I Rejected This Common Piece of Burnout Advice and Became a Happier Doctor

About four years ago, as physicians were adjusting to the new normal of practicing medicine during a pandemic, I started to reach my limit at work.

I knew I was burned out, but I didn’t know what to do about it, so I sought out advice from colleagues, physician-friends, physician-strangers on social media, and healthcare leaders I admired. Across the board, the most common thing I heard was: "Just go part time."

I’d always bristled at this suggestion. I understood the appeal of shaving off 20 or more hours of weekly work — it’s a straightforward change that doesn’t involve therapy or soul-searching. But many physicians I knew who’d gone part time didn’t seem any happier for it. And the trade-offs of working less (like making less money) didn’t seem worth it. There had to be other options.

As it turns out, there are.

My experiences with physician burnout, including my frustrations with the term “wellness,” motivated me to take it on as a cause — I learned as much about the affliction as possible, and began coaching other physicians who felt as lost and overwhelmed as I once had.

The truth is that going part time does make sense for some physicians, and it can play a role in combatting burnout. But it shouldn’t be the go-to strategy for everyone, or the whole plan for anyone. To beat burnout, you need to change your relationship with work — not just your schedule.

In this article, I break down some of the problems with the “just go part time” solution, discuss what you actually need to do to tackle burnout, and propose alternative work-life tweaks to consider (some of which have helped me personally).

Why going part time doesn’t always reduce burnout

For starters, going part time isn’t always feasible. It might be off the table because of financial constraints, full-time work requirements attached to loan repayment, or institutional employment policies, to name a few possible reasons. But, even for physicians who can choose to go part time, here’s why it’s not a magic bullet for burnout:

You might still be overworked: Many physicians who officially reduce their hours don’t see their workloads decrease proportionally. Instead of doing less work, they end up cramming the same responsibilities into a compressed timeframe. Tasks that were spread over five days now need to fit into three.

You might have trouble adapting to your new financial reality: Cutting your hours typically means taking a pay cut. Even if you accept this as a condition of going part time, if you’re technically working fewer hours but carrying the same workload, any reduction in salary might feel unfair and turn your scaled-back schedule into a source of stress rather than a stress reliever. Working less also often comes with financial sacrifices aside from lower pay. Benefits like health insurance, retirement contributions, and paid leave might be lessened or even eliminated.

And, unless you have enough money from savings or a second income stream to offset your pay cut, you might need to change your spending habits — that could mean giving up a hobby you enjoy or taking on tasks you normally outsource to make life easier. Or you might feel the need to take on additional work to make up for lost income.

Your free time might not stay free: There’s a saying that goes, "Work expands to fill the time available for its completion." If you curb your hours but otherwise approach work with the same mindset, your free time might fill up with the same old stressors in a different form. For example, you might use that time to answer EMR messages from patients who can’t get in to see you during your new hours. Or you might spend it on uncompensated but expected job tasks, like research or education.

You might not feel better, or less confused, about your career: If you’re completely overwhelmed by work, you might start to question if you’re cut out for your job, or for medicine in general. Feelings of inadequacy, doubt, and ennui related to your career are common with burnout, and going part time might not resolve them the way you'd hoped. And if you still feel overwhelmed after switching to part time, that might create or exacerbate concerns about your abilities as a physician. Shifting to part time can also lead to unexpected feelings of guilt — e.g., around not making full use of your extensive training, or not pulling your weight in a field struggling with attrition.

The basics of work-life balance

The key to reducing overwhelm is changing how you approach work and how it fits into your life. Whether or not you work fewer hours, here are the essential components of any plan to combat burnout:

Setting boundaries: Cutting hours doesn’t help if you don’t also take an axe to unmanageable expectations. Learning to say "no," delegating work you don’t have the bandwidth for, and restricting your availability are all crucial.

If you have trouble setting boundaries around work, various tools can help. For example, you can automatically decline meetings during hours you’ve blocked off on your calendar app, set your phone and other devices to “do not disturb” or “personal time” mode, and set up automated email responses that let people know when you’ll be available.

Reinforcing boundaries: Often, setting boundaries is only the first step. Regardless of the specific changes you decide on — offloading certain tasks, taking days off, or going offline once you clock out — make sure that whoever needs to respect your boundaries knows about them.

It’s important for you and your team to have an agreed-upon understanding of your job scope. Before you start working three days a week instead of six, lay out exactly how your responsibilities will change. It’s best for those changes to be on the record so you can refer back to them if you need to.

Rest and recovery: You can’t just subtract work from your life. You also need to add in rest and recovery. That means prioritizing sleep, having downtime, and doing activities that bring you a sense of calm. You won’t do yourself any favors by using all your extra time for things like errands, or even unpaid work activities that aren’t explicitly required but feel like unspoken obligations.

