Am I Too Young to Burnout?

It's three o'clock on Monday afternoon and I just spent the last 30 minutes going over a patient's laundry list of medications with her in detail. Taking each pill bottle out of her grocery bag one by one, half of which are expired. At the end I'm asked if I could go over the medications just one more time. At this point I take a deep breath, excuse myself, and walk toward my personal office, closing the door with a little more force than normal.

I stand in front of a painting on the wall depicting a beach in Hawaii. White sand, crystal clear water, blues skies, and one extremely comfortable looking beach chair. It takes me just a few seconds to mentally escape and firmly plant my buttocks in that chair, sand up to my ankles, and absolutely no other human being around for miles. Yes, this is nirvana … and then "beep, beep," the dreaded intercom. "Your patient is ready." The moment I hear those words I'm instantly transported back to my office in standard uniform - long white coat, button-down shirt, color-coordinated tie, and of course, the obligatory stethoscope wrapped around my neck. Break time is over and it's back to the grind. "Ok, let's go over these medications one more time."

I don't know about your medical school but I'm pretty sure we didn't have any lectures on burnout, or maybe I was just absent that day. But at age 36, and out of residency for almost seven years, burnout is definitely a concern of mine. Although I must admit, I'm not quite sure what defines burnout in the medical field.

Are these some of the signs: Wanting to seek early retirement? Limiting your practice to five patients a day? Or merely installing a margarita machine in your office, blasting some Jimmy Buffet, and calling it a day at 11 a.m.? Yes, I have thought about all of these things, I'm not proud of it, but it's the truth. Well, maybe not to the extent of installing a margarita machine, but it would certainly be nice to have some type of tropical, alcoholic beverage that would instantly put me on that beach in Hawaii. You know, the drinks that have the little umbrellas in them.

In all seriousness, the truth is, I have a pretty good life. I have a very nice patient population, great hours, financial stability, and I still enjoy the practice of medicine. So why do these notions enter my mind? Well, I think having direct contact with patients five days a week is mentally and emotionally draining - regardless of what field of medicine you practice. The core of what we do as physicians is merely to absorb what our patients tell us. We listen first, take everything in, and then give our two cents - sometimes sacrificing our own emotional well-being to heal our patients. Most of us, myself included, put our heads down and plunge forward, simply moving on to the next patient, with no regard for our own mental health. By the end of the day we're drained.

Of course not all patients treat us like this. Some actually empower, motivate, and re-energize us, but that doesn't appear to be the norm. Let's face it, most patients don't swing by the office to pat us on the back and tell us what a great job we are doing. Nor would I expect them to. We do have outlets: We can complain to our colleagues, family members, and friends. But ultimately, that's only a stop-gap measure, like covering a gaping wound with a band-aid.

I know I won't get much sympathy when I speak to my father about my frustrations - he's been a practicing family physician for over 40 years and never complains. At least not to his middle child. He does however pass on some good advice: "You need to take vacation!" Sounds like common sense, right? Then why do so many of us not take the time to get away from the office or the hospital? If we do, we are attached to our laptop or cell phone, constantly checking in to make sure our patients can survive without us for a week. Believe it or not they can. Dad has always been a proponent of working hard when you're at work, and leaving work behind when you're on vacation. I've found out that he's absolutely right.

So, what does this 36-year-old bachelor do when he finds himself staring at the picture of the beach in his office - following 45 minutes spent explaining to a patient that he doesn't need a Z-Pak for cold symptoms that began only two hours ago? He calls his best friend and says, "We need to book a trip to Vegas." A few days away from the office, and I'm recharged - ready to go back to my patients. (Well actually it takes about a week to recover from Vegas, but that's just the price you pay.)

I know that I'm still trying to figure out the best way to balance helping my patients and maintaining my own mental health. But, it's worth it. I want to be able to do this job, and do it well, as my father has for the last four decades. So whether it's taking my frustrations out on a daily basis on the treadmill, or taking the red-eye to Vegas with my closest friends, both achieve the same desired effect.

Another way I try and keep fresh is to avoid the same, worn-out routines of practicing medicine. I try to implement themes that I'm passionate about in my office. From using new techniques for educating patients on diet, exercise, and the risks associated with obesity to implementing new ideas in the office to change up the daily grind, these are just a few of the ways I try and keep the flame burning.

I believe that the ability to practice good medicine over the long term is based on our capacity to stay fresh and motivated as physicians. When I think of burning out as a physician, it reminds me of those candles my mother would put on my birthday cake as a child, the so-called "fake" candles. The ones that couldn't be blown out no matter how hard you tried - they would only flicker. Well, if after forty years of practicing medicine the candle is still burning, then I'm perfectly okay with the occasional flicker, as long as my passion for medicine still burns. The flicker, well that just means it's time for a little vacation. Thanks Dad.

Kevin Radbill, DO, is a 36-year-old physician who graduated from Nova Southeastern Medical School, and completed a family practice residency at Florida Hospital, East Orlando. He is currently in solo practice in Winter Park, Fla. He has a strong interest in preventive medicine and lipidology, and spends a lot of time counseling his patients on weight loss via proper nutrition and exercise.

This article originally appeared in the April 2011 issue of Physicians Practice.