Evolved Physician

Physicians have prescribed proper diet, hydration, recreation, rest, and sleep for millennia. We all know how critical these homeostatics are for good health.

But we don't have enough hands to help with all the work. The sheer volume of it demands every moment of every day and every night.

We devolve into “heads on a stick.” Our bodies become mere vehicles to carry our brains around in service of the work. Our stressed bodies try to communicate with us. They send us distress signals of dis-ease, but we push on valiantly for the sake of the work. We strain to get every task done by day’s end to fulfill our duty to our patients, literally sacrificing our health for theirs.

But when our physiology can no longer compensate, when our bodies and emotions finally break, we must confront the truth: we just can't dispatch 100% of the work every single day with our health intact. Some things must be left undone for another day.

And here's the problem: some of us are...

Healthcare workers deserve healthy work. Every worker does.

American workers are currently agitating for more humanized work conditions. They're voting with their feet, leaving their current jobs in search of healthier and possibly happier work.

Yet not everyone believes work should include health or happiness. For many, work is purely functional, and the best work is simply work done well to reach a desired end. The thought is, “Employers don't exist to make you healthy or happy; they exist to provide a paycheck. Get happy on your own time.” Personal, cultural, and generational lenses certainly color the meaning of work. But a new consensus on healthy work is sorely needed.

If you are a stressed out, burning out physician or clinician, your work situation is wholly unique. As a health expert, you know the damage that acute and chronic stress wreaks upon the body. And as a care provider, your potential impairment from a stressful job can impact the health and well-being...

If you’re stressed out or burning out from your stressful job, you dread getting out of bed in the morning. When your feet hit the floor and you drag yourself into another damaging, poorly malleable day, you are saying “Yes” to something.

Our current healthcare delivery model reminds me of a Netflix series I just watched called Squid Games. These desperate people who were in huge amounts of debt (where the bad guys were gonna take their kidneys and eyeballs if they didn’t pay up) signed up to win an insane amount of cash at the completion of a game.

As you might expect, the game was horrifically violent. And at various intervals the players had the opportunity to stop and decide if they would continue enduring the game’s brutality or free themselves from it. The vast majority continued to play. They continued to say “Yes.”

It made me think of you as a job-stressed physician or clinician.

When you go to work, you're voting with your feet....

Physicians and clinicians do heroic things every day for their patients but often lack the courage to fix their own broken job situations. Flex your courage today for your best good!

If you’re stressed out and burning out, you know you need to change your work situation. But fear unfailingly sets in: “What if I ask for an accommodation and my admin fires me? If I leave medicine, who will I be? How will I pay my kids’ tuition?” Once fear hijacks you, you become paralyzed. You do nothing about your stressful job situation and the burnout worsens with time.

But you know what’s funny? How courageous you are when it comes to patient care.  

It takes courage to go see an angry, demanding patient. It takes courage to tell a patient they have cancer. Heck, it takes courage just to show up to work every day.

How is it that you have so much courage in your daily work, but when it comes to creating healthy work for yourself, for your best welfare, fear takes...

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,...

If your job is stressing you out, burning you out, what work would you do instead if money were no object?

Would your current work change if, in perpetuity, all your bills were paid, all your needs were met, and you always had plenty of extra cash to do what you wanted when you wanted?

You might dismiss this question as unrealistic and insipid.

Yet as seemingly ridiculous as it may seem, this question is a technique designed to stretch your mind to consider new possibilities. Coach stuff. A similar coaching conversation might go like this:

Coach: “So you hate your job, and you’d like to brainstorm ideas about what else you might do. Okay, I have one. What would it be like to run away and join the circus?”

Female Client: (laughing): “The circus?”

Coach: (seriously) “Yes, the circus.”

Client (still laughing, but playfully considering): “Okay. I might have to let my beard grow…that won’t be a problem; I’m...

 If you're a stressed-out, burning-out physician considering new work but confused about your next steps, you can get clarity. And one way to get clarity about your future work is to look back at your decision to pursue medicine.

What's your story? Did you choose medicine because of other's dreams for you--dreams of prestige, influence, and presumptive wealth? Or perhaps you wanted to be a healer since day one. How did you get here?

Consider the moment you decided to pursue medicine and what fueled that decision? Look at it, eyes wide open. How much of a fit was it?

What I saw when I looked back.

I’ve always loved to read and learn, writing my first book at 8 years old. When it came time to choose my life’s work at the tender age of 15, my grandmother suggested medical school. I thought, “That sounds cool.” What a great way to learn about life! Of course I wanted to help people. But it wasn’t until a patient vomited on my shoe that it hit me:...

Changing your stressful work situation is often hindered by fear of risk and loss.

What will you do for health insurance? How will you pay off your school loans? How will you pay your kids’ tuition?

But planning before you firmly decide to make your change is perilous. Planning before deciding might prolong damage to your physical and emotional health or even cause you to give up on the idea altogether.

I was a guest at an event for physicians transitioning into entrepreneurism from clinical medicine. The fear of losing benefits was palpable and real. Financial fear can be so overwhelming that we stop our dreams in their tracks, resigning our change to a “right” time that may never come.

Although this and other responsibilities are real concerns, having a clear plan is not the first step.

Change requires a breaking, a severing, of the ties to your present status quo. Your new future demands a shift in attachments.

First and foremost, be committed to your change....

One of the first questions that stressed doctors ask at the mere thought of doing different work is “But what else can I do?”

You might have said this too. I did.

“This is all I know. This is all I can do.” So you continue to be stressed, you continue to stay in a bad job, and you continue to be damaged.

What if instead you changed the question from “What can I do?” to “What do I want to do?”

If you’re not sure what you want to do instead, there are so many ways to find out.

You can discover what you really want through inspiration, which is incredibly powerful, but also through experience. “Boots on the ground” experiences.

And these experiences come in two flavors: congruent and incongruent.

Congruent experiences mean that as you go throughout the course of your daily life, be it at work or outside work, you experience what I call “pokes to get you woke,” things that get you excited, that bring you...