Intentional time use: You only have so many waking hours in a day. No matter how many are spent on work, it’s important to reserve time for what truly matters to you. But, in order to do that, you first need to identify what your priorities are and where you’d ideally focus your energy if time weren’t a finite resource. Don’t dismiss anything as a waste of time if it makes you happy.

Alternatives to going part time

If you’re burned out, there are different ways to tweak your schedule, workload, or working conditions — either instead of or in addition to reducing your hours. Here are some to consider:

Negotiating for more variable or flexible hours: Rather than cutting your hours, you could adjust them to fit your lifestyle better. If not being available to pick up your kids from school or attend their extracurricular events is a major source of distress, you might be able to change when you start or finish work to accommodate those commitments. Having a mix of shorter and longer work days might also provide opportunities for better balance, as well as lessen the impact of a commute (if you have one).

Crafting your job responsibilities: Reshaping your role to involve more work that fulfills you and less that drains you can make a noticeable difference. For example, if you love quality improvement projects, research, education, or community engagement, see if your favorite type of work can be written into your job description with protected time. If you spend more of your total time working on things you enjoy, you’ll need less recovery time.

Incorporating remote work: Working remotely on certain days lets you work in different spaces. Diversifying your work environment can foster creativity and focus, and help you be more available to your family at least part of the time.

Doing more, on top of your day job: Losing a sense of purpose can contribute to burnout. Taking on more commitments certainly isn’t the right move for every burned-out physician. But, if you realize that your biggest career gripe is about being unfulfilled, not overworked, then ramping up your daily schedule might put some fire back in your belly. This could mean pursuing a new hobby, a side gig that generates extra income, or a leadership role within your professional society, or joining an advocacy group.

Case studies

A plan to beat burnout should be tailored to a physician’s needs. Here are a few hypothetical examples to illustrate how the specifics of the problem can inform the solution.

Burned-out doctor #1: After 10 years, Dr. B can’t take the 80-hour-work weeks anymore. He’s exhausted all the time and misses the outdoors. He feels pangs of sadness and regret whenever he sees someone carrying a tennis racket, because he had to quit his weekly league during residency. He’s saved a lot of money by keeping his expenses low, investing well, and traveling much less than he envisioned he would. Dr. B likes practicing medicine, but he hates that it’s cannibalized his whole life. When he fantasizes about the future, he envisions an early-ish retirement filled with leisure activities.

Their plan: Part-time might be a good fit for Dr. B, but he needs to clearly define the scope of his part-time work — ideally in a new contract or a rider to his full-time contract — so that he can have free time that’s completely protected. Dr. B might also want to negotiate for a sabbatical, whether or not he reduces his hours.

Burned-out doctor #2: Dr. S has always been good at the grind, but more and more, she feels unfulfilled by the monotony of her day-to-day job. Every day, she counts down the hours until her last appointment. But she often still feels bored after work too. She misses school, when classes changed every semester and there was always a new challenge ahead.

Their plan: Dr. S feels adrift in her career, but she’s not tired of working. She just isn’t getting the stimulation she needs from her day job anymore. Building a side business might be a great move for Dr. S, whether or not she reduces her workload. She can also speak with her organization about the possibility of replacing some of her clinical work with special projects.

Burned-out doctor #3: Dr. W always saw unyielding perseverance as the key to success. She believed results will follow if she just pshed harder. At the same time, she felt like she was standing on the edge of a cliff, teetering between the possibility of feeling better and the fear of unknown depression. She wanted to spend more quality time with her children, but her exhaustion got in the way. At work, she felt disengaged from her job responsibilities, even the parts of her role that once felt meaningful.

Their plan: Dr. W reached the point where she didn't know if she was meant to be a doctor, and she wanted to figure out if was time to say goodbye to medicine. So, she spent time rediscovering her true purpose and personal mission. She learned how to develop boundaries, used technology to enforce them, and communicated them clearly to her team. She found activities at work that aligned better with her passions, which helped her realize that clinical medicine was the right place for her. Outside of work, she used her time intentionally to connect with family and loved ones. She also set aside time for the hobbies that bring her joy — crafting and reading. These small but significant changes helped Dr. W. become a happier version of herself.

Ok, that third example isn’t hypothetical — that’s me!

One more thing ...

In this article, I’ve discussed factors in burnout that are at least partially within a doctor’s control. But burnout is also fueled by systemic problems in healthcare, such as documentation demands from insurance companies, increased consolidation of health systems, and pay disparities between specialties. On your own, you might feel powerless to fight the failures of the system. But the more we come together to shine a light on what’s going wrong, the more we can do collectively to steer our industry in the right direction.

***

A version of this post originally appeared on Santina Wheat's website.