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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I'm your host Toyosi Onwuemene, and it is such a pleasure to be talking with you today.

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I'm especially excited to talk about today's episode because it's about strategies to avoid

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burnout.

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And I think this is sorely needed because there's so much burnout in medicine.

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So over 60% of docs in 2021 reported that they were burned out.

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And yes, to some extent, there was a greater increase in burnout before the COVID or during

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the COVID pandemic.

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But the reality is that burnout has always been present with us.

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And it's a function of the field in which we practice and the high intensity and the

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high stakes and the fact that there is this feeling we get that we're responsible for

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everything.

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We're responsible for keeping the patient alive.

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We're responsible if the patient has a bad outcome.

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There's a lot that drives us towards burnout in medicine.

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And therefore, I am certainly not the first to talk about strategies to avoid burnout.

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But I did want to talk about strategies to avoid burnout in a different perspective.

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Is this an exhaustive list of all the things that you can do to avoid burnout?

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The answer is definitely no.

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But I think it's important to think about things differently.

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So this will be a little bit different from perhaps what you've been told as to how to

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avoid burnout.

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And this is especially pertinent for me because I feel like by the time, I mean, I've had

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burnout throughout stages of my medical training and my time as a faculty person.

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I will say that when I look back on my training, it's hard to say when the highest levels of

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burnout were because I was ready to quit medicine even in medical school.

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So definitely, there was burnout there, you know, and certainly as a resident.

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And oh, goodness, was I the crabbiest first year fellow ever?

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Wow, it feels like I've been burned out a lot in medicine.

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But anyway, I say all that to say that the time in my life that was most critical as

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far as being burned out was really as a faculty person.

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And I feel like I tolerated a lot when I first started in terms of all the resources I didn't

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have and all the things I was required to do.

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But everybody else was doing the same.

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So there was always the sense that, well, you know, everybody else is sucking it up

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and doing the work.

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Why don't I?

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But we can't measure our experience against other people's experiences, right?

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Because we don't know what resources they have access to.

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We don't know what other challenges they're facing.

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And so the right comparison is really to yourself.

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But anyway, I feel like I tolerated it for a long time until it got to a time during

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the pandemic where I just had given actually a lot, given everything.

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And I finally came to a day where I was just literally waiting.

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I was like a day from vacation and I was desperate.

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I was desperate to get away from the hospital.

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I was desperate to leave everything and I was exhausted.

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I was worn out and my spirit was so beat out.

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It was bad.

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I remember I came home that day having left behind the weight of work or at least, you

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know, shed as much of it as I could.

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And I saw my neighbor in the driveway and I forget what question she asked me.

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And I remember telling her that if I died right now, it would be a good outcome.

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And I won't say that I was suicidal, but I definitely had this sense of, you know what?

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The after life is looking really good right now.

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It won't be a bad outcome.

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You know, you know, you're you're kind of wow, nearing or at rock bottom when it feels

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better to be dead than alive.

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Yeah.

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So I would say that that may have been the lowest point of my time in medicine.

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Certainly was the lowest point of my time as a faculty member.

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The good news is about being at your lowest point is that there is nowhere else to go

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but up.

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You know, you can stay where you are.

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That's one option.

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But but up is a possibility.

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And so I'm on the other side of that now.

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And I feel like I work probably as hard now as I did then.

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But I have a sense of purpose about my work and I have joy and so much energy around my

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work.

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So even though I am still working hard, I'm definitely in a different place today than

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I was before.

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So I want to share with you seven strategies that I employ to avoid burnout.

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And I invite you to consider them as well.

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Here we go.

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Number one is to look around you with discernment.

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So another way to say it is to take off the rose colored glasses and really give your

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environment a long hard look.

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If you are a clinician, a physician who went through at least four years of medical school,

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possibly more, couple of years of residency, and couple of years of fellowship, you would

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count relative to the general population as a crazy person.

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And what I mean is that your baseline is very high functioning relative to the people around

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you.

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So recognize that as a person in medicine, as a clinician in particular, your tolerance

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of crap is very, very high.

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And if that were the end of the story, that would be good.

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But it gets worse because you look around you and there are people who can push the

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limits.

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That's like, oh, you can stay up three days in a row without going to bed, oh, I can do

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four.

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There's a lot of pathology in medicine.

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There are a lot of people who are sick in medicine.

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There are a lot of unhealthy doctors trying to care for patients.

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And we cannot give the health that we do not have.

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And oh, yeah, we can push medication and do chest compressions.

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We can do stuff, bring people back.

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We can help people feel better.

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But if we are unhealthy, we can physically help people, but emotionally, we don't serve

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them and potentially we're pulling them down.

