might make things better. You’re like, ha, it’s not going to work. That kind of attitudinal change is subtle at first, but if you find that it’s a pattern, I think it’s a really important sign of burnout.
Kyle: And we’re assuming that before this, those people didn’t have that attitude?
Dr. Judy: Yeah, right. That wasn’t like a personality thing.
Kyle: Right, because some people are just like that even when they’re not burnt out.
Dr. Judy: I know. You and I, I guess, are not like that, Kyle. But yes, we know some people who are a little “negative Nancy”.
Kyle: So how does that type of sign manifest itself as a behavior in the workplace?
How Do Warning Signs Manifest at Work?
Dr. Judy: I think that type of sign in the workplace will really weigh on interpersonal relationships at work. So how you choose to collaborate with your coworkers or when there is some kind of push for institutional change…somebody who’s a little bit more bright eyed and bushy tailed who wants to come in and make positive change…you basically end up blocking them. No, I’m not going to do that for you. I won’t put this flyer up. I’m not going to announce this event to my subordinates. I’m not doing any of that stuff.
That real disengagement and checking out and kind of bucking authority is how some of that negative cynicism can play out at work.
Kyle: Can you spot the signs of burnout in other people?
Dr. Judy: Yes.
Kyle: How do you do that?
Dr. Judy: Just by the way that they talk about their job. I think there are two things. One is they talk about their job like it’s just this dreadful thing, like they can’t get away from it. That’s another big part of it.
This sense of helplessness. Well, I can’t quit my job. I mean, whether it’s finances or my patients need me or it’s too important. I can’t do it. I went to school for this. I’m not going to give up on it now…that kind of thing. But it’s very much a huge burden.
I can feel that burden just by them talking about it. And then I think the other way that they talk about it is almost trying to convince themselves that their job is really good. Almost like, but you know what? No, I should be really grateful. I’m grateful, but I don’t want to complain. And it’s almost like they’re trying to talk themselves out of the fact that something’s wrong.
You just need to address it. It’s not that you’re being ungrateful. I notice that people do that sometimes even when they’re depressed, too. They’ll say, well, but it’s so stupid that I’m depressed. I’m just being ungrateful. I’m so lucky compared to the homeless person on the street.
I’m like, okay, of course, there are relative levels, but if it’s your distress, it’s still your distress, right? Yeah.
Kyle: So with all of these signs that we have to look out for, it seems like it would be pretty easy to recognize if you’re suffering from provider burnout, but so many people don’t even recognize that that’s what it is.
Dr. Judy: Yeah. So one, there’s not the recognition. I think that’s how a lot of providers are trained. Put your patients first, like who cares what your needs are, right? But I think the other part of it is that there’s still stigma. Again, if you’re a provider, you’re supposed to be better than everyone somehow. Like you’re supposed to be helping them.
So what does it look like if you’re suffering too? Well, that’s just crazy. Like we’re all humans. We’re not all immune to any of this stuff. And we’re all going to be prone to some kind of suffering at some point in our life because you know, we’re human beings and we’re alive.
So you have to give yourself that sort of leeway and grace that you might have some of your own stressors that come up, right? It’s just so crazy to me sometimes when providers are like, “Well, I got divorced and my kid and I are fighting a lot. I’m not sure if I’m going to get custody, but yeah, I’m still going to work like normal.”
I’m like – that’s not normal. Like sometimes things come up and why can’t you take a little bit of a break? Why can’t you use some of your personal days? I mean, I can’t tell you how many doctors and social workers and therapists I know who don’t use the kind of breaks that are afforded to them. I mean, they have personal days. They have sick days that they don’t use.
They don’t even use their vacation days for anything.
I’m like…don’t you think it might be helpful maybe right now, because you’re going through a lot, to use one vacation day a week maybe? Just for a few weeks how nice would that be? Then you go to work for four days.
Kyle: The irony is really thick there because these are the people who are advocating for wellness and health for their patients every day, but they’re not listening to their own advice.
Dr. Judy: Totally. And I think the more that you feel like a hypocrite too the worse the burnout gets because then you just feel so misaligned that the only way you can deal with that is the depersonalization… to distance yourself, but you have to process it.
Kyle: I got it just now. That’s so good.
