Self-Compassion: An Elixir for Physician Burnout

Excerpt from the forthcoming Mindful MD. 6 Ways Mindfulness Restores Your Autonomy and Cures Healthcare Burnout

Our Most Important Patient: Ourselves

As physicians, we learn to be very critical of ourselves. Our training focuses much more on deficits than strengths. We see the attending physician sneer at a med student or another resident when they miss one item on a broad differential diagnosis of a rare symptom or finding. We are subjected to ‘pimping’ where we are asked a series of ever more demanding questions, only so we can be shamed when we can’t answer one correctly. The incessant ratings, rankings, and comparisons of training leave us comparing ourselves to our peers and focusing on where we’re coming up short.

Additionally, we learn to put others first and to always be there for our patients, no matter the time of day, and no matter how fatigued and drained we might be. While this altruism is laudable, we don’t learn how to apply that same nurturance to ourselves.

All of this leaves us looking to others to affirm our worth. In the words of mindfulness educator Sharon Salzberg: ”When we experience inner impoverishment, love for another too easily becomes hunger: for reassurance, for acclaim, for affirmation of worth.”

With self-compassion, we’re shifting the lens from outward caring to inward. We are including ourselves in the group of people who receive care, love, forgiveness, and attention.

While this is not what most of us in medicine learn, we can.

This makes me think of a coaching client who I’ll call Ayesha, who came to me because she was forever behind in her charting. In fact, when we first met, she had over 200 unfinished charts in the queue. A forty-two-year-old family physician, Ayesha loved taking care of patients but did not love getting their notes done. Moreover, when we looked at her experience charting, it turned out that no sooner did she log into the electronic record than she found herself besieged by inner chastising voices: What’s wrong with you anyway? You’re so lazy. Everyone else is so much better at this than you are. You’ve always been slower than others. I don’t even know why you bother trying.

These voices cut through her, rapidly plummeting her mood and leaving her feeling heavy and defeated. Whatever motivation she might have had to get her charts done rapidly disappeared, and the next thing she knew, she was checking Facebook, stopping to file her nails, and going over the family shopping list. Anything but facing this mean bullying voice that stood between her and getting her charts done.

I knew that we needed to bolster her ability to be kinder to herself, to say things to herself that buoyed her up rather than taking her down. But when I mentioned the concept of self-compassion to her, she looked surprised. “Isn’t that what we bring to our patients? They’re the ones who are sick. Why would I need to be compassionate to myself?”

This is something I hear from many of the physicians I coach. Additionally, many believe that self-compassion will breed self-pity; that it is self-centered and means they will wallow in themselves—basically, sit around all day complaining and eating bonbons. But when you stop and think about it, isn’t it self-centered to be focused on ourselves and all of our perceived faults?

Interestingly, when we are kinder to ourselves, there’s often a sense of expansiveness. We are actually less stingy in the compassion we offer to others. Even the scarcity that comes from identifying as the special one on the team lessens, replaced by an abundance mindset that allows greater compassion for others.

As Ayesha began to build her muscle of self-compassion, she noticed something shifting in her level of motivation. Instead of sitting at her computer procrastinating, typing a few words, and then checking social media, she now found herself better able to get the charts done. In being kinder to herself, she moved into a greater level of efficacy and efficiency. No longer under the thumb of the inner critic, her fear of inner censure abated, and she was much more able to get her work done. Slowly, slowly, slowly, and then all at once (how mindfulness progress typically works), Ayesha was able to put her inner critic aside.

When Ayesha first started utilizing self-compassion, she said that it felt artificial. “I didn’t believe any of it! In fact, it seemed like a complete farce. But I kept at it. And now, I certainly don’t fully believe it 100 percent, but I am starting to believe it a little bit. Maybe that will continue to grow.”