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And so it's important for us to look around our environment and recognize the sickness

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that pervades the healthcare system.

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And I'm talking in particular about the healthcare workers within the healthcare system, particularly

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clinicians.

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And if you are a clinician scientist and you don't spend as much time doing clinical work,

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maybe you spare yourself some of that.

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But I will guarantee you that this is not a problem only for clinicians.

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It is a problem for scientists as well.

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This whole idea that you work and work and then you work again and the whole idea that

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rest is a problem.

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So it's just important to look around you with discernment and recognize that this is

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not the real world.

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The world that you inhabit on a daily basis as a clinician going into an academic medical

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environment is not a healthy world, not the real world.

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And so I invite you first to look around with discernment so that you recognize that this

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is not the environment by which you should set the standards of operating your life.

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Now we do that because it's the default environment.

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What are we going to do?

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But we can choose.

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And when we look around with discernment, not with judgment, not with blame, we're like,

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oh, all right, there are a lot of sick people around me.

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Got it.

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It's really powerful because it allows us to choose.

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What do I do to stay healthy in an environment where I'm surrounded by people who are not

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healthy?

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How do I avoid contagion?

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You could leave the environment.

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That's one option.

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You could come in with personal protective equipment.

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That's another option.

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The extent of the personal protective equipment that you come in with can vary, right?

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But you get to choose when you look around with discernment.

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You take off the rose-colored glasses.

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You stop saying, oh my gosh, it's such a wonderful environment.

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It is wonderful.

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There's so many great things that happen in medicine.

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And it's full of many clinicians, many clinician scientists who are sick.

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You can continue to be one of them, or you can choose how you're going to navigate this

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environment the moment you recognize that a sick environment could be making you sick.

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Again, this is not an invitation to quit medicine, though maybe that might be the answer for you

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right now.

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But it's an invitation to stop lying to yourself, to stop living in denial of being in a healthy

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environment because when you're no longer in that denial, then you don't ask yourself

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what is wrong with you.

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You recognize that the environment is driving some of the experiences you're having, and

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it gives you power to choose how to manage your experience.

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Okay.

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Number two is to recognize your ultimate weakness.

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Recognize your ultimate weakness.

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Your ultimate weakness, no it's not kryptonite, oh Superman.

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The ultimate weakness is that you don't have very much control over many things.

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But you do have control over yourself.

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Let's just get to the next thing right away.

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But it is important to recognize how little of anybody else beyond yourself you control.

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This is really powerful and important to recognize that you are so weak when it comes to controlling

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other people, that it is a waste of energy to invest time trying to do that.

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You are so weak, you are such a loser when it comes to controlling other people, I use

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that word intentionally, that you should stop trying.

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Because you cannot successfully control somebody else.

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Now, you know, some people are pretty skilled.

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So there's a lot of skilled people out there.

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I've seen skilled manipulators.

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I've seen people who are skilled at using fear tactics.

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There are a lot of strategies in medicine.

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But ultimately, you're pretty weak because you don't have power to control other people.

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If you're going to work to control other people, and some people are actually successful in

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controlling others, you're going to invest a lot of energy.

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And if you're investing a lot of energy in controlling people, you're probably not accomplishing

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anything of significance.

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But your weakness is that the power you have available to you is to control yourself to

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the best of your ability, because sometimes you can't even do that.

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But in recognizing your ultimate weakness, it allows you to think about, number three,

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shrinking to your circle of influence.

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If you cannot control a wider circle outside you, what can you control?

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You can control yourself.

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You can learn to control your thought life.

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You can learn to control the way you respond.

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You can learn to control you.

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Wow.

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How much power is there?

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How much is freed up?

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How much energy is freed up?

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When you stop running around chasing other people to fix the environment, and instead

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you change yourself.

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The power of changing yourself in an environment of sickness is that you stop asking the environment

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to fix itself so you can be better.

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You ask, how do I fix me so I can be better, whether the environment chooses or not?

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Because I have to tell you in medicine, we complain a bit a lot about our environments,

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but the reality is the environments we have are the environments we have collectively

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created.

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And the reason that they have not changed is that we connive to keep them alive.

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We do.

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We're like, I hate this system, it sucks so much.

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And things don't change.

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It's because we collude to keep things going.

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There is secondary gain.

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Maybe you don't see it personally, there are people who see the benefit, the secondary

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gain of the constant complaining and griping that happens because people aren't happy.

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But a lot of it won't change.

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Not unless you do, when you change, everything changes.

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When you change, it doesn't matter that people don't want to work.

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Doesn't matter.

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Because you get to choose how you respond.

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Whether you stay or you go, you get to choose.

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So number three is to shrink to your circle of influence.

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That's really you.

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Oh yeah, you can influence other people who are closest to you.

