Take This Job and Shove It

This song about burnout on the job was quite popular in 1977 (original version by Johnny Paycheck; subsequently also recorded by Dead Kennedys).  While many of you are not old enough to have been assaulted by the recording on AM radio, the sentiment probably isn’t at all foreign.  The phenomenon of burnout among medical professionals has been the subject of both serious research and discussion in the lay press.  A 2012 study in JAMA Internal Medicine revealed high levels of self-reported burnout among physicians, especially in “front-line” specialties such as family practice and emergency medicine, where over half of physicians reported some form of burnout.  (Fortunately, both primary care pediatrics and pediatric sub-specialties had below average rates.)  Also, physicians had higher rates of burnout than the general population.  (There are studies showing similar statistics for nurses, but I haven’t been able to find any studies specifically dealing with burnout among advanced practice providers.  I think we can assume it’s fairly similar.)

Burnout is defined as “a syndrome characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization), and a low sense of personal accomplishment.”  Effects of burnout include symptoms of depression and/or anxiety, loss of empathy and objectivization of patients and co-workers, unprofessional behavior, and high rates of error.  It can also lead people to leave the profession.  Thus, burnout is a problem for the physicians, for their patients, and ultimately for the system.

While a good bit has been written about the prevalence of burnout, there seems to be little data on what can be done to prevent it.  It doesn’t appear to correlate with hours worked, income, or satisfaction with work-life balance, but data are limited.

In the meantime, try this two-item screening tool for identifying burnout:

How often do you agree with the statement “I feel burned out from my work”?


Less than once a month

A few times a month

Once a week

A few times a week

Every day

How often do you agree with the statement, “I have become more callous toward people since I took this job”?


Less than once a month

A few times a month

Once a week

A few times a week

Every day

If, after that, you need a little pick-me-up, watch this – a good reminder of our value of health.

3 Responses to Take This Job and Shove It

  1. Klingbeil, Frederick says:

    Tremendous message Marc!

    You would be interested in knowing that I am a strong believer in taking responsibility for one’s life … and consciously focusing on staying healthy (and fit), being happy and achieving success. (It is easy to become unhealthy, be unhappy and unsuccessful … just sit around and complain).

    I think you would be interested to know that I consciously decided to change my job and career path when I came to the realization I wasn’t as happy and productive as I use to, could and want to be. I decided I needed to move on, (turn the section over to my partners Maya, Kim and Julia who are really enthusiastic and competent), and recapture my professional excitement. I needed to get back to my life’s purpose of “experiencing the highest quality-of-life I can, and helping others to do the same”.

    I really admire your fitness, style and leadership … please keep up the good work! You are a great example to others! You are making a real difference!!!


  2. […] When people find out what I do for a living, the first response is most often something along the lines of “That must be so hard.”  (That’s when they find out I’m a pediatric emergency physician; when they hear I’m also an administrator, it’s more of a sneer.)  My reply is typically that most kids are pretty healthy, and most of what I see is fortunately not that serious or ends well.  Which is true.  But the fact is, sometimes it is hard.  All of us in medicine have ways of coping with those difficult times, with patients who suffer and whom we can’t help as much as we’d hope to, with the child that dies.  But, as discussed in a recent New York Times article, too often that coping mechanism is to distance ourselves.  This detachment – which can cross over into callousness or cynicism, as documented famously in Samuel Shem’s novel The House of God – is contrary to the various oaths we take when entering the medical profession, in which we pledge to be compassionate and empathetic to the sufferings of those we care for.  It can play out in several ways.  Some physicians focus on the intellectual aspects and science of medicine.  For others, emotional detachment along with time and economic pressures can lead to burnout. […]

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