In her next coaching session, Ayesha reported that “In some ways it’s subtle, but I notice that I’m much more content at the end of each day. I have more emotional energy to get the work done. I am also noticing that I’ve been much more patient with my sixteen-year-old son, and I’m less reactive with him. As I develop more compassion for myself, I seem to have more for others as well.”

Perhaps this brief passage from Mindful MD can help you see ways you are being overly harsh with yourself. Perhaps it can help you see why kindness to yourself is actually the antidote for procrastination and inefficiency.

As you go through your week, see if you can replace inner criticism with a dose of mindful self-compassion. I’d love to hear how it goes!

Shoulds and the Paradox of Self-Motivation

I was coaching a physician recently who was struggling to start an exercise regimen. To protect her anonymity, I’ll call her Jamie.

Jamie had started and stopped exercising many times in the past but had never stuck with it. I could well understand this as she’s a mother of three with a busy career — her days are anything but quiet and full of free time.

Like many, Jamie had put on weight with her pregnancies and struggled to lose it. She also had a family history of diabetes and was worried about the extra weight increasing familial risk.

She’d tried everything from the Whole30 diet to Noom, from working out at her Y to shifting to an elliptical in her basement, and from having her husband push her to keep her accountable to app upon app, but nothing stuck. She just couldn’t get herself to stay motivated, no matter what she tried.

Like many others, Jamie didn’t know why she couldn’t do regular exercise. She just knew that she couldn’t. Having never gotten below an A- in her life, Jamie felt that, with exercise and self-care more generally, she was getting a big fat F.

So, Jamie and I got deep into discussion, and I asked her a few questions to help her understand what was getting in her way. I first asked her to share her thoughts on exercising. Here’s what she said:

  • I should get up at 5:15 every day and get on the elliptical.
  • I should be able to stick to my exercise routine.
  • I should be better at this.
  • I should be like other physician moms who figure out how to fit exercise into their busy lives.

Unfortunately, none of these thoughts improved her ability to sustain an exercise program. Something was still missing. 

Could it be that all these “shoulds” were actually getting in her way?

I’m wondering how you approach making a lifestyle change, developing a new habit, or getting some demanding task crossed off your to-do list. If you’re like me, Jamie, and many others, you may approach the issue by telling yourself that you should make the change. You should improve, you should become a kinder, more efficient, better person, you should just do whatever it is that you’re wanting to do. 

Unfortunately, all this “shoulding” may actually be stealing your motivation, rather than building it. As I discuss in my 2020 book, Everyday Resilience, these inner ‘should’ voices are ones we all have, yet without proper tools and skills, can really erode the inner resilience we all possess. At times, this voice of should can even become one that is punishing, harsh, and shaming, can’t it? It can even creep into our thinking around all kinds of things.

  • I should get out of bed early and get on the exercise bike.
  • I should be able to stick to my diet.
  • I should start meditating.
  • I should be nicer to my spouse.
  • I should be more patient.
  • I should get that work done.

Before you know it, all these shoulds then lead to a whole other level of self-judgment:  

  • What’s wrong with me not getting out of bed early and exercising?
  • Everyone else seems to be able to know how to manage their weight issues, but not me.
  • If I don’t get it together, I’m going to end up a fat diabetic sloth.
  • Why am I so unmotivated? What’s wrong with me that I don’t have the willpower everyone else has?
  • Why can’t I just suck it up and do better?

All of this begs the question: Have your shoulds motivated you? Have they helped you make the changes you want?

There’s a reason why so many of us can answer with a resounding ‘no.’ The fact is that telling ourselves that we should do something takes us away from the intrinsic or internal motivation that is what truly motivates us to do anything. The should takes us to an external source of motivation, one that is less likely to get the job done. The should leaves us trying to motivate ourselves because society says so or your parents told you to or how you think you should be doing something or other. It takes us away from what truly drives us in life — our desires, our passion, and what’s in it for us to take the action we want to take. We may believe that an external entity like money, keeping up appearances, or receiving praise from others will get us there, and they might for a brief while, but rarely in a sustainable way.