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For the most part, as you focus on yourself, then what you have the opportunity to do is

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to inspire others.

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It's much more powerful than trying to control them or manipulate them into doing what you

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want them to do.

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Number four is focus.

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Focus like a laser.

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Focus like a laser.

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Once you've discovered your superpower of changing yourself, it's time to focus.

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It's time to focus on growing that power.

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So how much of you can you control?

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Can you keep your cool even when a patient is yelling at you and you can feel his saliva

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in your face?

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Yeah.

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Focus like a laser on yourself allows you to increase your superpower to a place that

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you didn't even know existed.

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And so focus like a laser, focus your energy like a laser on yourself.

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Cause that's the person that you ultimately are able to control.

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I mean, yes, yes, you ultimately able to control yourself.

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Now does that mean you have power to control other people once you figured out yourself?

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No.

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You focus like a laser on yourself and that empowers you to make change happen for yourself.

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Other people see that you are changing and then they follow you.

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Focus like a laser.

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Number five is to choose to give people a pass.

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People are going to get it wrong.

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They're going to do the wrong thing.

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They're going to mess up.

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You could stand, you could judge them and yell at them and say, I can't believe you

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are so stupid.

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I can't believe this person we hired them.

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What's wrong with them?

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Or you can say, oh, that's interesting.

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You did that.

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Okay.

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And walk away.

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Choose to give people a pass.

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They're not perfect.

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They'll never be.

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Stop being surprised when this person who's always lying lies again.

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You're like, I can't believe you lied.

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But this is the 199th time you can't believe they have lied.

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When are you going to believe it?

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When are you going to believe that this person who's so amazing, so awesome, this guy that

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you refer and look up to is a liar?

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When are you going to accept it?

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And so you just say, oh, you lied again.

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There it is.

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Choose to give people a pass because the energy you use to try to convince them to change

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is somehow not being well spent because it's wasted.

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So choose.

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Choose to give people a pass.

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Say, oh, there you go.

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The guy who lies all the time, the guy who's always wheeling and dealing and trying to

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pull a fast one on you.

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And you just know that, okay, the moment you walk in the door and walk out the back door,

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right, you just have a plan.

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You don't have to stand and judge them and say, I can't believe you're like this.

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You just let it go.

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Just let it go.

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And that's why number six is know when it's time to walk away.

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Know when it's time to walk away.

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And this is so important because in reality, some of the people who are the sickest in

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our environments are some of the people who are the most decorated, right?

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The most decorated generals in medicine are some of the sickest in medicine.

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You can recognize them.

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Other people recognize them, but they're so successful.

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Nobody says anything.

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But you know, you know who they are.

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And that's why it's important for you to know when it's time to walk away.

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When all of a sudden you are growing in bad habits that don't serve you.

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Even no matter how amazing this person is, no matter how much of a mentor they were to

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you know when it's time to walk away from a culture that hurts you.

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Number seven is own your power to choose.

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I hear physicians saying all the time, I have no choice.

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You always, always have a choice.

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The reason you think you don't have a choice is because you do not know the options.

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Because the moment you figure out that you have options, then you know, you know beyond

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the shadow of a doubt that you have the power to choose.

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Own your power to choose.

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And you can choose not to have it.

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You can choose to have it in a little dose, but you're choosing.

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So own your power.

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Own your power to choose.

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As you do these things, you're going to begin to avoid burnout.

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You're going to begin to avoid burnout because number one, you look around with discernment

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and you just are not, you're not disillusioned.

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You're like, do people behave badly?

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Oh, okay, they do.

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There you go.

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Now use your energy for something else.

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Number two, recognize your ultimate weakness, your inability to control another person,

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except by fear or coercion or extreme craziness.

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But if you're going to be a normal human, recognize your inability to help people unless

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they want to be helped.

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Recognize that you don't successfully control people.

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Okay.

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Number three, shrink to your circle of influence, that's you.

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Number four, focus like a laser.

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Number five, choose to give people a pass.

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Number six, know when it's time to walk away.

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Oh, number seven, own your power to choose.

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And so those are seven strategies to avoid burnout, especially for clinicians trying

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to make the transition towards research.

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All right.

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It's been a pleasure talking with you, Jay.

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Thank you for listening.

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Go forth and prosper.

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Have a great week.

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Thank you.

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It is important to know that we do have a webinar coming up on December 20th at noon.

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This is when you don't have a mentor.

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And I'm betting there are many people out there who have no mentor.

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Come and listen to strategies to succeed, even whether or not you have a mentor.

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All right.

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It's been a pleasure.

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Thank you for listening.

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Please share this episode with someone and invite them to like and subscribe.

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Take care.

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Bye-bye.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.