July 1 is the traditional start of the medical academic year. The hallways are bustling with eager, young (and getting younger each year) physicians with seemingly limitless enthusiasm. Yet by the end of the year, surveys show that at least half of them will have some signs of burnout. This is not unique to health care. A 2013 Gallup study found that just 30% of American workers are engaged at work. This is remarkably consistent across sectors of the economy (health care is actually at the higher end, with 34% of physicians and 33% of nurses engaged), and is a figure that compares favorably with the global average of 13%.
The usual leading suspect is lack of work-life balance. But that is only a part of the picture. Research shows that there are four core needs that, if met, contribute to a feeling of satisfaction and engagement (or burnout, when these needs are not met):
- Physical – opportunities to regularly refresh and renew at work (e.g., taking breaks) and away from work
- (work-life balance)
- Emotional – feeling valued and appreciated for one’s contributions
- Mental – ability to focus in an absorbed way on the most important tasks, and determining when, where, and how to get the work done
- Spiritual – doing what you do best and enjoy most, and feeling connected to a higher purpose at work
A survey of over 12,000 workers (95% of them “white collar”) showed that of these, it was the ability to focus and to think creatively that was most often felt to be missing. A sense of meaning or significance to one’s work, and doing what is most enjoyed, were also lacking. I suspect that part of why health care professionals are somewhat more engaged than others is the strong sense of mission we have and share with the organization as a whole. We all want to feel that what we do is important, enjoyable, and appreciated. I am very fortunate that, for most of my career, I have been in jobs that are exactly that.
Satisfaction is more a function of the organization than of the industry. A common thread among those organizations with a highly engaged and satisfied workforce is certain characteristics of leaders: personal energy level, showing appreciation, and leading by example when it comes to creating focus and renewal.
Hoping to cast a positive shadow of leadership, I am getting ready to renew myself physically and mentally on a family vacation. No email, no work reading, and no blog next week.
Starting With Curious 
Hi Marc. Thanks for the thoughtful blog â I always look forward to reading them. Todayâs topic reminded me of a poem that was shared in the mindfulness program I completed last fall. It uses fire as a metaphor (Iâm not sure that is exactly the right term) for how we need to build space in our lives just as a fire will not burn if the logs are packed too tightly.
Wishing you a wonderful, restful vacation â¦. Deb Weiner
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Fire
Judy Brown
What makes a fire burn
is space between the logs,
a breathing space.
Too much of a good thing,
too many logs
packed in too tight
can douse the flames
almost as surely
as a pail of water would.
So building fires
requires attention
to the spaces in between,
as much as to the wood.
When we are able to build
open spaces
in the same way
we have learned
to pile on the logs,
then we can come to see how
it is fuel, and absence of the fuel
together, that make fire possible.
We only need to lay a log
lightly from time to time.
A fire
grows
simply because the space is there,
with openings
in which the flame
that knows just how it wants to burn
can find its way.