Let’s take a deeper dive into what it is that will truly provide the motivation you need. When you think about why all the shoulds actually erode our motivation, you can likely see the answer. After all, we humans tend to do things when there is something in it for us to do so. The old WIFM, or what’s in it for me, is an important truism.

The key is to make sure you’re aligning with your WIFM as opposed to the internalized voice of parents, teachers, and others which actually only serves to tap into our brain’s threat-defense system. Recall that this is the fight/flight/freeze system that our primitive brains developed to protect us from danger. Thank goodness our brains evolved in this way to ensure that our species rose up the evolutionary ladder! But in the modern world, this system is activated by threats of a psychological nature, ones that tell us we’re not good enough, smart enough, thin enough, or, in Jamie’s case, fit enough. And once the threat-defense system is activated, we’re operating in survival mode, small, withdrawn, fearful, and only focused on getting by. All too often, the result is procrastination, distraction, or avoidance.

For true self-motivation, we can go to an important psychological theory. One of the most influential theories on human motivation, in fact, is self-determination theory, which originated from the work of psychologists Edward Deci and Richard Ryan, who published Self-Determination and Intrinsic Motivation in Human Behavior in 1985.

The SDT informs that we tend to be driven by a need to grow and gain fulfillment. One of the core assumptions behind the SDT is that developing mastery over challenges, learning, and growing is essential for our sense of self.

SDT also points to the fact that while we may be temporarily motivated by external rewards (money, prizes, societal messages, recognition or validation by others), internal sources of motivation fuel the most desire and commitment toward our goals. Also, tapping into our intrinsic desire to achieve a goal can be a powerful motivator and keep us going when external rewards aren’t enough. While the idea of intrinsic motivation may seem like a new concept, it’s something we’ve known about for quite some time. Many studies confirm the truth of SDT, bolstering the fact that intrinsically motivated people are more able to reach their goals – resulting in happier and healthier (and more motivated) people.

Tips to self-motivate

Reading this, you may be wondering: what’s the alternative?

SDT helps us understand the true ways we can motivate ourselves. What’s key is getting in touch with the “why” behind the change you want to make. That will take you to your WIFM and help you move forward toward your goal.

When I asked Jamie about her WIFM, she readily identified that exercising was important for her so she could avoid diabetes and have the longevity she wanted to be there for her family. Her WIFM also meant how good it felt to fit into some cool clothes she had worn before giving birth. Instead of beating herself up with a litany of shoulds, when she focused on what was truly in it for her, she felt more of a sense of ease about exercising. In our next coaching session, she proudly told me that she had stayed on her exercise program for the entire prior month, a first for her. Of course, it was still challenging to fit this into her busy days but now she was able to do so.

Since I’m all about pragmatic approaches, here are 5 tips to self-motivate and reach your goals.

    1) Pay attention to the voice of the shoulds. Honing this type of self-awareness is always the first step in effecting any change. And guess what? This type of self-awareness is also known as mindfulness. After all, mindfulness is about getting to know what is going on inside and around us. We pay mindful attention in a kind and friendly way, not by adding more “shoulds” onto the existing pile! Why is mindfulness so important? The simple answer is that it helps us to be more present and aware in our lives. And this can make a huge difference in how we feel and experience both ourselves as well as the world around us.

    2) Now that you’re aware of when the shoulds are present, broaden your awareness by noticing how you feel mentally and physically when you experience them. Do you feel uplifted and excited to move forward? Alternatively, perhaps you experience a sense of dis-ease, a downward sense of gravity that pulls you back toward the shoulds. Get in touch with how different the extrinsic and intrinsic motivation feels to you. Since the latter likely leaves you much more uplifted, this will also contribute to greater motivation.

