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Epidemic Physician Burnout Affects Female Doctors Differently

Part 2:  What Does Physician Burnout Look Like for Women?

Guest Post by Dr. Dike Drummond of The Happy MD

WMDR is happy to present to you part 2 in the WMDR series on Physician Burnout:

Physician burnout is a serious matter.  As women physicians assume a greater role in patient care, in an increasingly complex healthcare workplace, it is important to be able to recognize, in our selves, and in others, what burnout looks like:  1). Emotional exhaustion; 2) Depersonalization: and 3) Feelings of Reduced Accomplishment.

THE FEMALE PATTERN—Simple as 1,2,3…….

Women seem to follow the classic three part pattern of the MBI (Maslach Burnout Inventory (MBI) http://www.mindgarden.com/products/mbi.htm)– what they reported in the order originally.

Stage One:

Burnout in female doctors starts with Emotional Exhaustion. Women traditionally support others in numerous areas of their lives … at home and at work. You have  only so much energy and compassion to go around. Exhaustion of reserves and entering the downward spiral are the usual first signs.

Stage Two:

Cynicism, sarcasm and blaming patients are step two of burnout for women. These depersonalization behaviors are actually a defense mechanism. This subconscious attempt shields you from the source of your energy drain. It feels somewhat better for an instant in time and yet does nothing to stop the actual drain or relieve the feeling of exhaustion. Cynicism is especially difficult for women to keep up for very long before stage three kicks in.

Stage Three:

Reduced accomplishment and doubting the quality of your practice and the difference your work will make in your patients’ lives.

THE MALE PATTERN= 2,1,?……..

Stage One:

Men more commonly start with depersonalization and cynicism which serves as a coping mechanism for overwhelming stress. “My patients are such a bunch of $%@+!%”. This is, again, a dysfunctional response to the inherent stress of being a doctor and is only a temporary relief. After all, these are the people we physicians spent decades learning to serve.

Stage Two:

Emotional exhaustion follows. The downward spiral worsens until they are tapped out. It is important to note that our medical education taught us to function for long periods of time “on empty”. This state of emotional exhaustion often is a chronic condition can be mistakenly interpreted as “a normal part of being a physician” by those suffering from burnout.

Stage Three:

By comparison to the female Burnout pattern, men’s stage three, reduced feelings of accomplishment, is remarkable for its absence! Male physicians are far less likely to feel that the quality of their work has diminished. A common statement is, “… sure I’m stressed, but I’m not burned out because I am still doing good work.”

This cynical, exhausted male physician keeps going despite burnout because he feels he is still a “good doctor”. This lack of a phase three allows men to continue to practice in denial of their distress despite the exhaustion and cynicism their coworkers, patients and family witness on a daily basis!

Another major difference between women and men physicians is their willingness to ask for help and support. Isolation is a constant challenge for physicians. Stress and burnout only deepen the sensation of being alone at the top and the belief that no one else could possibly help.

For many doctors, acknowledging burnout and telling someone else you can’t keep going like this feels like an admission of inadequacy, failure, not being tough enough or a sign that you actually are crazy (just as you might have suspected for a while now). Despite these tendencies, women physicians are much more likely to tell someone they are exhausted, ask for help and receive it.

Men are much more likely to remain in denial, isolated, descending into a classic disruptive doctor pattern or suffering a burnout complication such as divorce, drug and alcohol addiction and suicide.

What Should I do?

First, when you notice these signs in yourself, take a breath and take a break.

Next, recognize these symptoms and stages for what they are – burnout. This is a cue to step back, take better care of your own personal needs and create some boundaries for a more balanced life. You, your staff, your patients and your family will be glad you did.

Third, when you notice these signs and symptoms in a colleague, reach out.

Tell them what you are seeing and ask how they are doing. Be a little pushy. Keep checking in. The normal initial response to your outreach – from both women and men – will be denial. As long as you see signs of burnout, please keep reaching out. Be there as a friend when they finally ask for your support. Your caring and persistence could save their career, their marriage … even their life.

Dike Drummond, M.D., is a family physician, executive coach and creator of the Burnout Prevention Video Training Series. He provides stress management, burnout prevention and physician wellness and engagement coaching and consulting through his website, The Happy MD.

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