When Burnout Comes Back

Clinician burnout isn't necessarily a one-time event. One doctor who experienced recurrent burnout during his 20-year medical career shares his story.

Experts estimate that the cost to replace a burned-out physician who has left an organization ranges from $250,000 to $1 million—and that doesn’t account for losses due to lost productivity or medical mistakes.

While researchers work to come up with a broad calculation of burnout costs, the emotional toll on clinicians is undeniable, especially since burnout isn’t necessarily a one-time occurrence.

There are circumstances in which a physician at your organization may return to medicine after a burnout. 

Related: Beating Clinician Burnout

Chi Huang, MD, SFHM, FACP, is executive medical director of general medicine and hospital medicine shared services and section chief of hospital medicine at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, and an associate professor of internal medicine at Wake Forest Medical School. He offers his insights about what you should know to foster your team's long-term well-being.

The following transcript has been lightly edited.

HealthLeaders Media: Professional burnout is typically presented as an isolated occurrence. Do you think your experience of burning out and recovering multiple times is unusual?

Chi Huang, MD: I don't know if "re-burnout" is a new phenomenon to healthcare, or it's just me burning out two to three times in my career.

The first time I burned out was when I was an attending in the United States and also helping to start a nonprofit working with street children and child prostitutes in South America. Juggling work as a physician running a nonprofit, and being a father and husband was a great deal of pressure on many fronts. It wasn't until I had this experience that I really understood what burnout was and was able to define it.

I burned out two other times during my career as a physician leader and, by then, I was able to recognize and label it.

Related: Stop Ignoring Physician Burnout

HLM: Perhaps we don't hear much about re-burnout among physicians because many of them quit. Why have you kept coming back to medicine?

Huang, MD: I just love taking care of people. That's why I started the nonprofit, which has since ended. But I love taking care of kids on the streets at 2 a.m. when no one else will; I love taking care of patients on the floor at the end of life or the beginning of life. I just love being able to help people.

There are several reasons that I've been able to return to medicine.

One is that I've been blessed to be around people who are able to help understand me and what's going on in the burnout and mental health realm. They understand that this is something that occurs and can be addressed.

I also have really good mentors within and outside of medicine who have advised me not just how to grow as a leader but also as a person.

I've learned to own burnout as an issue I need to face. For me, that means recognizing that it occurs and finding steps to what I call self-care.

Finally, the latest study by Tait Shanafelt, MD, indicated that 54% of the physicians in the United States are burnt out. We, as physician leaders, need to continue to address this epidemic for our own sake and the sake of our patients and families.

HLM: How do you define self-care?

Huang, MD: For me, it means getting eight hours of sleep a night, engaging in rigorous exercise at least three to four times per week, writing short stories, and turning off my office cell phone and putting it in the proverbial glove compartment of my car at the end of my workday.

On my work calendar, I block off Friday mornings as my "professional day," during which I recharge my batteries by reading medical journals, writing papers, and doing other things for myself that help me be whole as a physician leader.

I've also at various times sought professional help from executive coaches and mental health professionals trained in cognitive behavioral therapy and mindfulness.

Related: 5 Keys to Finding Physician Champions

HLM: What is your advice for healthcare leaders?

Huang, MD: I have learned the hard way that being a workaholic and/or ignoring burnout are simply not worth it—in terms of my health, my family, or even as a physician leader.

So as a leader, I've tried to be vulnerable and open about my experiences with burnout, and explain to my team that I never want any of them to go through that suffering.

I also try to model good self-care and create a culture in which people support one another in carrying that out. I'm trying to debunk the notion that being a hard worker does not means going to every meeting and working late all the time. Being effective does not mean sending more emails.

I challenge the misconceptions by saying, "You are adult professionals. I expect you to take care of patients well and complete projects with deliverables on time, and that's the outcome that we're all trying to achieve."

Establishing that intention as a given for all of us, I will leave to go to my daughter's ballet recital. I have no qualms about that.

I try to lead by example; if I'm doing it as the boss, then other people will feel more comfortable taking a lunch break or what have you.

Finally, I try to create an environment where people feel safe to talk about what's going on in their lives in a confidential manner. And if someone is having a personal struggle—for example, losing a loved one or going through depression—our culture is that we support that person so he or she has time to recover and heal.