    3) Now ask yourself: what is in it for me to make this change? What’s important about this? How will it help me? If it’s still unclear, try to identify the consequences of staying in the situation versus making a change. What will happen if you stay? What will happen if you change? Again, focus on what is important about this—not what other people might think or how they will react to your decision, but what’s in it for you. To enliven this, take a few moments to try on the desired state. Just like trying on a new sweater, notice what this will feel like for you. Notice how your body will feel. Perhaps there’s a sense of relief, a release of physical tension. You may also find that you’re feeling lighter, more energetic, or clear in your mind. Perhaps there’s a feeling of confidence, certainty, and freedom.

    4) Replace the should with “I want to because ___”. Fill in your reasons at the end of this sentence. Whenever your mind takes to a should, go back to this key sentence. Make it a mantra for what truly has meaning for you.

    5) Lastly and most importantly, be kind to yourself. Be patient with yourself. If you fall off your path, avoid the temptation to add more shoulds (and shame) to the situation. Remind yourself that establishing new patterns takes time and the willingness to keep starting anew. Remind yourself that you are an imperfect human amongst other imperfect humans.

    A little self-kindness and self-acceptance go a very long way.

    In conclusion, changing and establishing new habits takes work. Motivating ourselves is something we all have to work toward. But if you want to reach your goals, you’ll motivate yourself by focusing on what’s in it for you to do so. This is the surefire way to build true, lasting, and successful change. With the right combination of factors, it’s more than possible to stay motivated and achieve any goal you may have. 

    Practice these 5 tips and you’ll free yourself from the tyranny of shoulds.  I can almost guarantee that you’ll soon be the one moving forward on whatever goal is truly important to you. The more you practice, the better you will become at creating exactly what it is you desire. And the better you get at creating your desired states, the more successful and happy you will be in life, in every possible way.

    It’s a VUCA Time in Healthcare

    I don’t have to tell you that these are complicated times in the world. The pandemic. Global warming. The war in Ukraine, and violence in many other parts of the globe. Inflation. Growing levels of inequity. The Great Resignation.

    In healthcare, in particular, these are very complicated times. The pandemic has brought to light many of the problems that were already brewing below the surface. Under resourcing. Shortages in staff. Negativity and discord. Burnout.

     It’s no surprise that the term VUCA is being used more and more to describe what’s occurring in healthcare. It’s a term that first arose in the military following the 9/11 attacks, and the same term is all too applicable to healthcare, everywhere on the globe.

    What Is VUCA

    We can think of VUCA as a big, tangled mess. A mess that is occurring in healthcare and elsewhere.

    V is for Volatility

    Upon an already stressed healthcare system, the pandemic brought with it many rapid and challenging changes in healthcare. Volatility is at bay in many ways but is most evident in the high levels of attrition and turnover we’re seeing — in physicians, nurses, technicians, therapists, and even in those who clean patient rooms.

    Indeed, a recent article in the Mayo Clinic Proceedings shed light on this issue. Looking at more than 20,000 respondents at 124 institutions, the study revealed that one in five physicians are planning on leaving their position in the next twelve months. For nurses, intent to leave was present in 40%. For advanced practice providers, 33%. This means a great deal of turmoil in hospitals and outpatient medical settings. It also raises questions about the sustainability of the entire enterprise.

    This “Great Resignation” in healthcare is something I was quoted in earlier this year in over half a dozen major news venues. While I was happy to be involved as an expert on the topic, I, like others in the field did not have a lot of tangible solutions to stem this tide.

    U is for Uncertainty

    With all this change, there is a massive sense of unpredictability and uncertainty about what will happen next.

    When will the pandemic end?

    What difficulty will come next?

    How will we do our jobs without adequate staff to support our efforts?

    What will the new normal be?

    C is for Complexity and Chaos

    The level of complexity in healthcare these days is almost inconceivable. So many moving parts. So much dissatisfaction and burnout. So much chaos. And the complexity and chaos have contributed to what can only be thought of as a giant vortex of negativity pulling all of healthcare into its hold.

