In a viewpoint published Nov. 16 in Medpage Today, Venktesh Ramnath, MD, a professor and pulmonologist at the University of California San Diego, reflects on his experience with burnout, arguing that its prevalence reveals deeper issues in medicine.
Dr. Ramnath begins by detailing his own burnout symptoms, including pervasive and constant thinking about work and a sense of exhaustion and stress in his personal life. He also acknowledges that many healthcare institutions have taken “important steps” to address burnout among their workforce, including wellness programs, resilience training and meditation apps.
“Yet, even the best of these can only go so far unless we also confront the deeper causes making medicine feel unsustainable in the first place,” he writes.
He outlines the root causes of the discontent felt by about half of all physicians, including: viral misinformation, new technologies, fears of litigation and burdensome productivity metrics.
“These data reflect a gap between how we envision the healthcare system functioning and how it is practiced today,” writes Dr. Ramnath. “Yet, until recently,many lacked words to describe what they were going through.”
Dr. Ramnath describes feeling validated by the term burnout, as it accurately describes his “chronic, persistent symptoms” and how they became “real and serious — and potentially permanent.”
The permanence of burnout is why coping mechanisms, such as wellness retreats, yoga, meditation or other methods of stress relief, do not go deep enough to address the true issue at hand.
“I found that when I returned to work, my distress would pick up without skipping a beat,” Dr. Ramnath writes.
He then counters that his experience with burnout forced him to reframe how he thinks about his job, his relationship with it and how he identifies with his occupation.
“Finding balance today means dialing back my obsession with multitasking and listening better. It means seeing administrators as professional partners determined to keep the clinical program’s lights on, not just ruthless cost-cutters,” he writes. “It means silencing my phone to listen to a patient’s story with curiosity and without interruption, even when they disagree with my recommendations. It means making a difference not by simply pushing through obstacles with sheer will, but by creating change with others, rather than against them.”
He also acknowledges that solving the burnout crisis will not happen on the backs of physicians alone, but requires a larger reorganization of how healthcare functions. In some clinics that focus on patients with substance use disorder, for example, social workers and addiction counselors have started visiting with patients before the physician, allowing the patients’ psychosocial concerns to be handled first. This can empower physicians to spend more time discussing medications and clinical interventions, “making them feel more present during their time together,” Dr. Ramnath writes.
“But system fixes like general wellness initiatives are often too limited and arrive too late for a profession that still prizes stoicism and silent suffering,” he adds.
By acknowledging and reckoning with burnout rather than coping with it, healthcare as a whole will be forced to acknowledge the systemic causes of it and build a more sustainable future for physicians.
