We have been dealing with the COVID pandemic since 2020.
And due to that, there is a lot of discussion about related physician burnout.
I had my own share of challenges with the pandemic, and for the most part I can relate to a majority of the people I interact with. I shared a similar anxiety of contracting the virus and bringing it to home to my family as did any other physician.
I felt at times that due to fear of contracting infection myself, I was rushing through the evaluations, and that made me feel guilty. I stopped enjoying my work, which I loved before the pandemic. The routine became monotonous and rushed. Although I did not experience burnout, I did feel pressure due to rapidly changing policies and guidelines.
I decided to quit my job and start my private practice. I am able to continue patient care via televisits and spend the amount of time I need with them without the fear of compromising my health or contracting any infection. I see several patients who are struggling with burnout, pandemic-related anxiety, and depression, which prompted me to write this article.
I see burnout as a constant struggle with a situation/system where the demands continue to grow. Even when one is giving their 100%, they are not able to meet the demands. One can push oneself to the extreme trying to make things work, telling oneself “I can handle this,” not realizing the limits when one starts breaking. Then the question arises: “Should I switch jobs?” To answer this question, one needs to identify the core problems at one’s current workplace.
Because of the pandemic, a lot of people had to leave their jobs for various reasons.
There was a resulting vacuum in healthcare as well as other businesses. To fill the vacuum, the responsibilities were distributed among those who were still working. A lot of systems gave more administrative roles and promotions to their employees. Everyone likes to grow in their career, so at the moment it seemed to be a good opportunity to advance their career. However, the responsibilities that they were already in charge of remained the same. So one person became responsible of doing the job of two to three people.
Now what about the home life, family responsibilities, childcare, day-to-day household chores? All of those remained the same. No one was designating those roles to anyone else. No one to share these duties plus additional work at the job became the recipe for exhaustion, both mental and physical. Constant stress leads to feelings of inadequacy, anxiety, and depression.
In my outpatient psychiatry practice I see a lot of patients in this situation who are now considering a job change. I usually guide them to identify how they ended up in this situation.
My first question to them is, when were you the happiest with your job?
The answer to this simple question opens the door to more exploration.
I like to break things down for them.
How was life pre-pandemic? Was it manageable or do you recall it being stressful even then? Were you planning to consider a job switch prior to the pandemic?
What was added to your plate since then, both at work and at home, and why? Was it a staff shortage or was it because you could not say no?
Staff shortages are a system problem. Is the employer recruiting for unfilled positions? Not being able to say no needs more work on an individual level. At home are you able to get help?
How well are you managing your current role and for how long do you think you can sustain it? How is it affecting your self-care and family?
Do you think you will be happy again if things are reversed?
Answers vary depending on the priorities.
Once you have all the answers, then it is time for action.
This is another set of questions that I work with them on:
How is your relationship with your employer? Do you feel comfortable in bringing up your concerns?
How long have you been working with a particular company? Do you feel that your concerns will have weight?
How to renegotiate your current role and your added responsibilities? This may require some coaching and communication skills.
Are you ready to take a pay cut, and what will be the implication on your personal life if you do so?
And then I repeat the question, Do you think you will be happy again if things are reversed?
Overall, one should have a very clear vision of one’s needs. Most of the time, if you have your priorities set and clear, it is easy to negotiate with your employer. This pandemic taught us a lot, including the importance of self-care and emotional well-being. Most employers are aware and are willing to work with their employees. Hiring a new person for the job can be costly, so retaining a good employee is in their best interest
Of course, if there is a conflict and both parties are unable to come together, then it is time to part ways.
“You are very hard to negotiate with” was the remark one of my previous employers made when I insisted on my work hours and did not agree to take more work than what was decided in my contract.
I took it as a compliment.
Burnout is real and it does not have any time span for when one can feel it. The common symptoms to look out for are anxious or depressed mood, irritability, feelings of inadequacy and guilt, not feeling in control, and appetite and sleep disturbances. All of these symptoms affect mood, efficiency, and work performance.
Please reach out for professional help if these symptoms are affecting your day-to-day functioning.
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About Dr Sirosh Masuood
Dr Masuood is a board-certified psychiatrist. She completed her general psychiatry training at Mount Sinai/Icahn School of Medicine in New York where she was chief resident. She pursued fellowship training in consultation and liaison (C&L) psychiatry at Long Island Jewish/North Shore Hospital in New York. She has vast experience in outpatient practice and C&L psychiatry. She has worked at Shady Grove Medical Center, Adventist Health Care, where she established the C&L service and served as medical director. Currently she is a partner in a private practice, Excel Psychiatric Consultation, in Germantown, Maryland, where she offers medication management and TMS. Dr Masuood has a special interest in physician well-being and offers psychotherapy and coaching to physicians.
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