    Additionally, there is so much change occurring that it has the makings of a dark joke:

    You work in a major urban area where you are in competition with the other major medical practice across town. You leave for a well-needed vacation on a Friday and return a week from Monday only to find that your health system has been acquired by your that practice. Guess what? Now you have to work side-by-side with the clinicians who were just 2 weeks ago, your biggest adversary.

    I hate to say it but, it can seem that, with all this VUCA, the joke may be on all of us in healthcare…

    A is for Ambiguity

    At the end of the day, we don’t know what all the changes in healthcare mean.

    What does all of this mean for my current situation?

    What does it mean for my future?

    If this continues, who will be left to take care of me and my loved ones?

    It is truly an ambiguous situation.

    Since many of us are experiencing a VUCA reality, it’s important to understand the impact it has.

    Certainly, a VUCA environment is both a disrupted and a disruptive one. It impacts all of us, doctors, nurses, technicians, therapists alike. Patients are certainly not spared. It can leave us:

    • Feeling unstable and ungrounded
    • Unsure of how to react to all the changes that are occurring
    • With lack of clarity on what our role is in a rapidly changing system
    • With reduced motivation to take actions that contribute to the greater good

    Most importantly, living and working in a VUCA environment can leave us fearful, reactive, and feeling out of control. This means that our limbic system is frequently activated, taking us into a fight/flight/freeze state. Unfortunately, in this state, we’re trapped in survival mode. And survival mode means that our world narrows, and that we are reduced to looking out for #1, ourselves. When we’re looking out for #1, we invariably have less left over to give to others. And yet, perhaps VUCA times require a greater degree of leaning into connection and shared community than ever.

    So, what can you do? 

    Let’s Look At 4 Ways To Overcome Uncertainty

    While the challenges of a VUCA world can seem inescapable and insurmountable, there are a number of steps you can take to manage yourself so you still show up in ways that you feel good about. So you can look back and feel proud about yourself and your actions.

    A mindful approach can help you hold steady amidst these challenging times. Here are 4 mindfulness strategies you can employ.

    1. Embrace uncertainty

    When you stop and think about it, uncertainty and change are the only things that are certain. Impermanence is one of the basic laws of our world.

    After all, everything changes. Our relationships change. Our kids grow up and change. Our bodies age and change. Our environments change. Our planet changes.

    All too often, however, we forget this basic truth. We somehow expect things to be predictable and stable.

    The problem is that this expectation sets us up for difficulty. It leaves us struggling unnecessarily when something shifts. It adds a layer of suffering above and beyond that caused by all the VUCA around us.

    What I’m getting at is that we have a choice. We can meet uncertainty with reactivity or we can meet it with mindful understanding.

    More than meditating on a remote mountainside, mindfulness helps us have the calm, steadiness, and clarity we need to work constructively with all the change and uncertainty.

    At the same time, while we can find ourselves resisting change, we can remind ourselves that it does not have to mean something bad! Just take a moment right now to think of all the difficulties you have faced in your life and work that are now resolved and far behind you. This can help you see how change has actually been quite the positive.

    1. Respond to complexity with compassion

    Even knowing that change is the only thing that is certain, it can still be difficult to weather. Living in such a VUCA time is difficult. You deserve compassion for managing all the challenges.

    With mindful awareness, we can bring ourselves compassion for what we’re going through. There is increasing evidence that self-compassion is a powerful antidote to stress and even burnout. From where I sit, I think that it is actually one of the most powerful medicinals available to us.

