When it comes to how to prevent burnout, you can choose to ignore it, drive on, or face it and turn things around
When burnout happens — if it happens — what are the symptoms and how do you get out of it? You likely need this article if you’ve read this so far. You likely already know if you’re in some phase of burnout, but how bad is your burnout? A successful chiropractor cannot be plagued with burnout. Not a happy one, anyway, and burnout is not a happy place. But when it comes to how to prevent burnout or how to exit a malaise, there are many ways out.
The burned-out doctor
Discipline, in a way, is the opposite of procrastination. You take it step by step, and burnout becomes a thing of the past. You’re too busy doing the right things.
We can put burnout on a scale, like the Oswesty scale, but we’ll call this the “Burnout Scale.” It goes from a 1 for mild and a 10 for severe. Take this test and find out where you are on this scale:
- No burnout here; you approach every day with excitement and with little fluctuation day to day.
- You find yourself thinking about what else you want to do besides where you are (the office). You are not thinking Present Time Consciousness (PTC). You’re off somewhere mentally, but you’re physically at work, seeing patients. You’re talking more about the weather than the patients’ problems.
- Your other problems are controlling you and they don’t even concern the office or your patients.
- You’re stuck in limbo: the office, employees, patients all seem to make you numb, and control of it all seems just too much.
- You go patient to patient just to do what you absolutely have to, not really listening, and you just want to get to the next one. You are five behind and have completely lost PTC.
- You wake up in the morning just wanting to get the day over.
- You have made adjustments — not to your patients, but to your schedule that will just get you by. You know, make enough to make ends meet somehow.
- You’re thinking about doing something else entirely (not chiropractic), it’s been on your mind for quite some time and you can’t get those thoughts out of your mind.
- You’re taking more time away from the office and you know you’re losing control and perhaps don’t really care.
- You’re becoming robotic, going through the paces, you’ve lost control, and patient counts are worsening by the month.
Any of these symptoms look familiar? This probably is not the first time you’ve read something on this, but perhaps you’re not taking it seriously. One has to take an honesty test with themselves and just admit if you have a burnout problem.
We all get brief feelings of some of these symptoms, but if they are more often than not, you have a burnout problem. Yeah, it’s tough to admit, and it also depends on your personality type. None of this makes you a bad chiropractor, but not a happy one either.
Going to work, day after day, week after week, months, years, decades … anyone can get some burnout, but some may be in total burnout and have lost control. To make it clear, I’m not talking about a so-called mid-life crisis. In a mid-life crisis you somehow have to have a Harley or Mustang Cobra. That is way easier to cure — get a Harley or that Cobra.
How to prevent burnout
Why do some doctors never seem to get burnout? I’m not sure any doctor can work at the same job for decades and not get some burnout, even for a brief time. When it comes to how to prevent burnout, you can choose to ignore it, drive on, or face it and turn things around. Any burnout can be turned around and stomped out. Doesn’t everyone, or most of us, want to practice our wonderful profession like we did our first year(s)? If you say yes, there’s hope. I’m assuming you loved your early start in chiropractic.
I have practiced for more than 40 years and had never heard of burnout until I was some 20 years into practice. Then I read an article on this subject and knew I had some of those symptoms — not bad, but some. The article wasn’t specific to chiropractic and how to prevent burnout, but pretty darn close. It went back to the feelings we got back in grade school when we didn’t want to go to school for no real good reason. Almost anyone can relate.
Professional burnout is not much different, but on a much larger scale and can make life miserable to downright destructive. We can call it by another name, maybe a rut or whatever, but it’s best known as burnout.
You read enough on this subject and you see stress as a major cause. Does the stress cause the burnout, or burnout cause the stress? Of course, eventually burnout will cause stress, mainly because you’re just not happy … and you’re seeking happiness, but your practice is in the way.
What are the consequences of burnout?
Ignored or unaddressed burnout can have significant consequences:
- Excessive stress
- Fatigue
- Insomnia
- Sadness, anger or irritability
- Alcohol or substance misuse
- Heart disease
- High blood pressure
- Subluxations re-occurring
I was once privileged to hear Hans Selye, MD, PhD, before he died, in 1982. This was at a Parker Seminar, mid-‘70s sometime. This is the guy who wrote the book on stress, the authority, the final word. He was doing an 80-minute class on the answer to stress. He promised at the beginning he was to give us the answer to stress. I thought wow, very cool. He’s got a short time, but I was excited — he’s the man. He talked 79 minutes and no answer — is he going to tell us or not? Finally, at the last few seconds he said, “The answer to stress, I promised you … hard physical exercise” and he walked off the stage. Geez, that’s it. We were all kind of speechless.
After being a bit puzzled for a while, I took note from his talk on the effects of built-up adrenaline and its natural effect if not burned off. Stress is a result. He never talked about eliminating stress or even reducing it, just the effects of it. Everyone has stress, good or bad, but nonetheless stress. The talk started to make sense to me. I started to do more exercise for sure. The standing joke that I tell my kids (all grown and have kids of their own) is that if I end up in a nursing home, they better have a gym. It is flat amazing the power of adrenalin, good and bad. You’ve heard of people lifting a car because a kid is trapped under it — that’s the power of adrenaline. Don’t let it be destructive when confronting how to prevent burnout. Exercise and burn it off and you’re one step ahead of burnout.
Expectations, stress and burnout
Unfortunately, exercise is not the complete answer to burnout. Exercise is always good and needed but it’s just not that easy for someone in burnout.
First off, understand you’ll never be as good as you can be. “What? I have blah blah degrees, blah blah techniques; I’m good at what I do.” I didn’t say that — I said you will never be as good as you can be. Accept that, okay? You’ll never have all the degrees there are or know every technique out there. Even with what you know, you can know more of it. Right?
A major part of burnout comes from not being focused on the task at hand. You lost that very important ingredient called “burning desire.” If you had that ingredient (we’ll call it BD for short) there’s no time for burnout. Another ingredient is “enthusiasm.” Nothing new here, right? With this combination, getting up in the morning to go to work would be easy, exciting and a happy feeling. With these ingredients, BD and enthusiasm, your attitude will change and everyone around you will feel it. It is contagious.
If you want to be the magnet, you have to be charged and maintain the charge (we’ll get to that part). People are attracted to people who exude BD and enthusiasm. They aren’t attracted to people who are just smart.
Example: You walk into the room with a patient, you greet them with their first name (everyone likes their name) and you say it like you really miss them (everyone likes to be missed). You know the tone: uplifting, with some energy. You have to be the starter, the ever-ready battery that keeps the drum beating. This is the start of the positive feedback cycle. It is up to you to create that atmosphere. It will likely never just happen — you have to have the BD and enthusiasm to keep your battery charged.
Part II of this article will appear next issue.
RONALD WARNINGER, DC, DACS, graduated from Palmer College of Chiropractic in 1973 and received the Diplomate of Chiropractic Science from Life Chiropractic College in 1994. He was in active practice for 42 years and has been a member of the Washington State Chiropractic Association (WSCA) since it formed. He served on the Washington Chiropractic Trust for six years as their secretary and was an active member in the Central Washington Chiropractors Association and served as their president for six years. He is retired at the present time and enjoys traveling to Europe with his wife and across the U.S. in a motorhome, visiting 47 U.S. national parks.
