Dealing with Regret: Discovering Growth and Self Compassion

High-stakes decisions with no easy solution, challenging interactions with patients and family, and outcomes that don’t always go as planned: these are unavoidable facts of life for most physicians.  

The lost opportunities or unanticipated consequences may lead to feelings of regret that can haunt you when you least expect it. Although this is completely normal, coming to terms with regret can be difficult. This aspect of professional life is rarely discussed out in the open, making the journey forward all the more arduous.

In this article, we’ll talk about regret, what it can teach you, and how it might help you to become an even more effective physician.

Regret Is Normal, and It’s a Sign of Compassion

Although it can feel crushing in the moment, regret is not a weakness or a marker of failure. Instead, it can help to reframe regret as evidence that you are compassionate and invested in the outcome of your decisions. Whether that’s the well-being of your patients, the strength of your relationships, or the integrity of your work, you wouldn't feel regret if you didn’t care deeply.

Learning from Regret

When you recognize regret in this way, you can break the cycle of rumination and open yourself up to the multitude of lessons it holds, including opportunities for reflection and growth.

Perhaps the lesson is learning to slow down, to listen more closely to your patient, to take an extra breath before responding to a difficult conversation. Maybe it’s committing to take a more active role, advocating more effectively when faced with challenging situations. Or it could be a recommitment to ongoing learning and professional growth.

It’s important to acknowledge that although the past cannot be changed, it can inform the future.

Here are some questions to ask yourself that might help to create mental space for new ideas:

• Are there ways that you can mitigate the consequences, even now?

• What would have needed to happen for things to have turned out differently?

• What actions are within your control?

• What resources might you need that were not available to you then?

• How might you respond next time you’re faced with this situation?

The Importance of Self-Compassion

As a physician, perfectionism is probably one of your driving forces. But at the same time, you may hold yourself to impossibly high standards.  

Although you may never have been taught this in training, at some point in your career, you will very likely make a decision that, in hindsight, turns out to be wrong. Other times, some outcomes will simply be beyond your control.

Self-compassion means treating yourself with the same kindness and understanding that you would offer a colleague or friend. And at the same time, caring for yourself helps you to stay present and capable of providing the best care for your patients.

Sometimes regret can feel overwhelming, despite your best efforts to overcome it. When needed, professional help in the form of a counselor or a coach can be sustaining.

Turning Regret into Action

It’s important to not only acknowledge regret, but to turn your reflections into action. Use this hard-earned awareness to make adjustments, both big and small, that will help you navigate future challenges with more confidence and clarity. Depending on the source of your regret, it might mean

• Taking a course

• Learning or perfecting a skill

• Seeking feedback or support from a trusted colleague, coach, or mentor

• Implementing measurable changes in a process or procedure

• Practicing mindful communication

• Setting clearer boundaries

• Reaching out to a mental health professional

Moving forward from regret is about progress, not perfection. It's about using each experience to inform your next steps without getting stuck in the past.

Discovering Resilience and Growth

Learning from regret will strengthen your resilience and shape your compassion for others who may find themselves mired in similar situations. Through this process, you will build a toolbox of strategies that will support you through the inevitable challenges in the future.

Regret may never completely disappear, but with time and practice, it can become a guide, pointing you towards opportunities for personal growth and a deeper connection with the values that first led you to find your place in the medical profession.

Coaching for Healthcare Leaders

As a member of the American College of Cardiology’s Physician Well-Being Working Group, I am fortunate to be part of the change that’s happening within cardiology and healthcare in general.

Coaching is increasingly recognized as a way to support and retain physicians, an aid for reducing burnout, and a tool that can improve the healthcare environment for physicians, staff, and the patients that we serve.

The first in a series of webinars put on through the ACC was presented in early 2024. You can watch it here, or maybe take it along with you and listen during your commute to work.

How Do You Know if You’re Burned Out?

Burnout is not going away.

It’s no surprise that nationwide, levels of burnout reached record highs during the pandemic, impacting over 60 percent of physicians. But now that we are back to a semblance of normal, the percentage of physicians experiencing burnout symptoms hovers a little under 50 percent. That’s still far above the “baseline” of 38 percent in 2020.

Topping the list of burnout-inducing specialties are

💉Emergency Medicine,

💉Internal Medicine,

💉OB-GYN

💉Family Medicine

Although burnout has decreased in all of these groups, more than 50 percent of doctors surveyed in these specialties described classic symptoms of burnout.

While any improvement is good news, the fact that nearly one in two physicians across the board are suffering from burnout is nothing to celebrate.

Not only is burnout demoralizing, but it also contributes to job turnover and increased healthcare costs. Not surprisingly, a Mayo Clinic study found that burnout can raise the likelihood of medical errors. And a 2019 study reported a conservative yearly cost to the US healthcare system of $4.6 billion dollars.

So how do you know if you're burned out?

❓ A. Is it just a feeling?
❓ B. Is it something we can measure?

If you answered B, you're right. Burnout isn’t just a trending term. There are standardized tools to measure burnout. The Maslach Burnout Inventory is the granddaddy of burnout tools, and has been in use since 1981.

Burnout affects doctors of all ages and across all spectrums. It is not a personal failing, and it’s not a mental illness.

If you’re experiencing burnout, it’s important to understand that burnout is not your fault, and you’re not alone. Here’s what you need to know:

✴ According to the World Health Organization and the ICD-11, burnout results "from chronic workplace stress that has not been successfully managed."

✴ Symptoms of burnout include:

🚫 feelings of low energy or exhaustion
🚫 negative feelings or cynicism about your job
🚫 loss of motivation and a sense of detachment from work

✴ Burnout is not a mental health condition.

So how do you know if you’re burned out? If you're wondering if you've just hit a rough spot or if you're truly burned out, you could invest in the Maslach Inventory. Or you could save yourself a little time and money and take a simple Two-Minute Burnout Inventory created by Chris Bailey for Harvard Business Review.

If you're a physician living with burnout, you don't need to suffer in silence. There are ways to get through it, but you can't always get there on your own.

Systemic changes to our profession are critical, and there are signs that change is coming. But while we wait for the slow gears of progress, it's important that you take care of yourself now.

Your health, your loved ones, and your patients are counting on you. If you’re feeling burned out, consider coaching, either through your institution, or through a certified Physician Coach. Studies, including a randomized controlled trial published in 2024, have found coaching to be an effective strategy for reducing physician burnout.

There are no easy answers to the complex issues facing healthcare today, but getting clarity on your own needs and values will empower you to chart your own course.

An earlier version of this article was published in April 2023.

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