    Preventing Physician Burnout In Healthcare: Focus on Your Strengths

    preventing physician burnout in healthcare
    Photo by Andreas Fidler on Unsplash

    It’s difficult preventing physician burnout when the demands keep increasing and it feels like the system is against you. For some, burnout becomes the norm, and it takes a big toll. In case you’re unsure, here are the three components of physician burnout:

    1. Emotional exhaustion and depletion
    2. Cynicism, depersonalization, and withdrawal from your work
    3. Inability to connect with your strengths and your accomplishments

    These run together, creating a downward cycle. Looking at the last one, however, we see how a focus on one’s weaknesses can set the stage for burnout. As physicians, we are often our own harshest critics, saying things to ourselves that we wouldn’t say to others. Among the hundreds of physicians I’ve coached, I’ve seen many hyper-focused on their perceived inadequacies. Perhaps you can relate to this? Here are a few questions to help you see if you’re leaning in this direction:

    Do you tend to see your strengths or your weaknesses?
    Are you paying attention to what you’ve accomplished or what you haven’t?
    Do you notice what’s going well or what isn’t?

    If you answered yes, know that you probably come by these patterns honestly. They’re the result of our education, our workplace environments, and the broader culture we live in. Changing these habits takes some practice, but it’s a sure way to reverse the cycle of burnout.

    Roadblocks to Seeing Our Strengths

    Medical training tends to be deficit-based. In residency, our noses were often rubbed in any mistake we made. An Internal Medicine resident recently told me, “On my Onc rotation, the attending kept focusing on how few of the chemo regimens I was up on. On my Cards rotation, the fellow kept at my not being up on the latest STEMI trials. No one seems to notice when I do know something. It’s been so long since I’ve gotten any positive feedback, I’m not even sure if I have any strengths at all.” These types of hypercritical experiences of belittlement create stress, worsen physical and mental health, and can even lead to suicidal thoughts.

    Most physicians have stories from their residency about being “pimped,” asked question after question by an attending, just so they’d finally get to the inevitable embarrassment of not knowing the answer. This pattern can leave us focused on our weaknesses as it relates to the practice of medicine.

    Experiences like these are pervasive in our training and, for some, may be reminiscent of messages we received earlier in life. Whatever the origin, these self-defeating messages can fuel the downward spiral of burnout.

    Physician Burnout and Negative Self-Talk

    Let me share with you an example of just how deep this goes. When I give talks on resilience and preventing physician burnout, I ask:

    What’s your typical ratio of self-promoting to self-defeating messages?

    And do you know their typical response?

    What is a self-promoting message?

    Physicians are so used to the self-defeating voices that it’s difficult to identify with the concept of positive self-talk.

    In addition to what we learn in our training, this also may result from perfectionism. Many physicians consider perfectionism an asset. And, while it may have served us in taking tests, perfectionism can hold us back today.

    Physician Burnout and Perfectionism

    Here’s one way of thinking about perfectionism:

    • Holding out for a barely attainable standard and then berate yourself for not achieving it.
    • Procrastinating to avoid facing self-criticism.
    • Believing that berating yourself will improve your performance.
    • Ruminating and experiencing anxiety about your performance.
    • Experiencing a lack of confidence.

    Bottom line: Difficulty appreciating your strengths and successes.

    A different frame to consider is: Have I done my very best? Can that be good enough?

    Preventing Physician Burnout and a Strengths-Based Approach

    If this resonates and you notice that the negatives dominate your thought processes, practice giving more attention to your positives. As discussed in a previous post, a strengths-based approach tends to be more motivating than whipping ourselves about our deficits. Here are some practical ways for you to shift focus to your strengths.

    • Notice when you get stuck focusing on your weaknesses.
    • Push yourself to shift attention to what’s going well.
    • Notice the “bright spots” in each day—times when something good happens; when you utilize your strengths.

    When you find yourself back in the cycle of self-defeating thoughts, ask yourself:

    • What’s right about me?
    • Am I doing well?
    • What are the three things I’ve accomplished today?

    Develop the habit of noticing what’s going well. Celebrate doing your best and practice letting “good enough” be enough. You may just find that this frees up your energy, replacing physician burnout with physician resilience which in turn helps you in preventing physician burnout.

