The emotion in the delivery room was a mixture of fear and excitement—the feeling that something you’ve wanted is about to become a reality. The couple in the room was young and the woman was fully dilated. Labor was smooth so far and she had just begun pushing.
I was the physician in the room, and the only excitement I could muster was for the end of the delivery. I loved labor and delivery, but in that moment I wanted to be anywhere but there.
Clearly my feelings were a stark juxtaposition to the happiness in the room, and it was in that moment that I realized I needed a change. This was not who I thought I would become when I was an altruistic medical student. The constant stress and increasing bureaucratic demands were taking their toll. I was burned out.
Physician burnout is the result of prolonged stress with three major components: exhaustion, cynicism or disengagement, and a reduced sense of professional achievement. I was experiencing all three, and now I know I was not alone. According to an article published in the Mayo Proceedings, 54% of physicians show signs of burnout and that number had increased from 45% in just three years.
It wasn’t easy admitting that I needed help and I wasn’t sure where to turn, but I found a life coach who worked with other professional women who were in similar situations. With a great deal of introspection, it became clear that private practice no longer fit my needs.
I thought about leaving clinical medicine. It was a daunting option and giving up a steady income was unfathomable. I was still paying off medical school loans. I had come this far. How could I leave?
Luckily, I didn’t have to make an all-or-nothing choice. At that time, OB/GYN hospitalist programs were becoming more prevalent. In hospitalist programs, hospitals are staffed 24/7 by clinicians who partner with community physicians and midwives to ensure continuity of care for antepartum, intrapartum, and gynecologic patients. Generally, the clinicians rotate in 24-hour shifts, for a few days every month, to ensure comprehensive coverage of facility and community needs.
The work schedule was attractive, but the amount of time off was even more appealing. I knew I’d miss the relationships with my patients as well as being in the operating room, but I needed to take a leap of faith and give hospitalist medicine a try.
I joined Ob Hospitalist Group (OBHG), the largest OB/GYN hospitalist group in the nation, and relocated to Houston where a new program was opening at a community hospital. I had high hopes that this career transition and the abundance of personal time this position afforded would bring clarity and help answer questions for me. Do I stay in clinical medicine? Am I still passionate about medicine?
It took me about six months of rest and recuperation before I felt like I was no longer exhausted and that I’d gotten my life back. I had time to reconnect with people, return to loved hobbies and take part in new experiences. My passion and enthusiasm for the practice of medicine returned.
My journey inspired a purpose and passion within me. I wanted to help other doctors facing burnout. After a year of training, I became certified as a professional co-active coach and a physician development coach. My work as a coach focuses on all aspects of physician burnout, from increasing awareness to working with doctors to find solutions that fit their professional and personal lives.
Finding balance is a lifelong struggle. It’s not something you achieve once. Rather, it’s a state of equilibrium that can easily become unstable. Thankfully, achieving balance is not rocket science, but it does go beyond surface advice of healthy eating and exercise. If you are a physician, or if you work with physicians, here are three lessons I’ve learned that that I share with clients.
- Create priorities: I ask each of my clients to look at their daily tasks and to ask two questions: What are the things that only I can do? What are the things that I enjoy doing? If an item on their list does not fall into one of these two categories, it is something that they can delegate. As an example, electronic health records have shifted many previously clerical duties to the physician.
However, doctors can create workflows and protocols to help overcome this burden. Consider creating order sets for frequently seen office visits. Every possible situation will not be covered by protocols or order sets, but if three out of four charts no longer need your attention, I’d consider that a win. Joining OBHG has eliminated many of these office burdens as the backend functions are handled by the company.
We all have responsibilities outside of the office as well. Again, if they do not fall into one of the two categories described above, evaluate ways to outsource some of these items. In this age of grocery delivery services and virtual concierge, we can allow others to reduce our workload. The hardest part may be giving ourselves permission to do so.
- Define your values: Values are not morals or standards; rather, they are “the qualities of a life lived fully from the inside out,” wrote Henry Kimsey-House, Karen Kimsey-House, Phillip Sandahl and Laura Whitworth in the book “Co-Active Coaching: Changing Business, Transforming Lives."
Your values are qualities you admire and things you can’t live without. Traits that irritate or anger us are antonyms of a value. For example, some of my values are honesty, creativity and connection with others. Consistently honoring these values will lead to a life of satisfaction and fulfillment.
- Nurture important relationships: When we are exhausted, it is easy to neglect friends and family, but doing so only serves to create distance between us and those we love at a time when support is of utmost importance. Further, establishing relationships with other physicians on the medical staff and creating a culture of collaboration can improve work satisfaction.
One of the most important relationships to nurture is the one with yourself. Physicians self-sacrifice all too often, and it is almost impossible to serve others effectively when your own vessel is empty. I’ve learned that there is truth behind the saying, “Put your oxygen mask on yourself before helping others.” It took almost leaving medicine, and a career reset with OBHG, to fully realize it.
Nahille Natour, M.D., is a practicing OB/GYN hospitalist with Ob Hospitalist Group and a certified physician development coach.