There are many reasons for physician stress. Doctors are caught in a web of pressures ranging from diminishing financial reimbursement to Medicare/Medi-Cal audits to fraud and abuse concerns. Physicians typically enter the medical field with the expectation that they will make people’s lives better and that patients will appreciate them. However, for many, medicine becomes a daily grind overseen by massive managed care organizations and faceless government bureaucracies.

Physician discontent is evident in every specialty, and there is a growing awareness that doctors are at risk for burnout, which threatens the sustainability of the healthcare system. Attention to physician well-being promotes patient safety and reduces the probability of errors, thereby diminishing the threat of malpractice litigation.

A 2001 study published in the Journal of General Internal Medicine reported that physicians were less satisfied in every aspect of their professional life than physicians from a decade earlier. Dissatisfaction was documented throughout physician specialties, including primary care, surgery, infectious disease and anesthesiology.

Recognizing the issue of physician stress, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) now mandates that hospital medical staffs have physician wellbeing committees. This mandate, along with monitoring by state medical boards and increased consumer concerns, has created a climate that lends urgency to the creation of better systems for monitoring and promoting physician health.

While most of the well-being committees originally dealt only with substance abuse—usually after the fact—they are now beginning to focus their energies on prevention and a wider range of social issues, such as disruptive behavior, depression and other mental illnesses, family stress and sexual boundary violations.

Burnout—as a syndrome—is present in many individuals under constant pressure. It has been associated with impaired job performance and poor health. This could include headaches, sleep disturbances, irritability, marital difficulties, fatigue, hypertension, anxiety, depression and myocardial infarction. Burnout may also contribute to alcoholism and drug addiction.

Symptoms of burnout can lead to physician error, and these errors can, in turn, contribute to burnout. This vicious circle underlies the potential human costs of medical mistakes, which can be devastating for a physician.

In a 2001 paper by Eric L. Weiner, Geoffrey R. Swain, Barbara Wolf and Mark Gottlieb titled “A Qualitative Study of Physicians’ Own Wellness Promotion Practices,” the methods used by 130 primary care physicians to promote their own well-being were examined.

The main ways physicians took care of themselves included spending time with family and friends, religious or spiritual activities, finding meaning in their work, setting limits at work and adopting a healthy philosophical outlook.

The following are some suggestions you can use to stay well and avoid burnout.

• Take care of your own body.
  Physicians are always caring for others’ bodies. But when was the last time you had a physical? When was the last time that you took the time to remember what a joy it is “to be”? A regular regimen of exercise, relaxation, adequate sleep and good nutrition is essential to achieve physical well-being. Meditation or breathing exercises and even something as simple as yawning or taking a deep breath allows the body to relax.
• Be your own best friend.
  If you made a mistake or things didn’t quite turn out as you planned, your best friend wouldn’t give you a hard time. But many doctors treat themselves in ways no friend ever would. In medicine, perfectionism is pursued and rewarded. However, perfectionism makes it harder to cope with the reality of being a caregiver. Some things are not within your control. You must learn to base your self-esteem on what you do have control over—your efforts.
• Listen and communicate.
  Physicians’ training often leads them to look for and demand solutions to every problem. It’s ingrained in the culture to rush in and make everything all right, but this can interfere with empathetic communication. Many physicians can work on “listening without having to fix things.” Conversely, you can learn to describe your feelings to other people without the expectation that they will do something about it.
• Don’t be afraid of change. Be flexible.
  Physicians often react to stress by working harder, a solution that only makes the problem worse. Another common response is to accept change with resentment. Change is a necessary part of life and people typically experience a tremendous sense of relief when they finally accept its inevitability. Yet, like many of the suggestions above, this ability to accept change and to be more flexible is difficult for many physicians to embrace. Change forces you out of your comfort zone and makes you reassess what you really want out of life. A creative response to change can restore your sense of mission and purpose.