Unpacking Burnout in Medicine
posted 8th April 2025
Imagine sitting down with someone who’s spent years navigating the trenches of healthcare—a Chief Wellness Officer at a major university system and an Associate Professor of Psychiatry, whose national bestselling book peels back the curtain on the human struggles behind the stethoscope. The conversation starts with a confession: even psychiatrists wrestle with therapy homework, proving we’re all more alike than we think.
So, what exactly is burnout?
It’s not just work is hard or “I’m tired”—terms too often tossed around casually. Burnout, as defined by researchers, is a workplace-specific syndrome with three core symptoms: emotional exhaustion, depersonalisation or cynicism, and a reduced sense of personal accomplishment. It’s not in the psychiatric manual but is recognized by the World Health Organization as tied to work—whether that’s a hospital, a home, or a classroom.
Emotional exhaustion leaves you drained, with nothing left to give. Cynicism turns frustration into anger at colleagues, patients, or the job itself, while depersonalisation—a coping mechanism gone rogue—creates a wall so thick you lose connection entirely.
The kicker?
It’s the reduced accomplishment that often drives people to seek help. In healthcare, where 50% of professionals experience burnout, exhaustion and detachment are shrugged off as par for the course—but when someone says, You’re not doing your job, it cuts deep.
The stakes are high. For healthcare professionals, burnout fuels depression, suicidal thoughts, and substance use. For patients, it means more errors, less satisfaction, and longer hospital stays. Zoom out, and the ripple effect is clear: burnt-out clinicians leave, shrinking access to care and costing systems dearly.
Why it hits hard
What’s striking is how normalized burnout has become. A study of surgeons using the Male Well-being Index found that 71% of those in the bottom 30% rated themselves average or above. When everyone’s sleepless and struggling, it’s easy to think, This is fine. But it’s not. Physicians’ mental health fares worse than the general public’s and other high-stress fields, driven by a toxic mix of system pressures (insurance, quotas, documentation), individual vulnerabilities (personal history), and a culture that glorifies overwork and shuns feelings. When the system fails and emotions are taboo, self-blame takes over. It’s a heartbreaking parallel to abusive relationships—unable to hate the hospital or the bureaucracy, the burden falls inward.
The culture problem
This culture doesn’t just tolerate burnout—it punishes vulnerability. Medical students face real penalties for emotional needs—evaluations branding them insubordinate or too involved for feeling deeply. A comment like too nice to nursing once sparked tears and self-doubt, revealing a system where competition stamps out empathy. Even in psychiatry, self-disclosure is scolded as horrible boundaries, teaching clinicians to suppress rather than wield emotions wisely.
Depersonalisation becomes second nature. Picture a code—someone dies, and the room moves on to lunch without a word. The lesson? Hide your tears. Over time, it’s not a choice but a groove worn into the brain. Only in rare moments—like when personal grief cracks the armor—does the weight of that detachment hit home.
A therapist once challenged a proud moment of not crying over a patient’s loss: “Why is that good?” The question exposed a warped norm. When a football player was coded on live TV, the public reeled while healthcare workers shrugged—codes are routine. That disconnect, unnoticed until others react, signals
something’s off.
Searching for solutions
Are medical schools rethinking this? Some are, but it’s patchwork. High-profile tragedies—like suicides—spur investment in wellness, with programs ditching grades to ease competition. Yet students pivot to new battlegrounds, like churning out publications. There’s no gold standard yet—system fixes like AI or staffing tweaks get more attention than cultural shifts, which are harder to measure. Stigma itself remains understudied; a touchy-feely topic medicine sidesteps.
Emotional regulation—or suppression?
Emotional regulation takes on a dual meaning here. In mental health, it’s about managing big feelings—using tools like journaling or ice to cope, not erase. But in medicine, it’s suppression: How do I not feel?)Over-regulation becomes dissociation—a protective shield turned liability. It’s not named trauma, but it mirrors it, a constant state of floating above the pain to function. Dissociation serves survival, yet blanketing it across every case isn’t healthy—it’s a permanent trauma response no one acknowledges.
The human toll
This tension isn’t abstract. At a dinner party, a physician shared his struggle after failing to save a shooting victim. Therapy was his lifeline—he had no choice but to seek help or quit. Even young EMT students feel it early, overwhelmed before their careers begin. Burnout’s contagion is real: cynicism and hopelessness spread, dragging down teams and patients alike. A struggling coworker’s slack becomes your burden; their anger poisons the air. Ignoring it doesn’t make you tough—it weakens everyone.
A vulnerable turning point
The book behind this conversation was born from an unguarded moment. During an interview—maybe NPR—a spontaneous admission of personal struggle slipped out. Panic followed: Put it back! The reporter pivoted, making it the story’s heart. It wasn’t planned, but it revealed a truth: if a boring story shocks, we’re not talking enough. Labeled courageous, it feels more like it should be mundane—another sad doctor shouldn’t be headline-worthy.
The goal?
Make these stories so common they’re unremarkable, raising a bar that’s painfully low.
Based on the book by Dr Jessi Gold
HOW DO YOU FEEL? One Doctor's Search for Humanity in Medicine