    Doctor Stress, Overwhelm, And Physician Burnout Treatment

    doctor stress physician burnout treatment

    Demystifying Physician Mindfulness: A 12-Part Mindfulness In Medicine Series

    Does mindfulness in your medical practice seem achievable, or are you allowing “doctor stress”, overwhelm, and burnout run your life?

    For many of my readers, the concept of mindfulness may seem out of reach. The term evokes imagery of tranquil monks and mountain tops, existing miles away, both literally and metaphorically. I created this series to bridge this distance, and to introduce mindfulness to practicing physicians as an accessible stress management tool for doctors, and a form of physician burnout treatment.

    Each post in this series will examine the relationship between mindfulness and a specific area of a doctor’s day-to-day life. They each include a doctor’s story, and how the rigors of practice hamper their ability to fully enjoy that part of their life. After detailing their situation, I provide guidance for how the doctor can utilize mindfulness to gain fulfillment and mastery in that area.

    With each post, I’ll give you an actionable step that will help you integrate the post topic into your daily life. I’ll also provide an exercise that you can practice in your free time that will help strengthen your resilience, calm, and fulfillment. My goal is to transform mindfulness from a daunting, unapproachable ideal into a broad toolkit that you have easy access to. Simply put, I want to help you be a happier, more productive version of yourself, at the workplace and at home.

    Without further ado, the inaugural installment of Demystifying Mindfulness!


    TODAY’S TOPIC: Doctor Stress, Overwhelm, And Physician Burnout Treatment

    Our physician: Dr. P, is a cardiologist in a large Midwestern practice: 
    “I don’t know what to do. I feel like I’m drowning in my work. Every day of my practice feels like a battle, and when I’m with patients all I can think about is getting to the end of my day. I used to be in love with my practice and I don’t know what happened. Now, my work feels meaningless, and I’m completely overwhelmed.  What can I do?”


     
    Dear Dr. P, 
    You’ve already won half the battle. You’ve noticed that you’re locked in an ineffective pattern at work, and you’re interested in strategies to improve your situation. This realization is no small thing! What I want you to start doing is focusing on your physical experience. You’ve just wrapped up with your last patient of the day, you’re late to make it home for dinner with your family, you still have a half dozen charts to complete – what does your body feel like? Is your heart rate elevated? Are your hands tense? Are you sweating? Get in tune with the physical sensations that accompany the feeling of overwhelm, and you’re well on your way to combating it,  and feeling more in control. 
     
    Physical sensations often precede feelings of overwhelm; in some ways they’re an early warning system that can help you break the vicious cycle. Once you notice these physical precursors, take a brief pause. If you can take 5 seconds in between patients to take deep breaths and ground yourself, that’s a victory. See how many of these pauses you can give yourself in a workday. While this may seem trivial, over time, mindful pauses will begin to weave together into a calmer day, and a calmer and happier life. 

    In addition to your feelings of “doctor stress”, overwhelm, and burnout, you wrote that you no longer feel connected to your work. Overwhelm and lack of passion and fulfillment often go hand in hand. Of course, it’s challenging to stay connected to work when it’s so demanding. Reducing feelings of overwhelm by mindfully pausing throughout the day will help you feel more authentically connected to your work, and may revive some of the enthusiasm you’ve experienced in the past. Reciprocally, mindfully nourishing your commitment to patients will shrink feelings of overwhelm.

    At the end of every day, I encourage you to write down things that went well in your day. Focusing on what went well can reconnect you to your strengths and your sense of meaning. As doctors, we are trained to focus on what is going wrong. Give yourself structured time to focus on what is going right. 

    Give this mindful strategy a shot to offset the daily stress in the medical field physicians like you face,  and to help reduce the risk of physician burnout as you move toward being more present and fulfilled in your practice 

    To your resilience,
    Dr. Gail Gazelle


    Have an idea for a future Demystifying Mindfulness post? Want Dr. Gazelle to help you tackle your problem? Write in at drgazelle@mdcanhelp.com or contact us on the website.