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Burnout is an Expression of Grief, Not a Lack of Compassion

This article appeared in a slightly different form on KevinMD.

“The wound is the place where the light enters you.”- Rumi

Over the last 5 years, the word “burnout” has become nearly synonymous with the state of healthcare. With over 60% of physicians surveyed reporting burnout in 2021, it’s an epidemic in our profession.

Burnout is not a personal failing or a psychological illness. Rather, burnout is a response to chronic workplace-related stress.

Symptoms of burnout include:

·         Exhaustion

·         Cynicism

·         Inefficiency

But burnout is not a failure of compassion.

In fact, burnout may be a natural reaction to the recognition that you are unable to provide the compassionate care that your patients need.

The experience of burnout may mirror in some ways the experience of grief. Both are a response to loss. And like burnout, grief is often experienced as exhaustion and difficulty thinking clearly.

Compassion fatigue on the other hand produces a sense of indifference to the suffering of others. It’s an emotional withdrawal generally caused by exposure to traumatic events. For physicians, it may be a response to relentless illness and death.  The COVID-19 pandemic is a classic example of a driver of compassion fatigue, especially for those who worked in the ER and ICU in the early days of this disaster.

It’s not uncommon for physicians to experience compassion fatigue from time to time. It doesn’t mean that they are not compassionate people, but rather that they are suffering and in need of relief.  

We might consider burnout as a type of disenfranchised grief. But it is not compassion fatigue.

Equating burnout with a lack of compassion is a heavy-handed way of placing the blame on physicians while deflecting it from the systems that created the problem.

As a coach, I have found that many physicians with burnout are in fact grieving the lack of connection to their patients. Often this is due to system-wide emphasis on RVUs combined with excessive clerical work that undermines their ability to spend meaningful time with patients.

If you’re experiencing burnout, it’s important to recognize it for the wound that it is, have compassion for yourself, and create a plan to move forward.

As Rumi states so eloquently “the wound is the place where the light enters you.” What does this light illuminate for you?

Are you suffering from burnout? Remember that burnout is not a failure on your part, but rather a symptom of a system that is not working for you. If you feel stuck, consider coaching.


As a physician coach, I can work with you to explore what’s possible and create a plan that aligns with your personal values and aspirations. Schedule your exploratory conversation with me by clicking the button below.

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References

Compassion Fatigue, Empathy Burnout for Health Care Workers: Which is it? Mental Health America, 2023.

Erickson, M. Good leadership, self-compassion key to tackling physician burnout. Stanford Medicine News Center 2017.

Lathrop D. Disenfranchised grief and physician burnout. Ann Fam Med. 2017

Maslach C. et al. Job burnout. Annu Rev Psychol. 2001

Mughal S. et al. Grief Reaction. [Updated 2022 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023

Shanafelt, TD et al. Changes in burnout and satisfaction with work-life integration in physicians during the first 2 years of the COVD-19pandemic. Mayo Clinic Proceedings. 2022