Ending the stigma
Lakshman Swamy, MD, MBA
Pulmonary/critical care fellow at Boston Medical Center
Swamy was a third-year medical resident working nights with two small children at home when burnout hit him. “I became very cynical and laughed about a lot of things—beyond the gallows humor physicians typically use to get by,” he says. “I was falling apart, getting less sleep, and I felt like I was failing with my patients and at home.” He says his work was becoming shoddy and he was being selfish and passing patients off to the next shift.
“It was unprofessional and a really bad spot for me,” he adds. “The big takeaway is, at the time, I could not have told you it was because I was burned out. I couldn’t recognize it in myself, and if I had done so, there were innumerable supports that could have helped.” When he rotated off that shift, his situation improved. Now, he advocates for doctors to look for signs of burnout in each other and to take action when they do.
He advises doctors who suspect a colleague might be heading for burnout to meet with them outside of work to discuss it. “Say, ‘Hey, is everything OK?’ or use other open-ended questions,” says Swamy. “You don’t have to say burnout, because people are often sensitive to that. They might be defensive in the moment, but it lays the groundwork to actually talk to them.”
Speak with them alone, he adds, and not from a position that implies they are unable to do their job. If there is no personal relationship, talk with someone who knows them better and tell them about your concerns. For residents, Swamy advises speaking to the chief resident, but choose your words carefully.
“There’s a big stigma speaking about mental health in medical culture, and burnout relates to that” says Swamy. “If you are in a world where you cannot show weakness and someone is very clearly suffering, the answer is not to go to their seniors and effectively say you think they are weak.
You never want to throw people under the bus.”
While he appreciates employers providing yoga or massages for physicians, those do not address the root causes of the problem. “I personally find a lot of wellness in running and doing yoga, but that doesn’t address the root cause of sitting in front of a computer going mad trying to click all the boxes.
“Burnout is a symptom of an incredibly broken healthcare system,” says Swamy. “It needs addressing, but the root causes are deep and pervasive."