Is Burnout Real?

Is Burnout Real?

Physician burnout isn’t something new that we are not allowed to talk about anymore. It is a real condition with symptoms that can be measured, recognized and dealt with in order to avoid an increase in suicides among medical professions. In “The Script Pad,” Dr. Randy Cooks goes in depth to help us understand what it is, how we can deal with it and what to do to prevent it.


I don’t recall precisely when I first became aware of the conversation about physician burnout.  If it was part of the conversation when I entered medical school in the early 1970s, I was unaware.  It also escaped my notice during residency and even my early decades in private practice.  But at some point, I began to hear it.  At first, it was just an occasional whisper, but now, it’s a full-throated roar.  And like so many insoluble problems, there is no shortage of opinion, yet no one seems to know quite how to deal with it.  


So, a few days ago, I decided to behave like a credible scientist and find some data.  The earliest mention I can find for the term “burnout” in the clinical literature appeared in 1974.  Herbert Freudenberger published his anecdotal observations of mental health workers in a free clinic whom he observed to exhibit symptoms that he labeled as “burnout”.  He chose the term because of the dictionary definition: “to fail, wear out, or become exhausted by making excessive demands on energy, strength, or resources.”  His paper included a rather lengthy list of suggestions on how to help those dealing with burnout, but it wasn’t really a controlled study of the problem.  


Not long after Freudenberger’s observations, Christina Maslach, et al began to study burnout by developing very precise measurement tools, and in 1978, the Maslach Burnout Inventory (MBI) was published as a tool to objectively measure burnout.  The MBI has proven to be highly reliable in recognizing expressions of burnout and is available in five different versions, one of which is designed specifically for healthcare professionals.


So…against that background, I want to make two very important points.  Firstly, burnout is not new.  What’s new is that we’re finally talking about it in the open.  In times past, to complain about emotional exhaustion and depersonalization was to risk being stigmatized and to lack the “right stuff” to be a physician.  The symptoms of burnout are real, and they are measurable, and it is critical to recognize it when we see it or feel it and to address it with the same level of care that we would with any symptom of ill health.  To fail to do so is beyond irresponsible.  The evidence for that lies in the shocking numbers of suicides among medical professionals annually. 


Secondly, the good news is that there are some relatively simple, easily accessible steps to deal with or, even better, head off burnout before it becomes a problem.  Professional coaching has been a highly popular and demonstrably effective method of dealing with the realities of the business world for years.  In much the same way that being a good student of business doesn’t guarantee being successful at business, the same is true of medicine.  The challenges and realities of the practice environment are entirely different from the learning environment.  Coaching affords a completely objective and unbiased advocate to help identify your strengths and weaknesses and to give you the space and the tools and the encouragement to perform at your best.  A paper in a recent issue of the Journal of General Internal Medicine agrees with me on this.  I hope you’ll check it out.


Gail Gazelle, MD, Jane M. Liebschutz, MD, MPH, and Helen Riess, MD; Physician Burnout: Coaching a Way Out, J Gen Intern Med 30(4):508–13



To read more of Dr. Randy Cook's blog "The Script Pad" go to Dr. Cook is also host of MD Coaches, LLC's weekly Rx for Success Podcast found at


MD Coaches, LLC is a company dedicated to developing and empowering physicians to realize a greater satisfaction in their roles. Understanding the challenges and operational concerns for both physicians and hospital administrators. MD Coaches utilizes experience and coaching skils to support their physician clients in establishing strategies for positive career progression.


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