Dear Boss,
I’m a board certified emergency physician who has been working full time for 4 years in a busy ER since getting out of residency. I thought I’d be able to do this forever, but I’m already feeling burned out. I can’t imagine doing this for another 25 or 30 years. Can you help me?

Dear Singed,
You didn’t define how many clinical hours you do, but many docs fall victim to the paycheck and end up working more shifts than they should just to pay the bills. If you’re doing more than 15 or 16 shifts a month, consider making some budgetary changes to live off less money and cut down your shifts for a few months to see if that helps. Less sleep deprivation and more free time for exercise, family or your hobbies, may lessen the burn out. I have a good friend who was feeling pretty burned out about 7 years into his career. He realized that if he cut back 3 shifts every third month, he greatly decreased his burnout and really enjoyed life more.

Schedule Regularity
Consider how your schedule flows. Are you constantly jumping back and forth between nights and days or do you have a nice forward progression to your schedule. If not, consider discussing shift patterns with your scheduler.

Find Your Motivation
Having recently returned from the ACEP Scientific Assembly, I can tell you there’s nothing more invigorating than a great conference to psyche you up for the vastness of our specialty and the important work that we do. A note of caution: be wary of a conference that masquerades as a vacation. You might benefit from a great conference or a great vacation, but don’t multi-task and try to do both at the same time or you’ll miss out on the benefits of both.

Spend a little introspective time thinking about why you might be burned out. Sure, it could be the schedule or the hours but maybe it’s the patient population, the interactions with the nurses or other attendings or the acuity and volume of the patients. Only an honest self-examination will reveal the true source of the problem. Once you have an understanding of that, you can develop a realistic solution. Sometimes it involves a change in location. Other times, it simply means spending a little more free time doing something you enjoy. Either way, you have a long, exciting career ahead of you and you’ll be a stronger physician for having tackled these issues early and honestly.

Mike Silverman, MD, is chairman of emergency medicine at Harbor Hospital in Baltimore and on the faculty at the TeamHealth Leadership Academy

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