The four major contributors to burnout.

The first cause is the imbalance between your heavy responsibilities & liabilities, and the modest or variable support and cooperation you get. You are asked to stop pain, cure illness, and save lives, all without mistakes, but you have to do it for long hours, sleep deprived, and keep a flawless written record of it!

The second cause is relationships with patients. These include the demanding who expect the impossible, the needy who are incapable of feeling safe or self-sufficient, the irresponsible who blame their problems in life on everyone and everything, except themselves, the emotionally distraught who are always distressed, the medically complex who remain ill despite progress on one condition, and the noncompliant whose behavior says that they reject your expertise even though their words claim to accept it.

The third cause is the guaranteed failure rate through patient death.   Death after a long and satisfying life is one thing, but early death is always tragic and deeply painful.

Finally, the fourth cause is the built-in dysfunctionality of a broken healthcare system, including the high threat of lawsuits, increasing demands of investors and your falling income and economic security, your declining independence and freedom to practice and being told by non-physicians what you can and can’t do, and the pressure on you to treat the chart instead of relating authentically with patients.       

What can we do? I will talk about the results or by-products of burnout in my next blog.