Burnout is Shameful. Having It Is Not.

Burnout is a logical progression, not a personal failure.

2024 will be the 50th anniversary of the term “burnout”. And despite five decades of ever-increasing awareness, the healthcare industry has utterly failed to substantially mitigate it.

Nearly half of physicians were suffering from burnout before the brutal onslaught of the worldwide pandemic, and healthcare workers as a whole are suffering in unprecedented ways since. The fact that the medical profession has remained rife with burnout for half a century and counting is shameful.

WHO listed burnout in its 11th Revision of the International Classification of Diseases (ICD-11) for Mortality and Morbidity Statistics, and defined it thusly:

“Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”

Fortunately, its inclusion gave burnout a shred more legitimacy as a “real” thing, an official problem to be addressed. Unfortunately, this definition is sorely inadequate.

What does “successfully managed” chronic job stress even look like? Does it mean you only need to take one medication to drag yourself to work instead of two?  And who’s doing the managing? It appears that responsibility is still sitting quite squarely on the shoulders of individual providers.

Chronic workplace stress should not be “managed.” Chronic workplace stress should be severely curtailed at the barest minimum, if not eliminated.

We physicians and clinicians encounter very stressful situations trying to help sick people. That is part of our work. But the way we do that work shouldn’t be stressful.  That’s just EXTRA. It’s all the extra that throws us over the edge. See the difference?

Physicians and clinicians want to take care of people. We want to be great at it. We don’t come to work to fail.

But when the demands of our work far exceed the organizational resources available for us to meet them, our only choice to get the work done is to draw on our personal resources. Understanding these “energy accounts” will be critical to healing provider burnout--another article for another day. Sufficient here to share that if this resource inequity persists over time, we become personally overdrawn. We become emotionally, physically, mentally, relationally, and spiritually exhausted. Exhaustion is the primary feature of burnout.

And that exhaustion creates protective responses. It makes logical sense that if your work is chronically wounding you, you’d become reactively cynical and disengaged—a second feature of burnout. And it also makes sense that you’re just exhausted and DONE, you would feel like you’re not doing your job well, or nothing you do even matters—the third feature of burnout.

Being burned out is not a personal failure. It’s a logical progression.

So instead of heaping blame and shame on physicians and clinicians for being substandard in some way, the healthcare industry must focus its full attention first on giving them what they need to do their “extra” work in a stress-free, healthy manner. Everything else must follow.

Instead of you feeling shame that you are less resilient than your colleagues, focus on what you need your work to be so that you are healthy and whole.

Burnout is a normal response to an abnormal work situation.

50 years of burnout in the medical profession is shameful. Having it is not.