Burn out...a term I seem to hear a lot these days. I have been in healthcare for over 20 years, and there has been a significant change in the field during that time. It can be very difficult to deal with burn out at work and not let it affect your home life. We have discussed the struggles of working moms from many different perspectives with our blog entries over the past couple of years. We have discussed ways to try and balance work and motherhood. We have given examples of how to make the most of the quality time you have with your kids and let go of the guilt you feel when you are not with them. So what about when you struggle with your chosen career? Most working moms, myself included, will shout from the rooftops about how their job/career is part of their identity and not something they wanted to give up once they became a mom. They will take it one step further and explain how being fulfilled at work makes them a better mom. So despite the stress and struggles, we will say it"s worth it...until it's not. As we become more mature (my term for older 😉), we start to look at life differently. I would argue that some of the beliefs we adopt as we age and reflect on the years gone by, should be present earlier in life, and we should, if at all possible, do everything in our power to avoid having to use the term "burn out".
I entered medical school in 1994 with dreams of becoming an orthopedic surgeon, realizing it would be a long road ahead. I could not have been more excited to match into an excellent residency program, and I started that journey in 1998. It was crazy long hours and a lot of hard work in a very male dominated specialty. I continued on the path toward my dream and had the great fortune to become a mom during that time as well. Another dream come true...to be the mom of two amazing daughters. Onward to a fellowship and then my first "real job" as a hospital employed attending physician. Two years later I left that job and joined the practice which I am still a partner in today. I have been with my current private practice for 17 years, so a total of 19 years in practice plus the 5 years of residency and 1 year of fellowship before that. Quick math brings us to 25 years as a doctor! As we all often say related to many circumstances... "where did the time go?" How is it possible that I have daughters in their twenties and I am soon to be 52? I truly can't believe it. Residency seems like a lifetime ago and the pure excitement of my work and helping people also seems like a thing of the past. Physician...it is one of the most noble professions. We devote our young adult years to studying, training and sacrificing so we can help people. We expect to make a good living doing so in order to pay off our medical school loans and all the debt we may continue to acquire during residency. However, we realize the perception of the "rich doctor" is false and also a thing of the past, but we still hope to be compensated well for what do.
We realize the business of healthcare has become something we no longer recognize. We continue to work hard for some giant health system or mega private practice and no longer have the control over how we want to practice medicine. We are governed by the insurance companies and the big business types who run the health systems and practices. We are the hamsters on the wheel dealing with all kinds of restrictions and denials and decreased reimbursements. Much of the time, we are justifying what we are doing to people who are no longer or never were clinicians yet have the right to deny the MRIs we want to order or the surgery the patient needs because all the little boxes on their computer screen were not checked. Yet if he or she was the patient, they would surely have a different opinion.
I suppose anything you do for 20+ years can become stale, and the term burn out can be found in many different occupations. I do feel like it is an epidemic in the healthcare industry right now. This is not unique to physicians. It is being seen in physician assistants, nurses, therapists and all other types of healthcare workers. The rewarding aspect of this profession is being smothered by the struggles and frustrations dealt with on a daily basis. We are dealing with lack of resources and staffing which has been amplified since the pandemic. Obviously, healthcare was affected significantly during the pandemic, and we continue to feel the effects of that now. However, I don't think we can blame the entirety of the current situation on Covid. Many of these issues were present before, but are certainly amplified now. I don't know if there is a solution, because it can be very hard for many of us to make a change in our career once we have been in it for many years. Maybe we don't even want to do that, but we just want to work in a better environment. We have worked very hard to have a special skill set with the ability to treat patients, and in the case of surgeons, we have spent countless hours perfecting our craft so that we can be trusted to cut into another human being. It is truly a unique position to hold, and it brings with it a tremendous amount of stress and responsibility. I may not have anyone's life in may hands as an orthopedic surgeon versus another specialty such as cardiothoracic surgery, but there is still a lot of pressure on me every time I walk into that OR to do a shoulder surgery, even when I have done it thousands of times before. That part of my job, while stressful at times, I still enjoy very much. The OR is a special place which is hard to describe unless you work there.
There is no greater reward than a happy, appreciative patient who sings your praises during a post-op visit and utters the words.. "you changed my life". I have received many thoughtful notes over the years and cared for many families who have become special to me. Despite all of that, there are some days when I admit feeling like it is time to walk away. Problem is...I can't...most of us can't. We need to make a living and take care of our families. Our families...who often take the brunt of our frustrations when we come home in a bad mood or too tired to play with our kids or go out to dinner. Our families...who we love and want the best for but know on some days we are not equipped to be the best moms we can be because the day at work has truly sucked the life out of us. Our families... who just want to talk and wonder "how was our day?"...but we have no words left after talking to 30 patients and every unhappy member of the staff who feels overworked. Our families...who love us unconditionally, no matter how cranky we are. Our families...specifically are kids who look up to us and want nothing more than to be with us and can't wait for us to get home from work... until they are teenagers of course😉
So what is the answer? I wish I knew. What would I do differently so that I would not be a member of the burn out club? I don't know. Could I have made a change in my career ten years ago which would have avoided this...the answer is no. Once again, I trained for years to be able to do what I do. I am good at what I do, and I have helped thousands of patients over the years. I can still be excited about a day in the OR when I have a bunch of my favorite cases to do with a great team and music playing in the background. I can have a great day in the office when my PA comes and tells me she has seen a string of happy post-op patients who are progressing ahead of schedule and are so thankful. I can be happy when new patients come in and say they were recommended to me by a friend or family member who I took care of in the past with a great outcome.
I am blessed to work with many wonderful people, but even all of these good things can't make up for the struggles and frustrations on a daily basis as well as the long hours I still put in with less and less to show for it as time goes by. All of these good things I just listed are not enough to keep me in this role if I was financially and otherwise able to walk away now. I have given medicine/orthopedics 25 years of my life, and while many give much more, I could be satisfied with this, and feel that I have given enough. I am fortunate to know that my now adult kids do not resent my career. As they got older, they understood the demands of my work and appreciated how I put them first always even if I occasionally had to miss something. It was a rare occurrence, and we were lucky to have the amazing support of my parents who could always be there if I couldn't.
At almost 52, what would I tell my 42 year old self to do differently?
1. Think about other possibilities, plan ahead.
2. Consider the chance that this career may not be what you want to retire from at 65.
3. Invest more and learn more about passive income,
but don't deprive yourself or your kids of fun things or experiences.
4. Explore other avenues/careers which could utilize your specialized training.
5. Learn something new (would likely be impossible as a single full time working mom) but could try.
6. Don't bring your work frustrations home (actually that is better advice for almost 52 year old me!)
7. Realize that life is short and you will be almost 52 in the blink of an eye.
