Burning out of the profession: Will there be a doctor or nurse there for you when you need one?

Photograph by Oles kanebckuu

News outlets have recently been full of stories of physicians and other clinicians leaving their current jobs, and sometimes the profession as a whole. Bedside RNs are opting to work in the outpatient setting. Physicians are leaving for private practice or to work in tech startups.

This is likely just the beginning of the exodus of clinicians from patient care. In reality the pandemic simply brought to a head the demoralization of already overworked and under-supported clinicians. Burnout has been recognized as a significant threat to the healthcare system for the last decade.

A recent article in Bloomberg by Carey Goldberg reports that national surveys suggest pandemic stress has compelled 15% to 25% of physicians to think seriously about leaving medicine or going into early retirement.

Few doctors are quitting now because they don’t want to abandon their colleagues, according to Wendy Dean, MD, a physician coach and psychiatrist and surgeon who is known for her work on Moral Injury in healthcare. But she’s increasingly hearing doctors say, “We are breaking. And we will stay in the trenches until the war is over. But then we’re going to get out.”

"We are breaking. And we will stay in the trenches until the war is over. But then we’re going to get out.”

So what is driving healthcare workers away from their careers? Surveys and anecdotal evidence suggest it’s multi-factorial. But key issues revolve around significant lack of support:

• under-staffing

• disrespect by management

• disrespect by the public at large

In some states physicians face the moral dilemma of rationing care - a traumatizing experience for anyone to have to go through, made even more so by the ways in which hospitals are full of people unvaccinated and dying needlessly, and by hospital administrations placing excessive responsibilities onto already overworked staff. These are components of the moral injury Dean describes.

I focus on the responsibility of leaders to address burnout. I’ve seen poor leadership impact my colleagues, driving burnout. I’ve experienced this myself. Good leaders recognize that the physicians, nurses, respiratory therapists, CRNAs and other hardworking frontline staff understand the problems and have good ideas to make the working environment better. Good leaders lean into the strengths of their employees, take their insights in stride.

Many frontline clinicians throughout the country do not trust their leaders to do the right thing. That trust can be re-earned when leaders show up for their hospital staff:

• supporting them by making sure they are given supplies

• advocating to governing bodies local and regional and

• listening to (and actually following through) on demands being made for improved staffing support