Preventing “Burnout”

Strategies to prevent emotional exhaustion in stressful situations are useful not just for doctors, but for everyone dealing with spinal disease.

Physician burnout a syndrome characterized by a sense of diminished personal achievement and emotional exhaustion that almost 50 percent of all doctors experience. Burnout is caused by unrelenting, emotionally intensive work and has become an epidemic as physicians are increasingly charged with caring for more and more patients but given less control and fewer resources to do it.

I have also noticed that its not just physicians who struggle with burnout. Patients can experience burnout through the same unrelenting psychological pressure from repeated doctors visits, tests, dealing with insurance, pain, and fear. Preventing burnout is a problem that I proactively try to think about not just for myself, but also for my Patients. My strategy is inspired by the stoic lumbar vertebrae.

The lumbar vertebra is not a solid piece of rock—if it were it could be shattered like a crystal. The lumbar vertebra is an evolved structure and is able to withstand incredible pressure. It does this through a series of internal bony struts that are oriented vertically and horizontally. The vertical struts resist compression, while the horizontal struts prevent shear and bucking of the vertical struts. In other words, if there were only vertical supports, they could easily crack under pressure. The horizontal struts prevent this.

I use the analogy of having vertical and horizontal struts in your personality and life to prevent burnout :

-The vertical struts are aspects of our personality which we can strengthen. For me this is my medical knowledge, my practice of surgery, and my personal philosophy that I use daily to care for others. These are the tools I use to eliminate disease.

-Horizontal struts support the vertical struts and are areas in my life from which I draw strength/inspiration to become a better physician. For me this is my family, nature, and art.

Personal vertical and horizontal struts are unique to each individual. If you are a patient or physician dealing with burnout I encourage you to do the following:

  1. Draw three vertical lines.

  2. Label each vertical line with a internal characteristic you are proud of and use daily. This could be anything unique to you.

  3. Draw three horizontal lines across this.

  4. Label each horizontal line with areas in your life from which you draw external strength such as friends, family, gardening etc.

Periodically think about and draw out this diagram when you are dealing with symptoms of burnout.

In this video:

-The rugged Mendocino Coast is a great place for contemplation.

-An Old Man

-A Redwood Forest

-Biking to work to see an emergent consult.

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Exercises for Acute/Chronic Low Back Pain/Injury Prevention