Decoding burnout: the complex symptoms and hidden tolls in health care

Deciphering burnout can sometimes feel like interpreting the orders of your favorite attending physician. Though I don’t consider myself “old,” I started my medical career before electronic medical records, when paper charts were the norm and computers were rare. We carried little pocket notebooks filled with essential information because at 2 am, after weeks of little sleep, that crucial detail always seemed to slip our minds.

Back then, we relied on pagers—old-school devices that would blare at us unexpectedly throughout the day. Some pagers didn’t even have caller IDs, so remembering the callback number was challenging. If you are lucky, you might get a newer pager with a display for checking messages. Maybe I’m exaggerating a bit, but that’s how it was.

As a resident or student, you were at the bottom of the pecking order, often the first at the bedside of the following emergency patient or on the wards. Did you ever have an attending whose handwriting resembled ancient scripts from a lost Egyptian tomb? I certainly did. We would pass around their sacred scribbles, trying to decipher what was written. Usually, we could make out the first letter, but it was anyone’s guess after that. Decoding burnout can sometimes feel just like that. Despite our efforts to define it, it can sometimes be complicated.

Burnout can present differently. Physicians are adept at hiding our emotions and keeping our cool in the most challenging situations.

Here are some common presentations of burnout:

1. No apparent symptoms at all. This person holds it together until one day, without much warning, they might snap and no longer continue their work.

2. Resignation. Indeed, some people simply quit. Alternatively, they may engage in what’s termed as “quiet quitting” — a modern phenomenon where individuals slowly disengage from unnecessary responsibilities such as committees and non-essential activities. According to Gallup’s State of the Global Workplace 2023 Report, 59 percent of the global workforce participates in quiet quitting. This trend is often linked to employees feeling disengaged and experiencing high stress levels in their workplace environments.

3. Physical illness. Chronic, unmitigated stress can wreak havoc on one’s body. Often, as physicians, we might not afford ourselves the grace to recognize mental stress, depression, or workplace burnout as reasons to take a break. Instead, we wait until illness strikes due to neglect of ourselves and the negative impacts of chronic stress. Research published in the Journal of Hospital Management and Health Policy suggests that the vast majority, 64 percent, of practitioners do not seek help for burnout or depression because they do not believe the symptoms are severe enough to warrant medical intervention. This reluctance to address mental health concerns promptly can lead to exacerbated physical health issues over time.

4. Relationship breakdown. Sometimes, those closest to us bear the most significant impact of burnout. The strain can lead to breakdowns in communication, emotional distance, and conflicts that further compound the individual’s stress.

5. Professional performance decline. Burnout often manifests in tangible ways in professional settings. Health care providers experiencing burnout may exhibit decreased efficiency, leading to increased errors in patient care. This decline in performance can negatively impact reviews and patient satisfaction scores, perpetuating a cycle of stress and dissatisfaction.

6. Emotional exhaustion. Emotional exhaustion is one of the most recognizable signs of burnout. Health care professionals may feel constantly drained, detached from work, and lacking empathy toward patients and colleagues. This emotional depletion can impair their ability to provide compassionate care, exacerbating feelings of inadequacy and burnout.

7. Cynicism and negativity. Burnout can manifest as a cynical attitude towards work, colleagues, and patients. Health care providers may develop a sense of detachment, viewing their work through negativity and hopelessness. This can lead to increased isolation, reduced collaboration, and a diminished sense of fulfillment in their profession.

Burnout can be more complex. Sometimes, you need someone objective to help you decode it and understand its root causes.

Navigating burnout in health care isn’t just about recognizing the signs—it’s about understanding its complex manifestations and seeking support when needed. Whether it’s the silent withdrawal from responsibilities or the physical toll of unrelenting stress, burnout affects individuals uniquely. By acknowledging its presence and discussing it openly, we can begin to dismantle the stigma surrounding mental health in medical professions. Let’s continue to decode burnout, support one another, and build environments where well-being thrives.

Tomi Mitchell, a family physician and founder of Dr. Tomi Mitchell Holistic Wellness Strategies, is not only a distinguished international keynote speaker but also a passionate advocate for mental health and physician’s well-being, hosting her podcast, The Mental Health & Wellness Show. With over a decade of experience in presenting, public speaking, and training, she excels in creating meaningful connections with her audience. Connect with her on Facebook, Instagram, and LinkedIn and book a discovery call.


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