I was one of those people, and still am, who always knew that I wanted to be a physician.

I jumped through all the hoops — undergraduate courses, MCATs, medical school, residency — to finally become a practicing physician, working at a family medicine clinic, in a hospital, and with low-risk obstetrics. Four months after completing residency, I found myself burned out.

My being meticulous and thorough, my ability to keep up with time pressures — the conveyor belt of patients in a fee-for-service system, — and the lack of compensation for administration work in all three different clinical settings led to my burnout. I backed off a bit, realizing that two clinical settings was more realistic. I let go of hospital medicine and kept the family medicine clinic and obstetrics work. I also locumed, which provided great work flexibility as I started a family. 

All was great until my inclination to do more led me to create an online startup that directly connects job-seeking physicians and medical facilities. This project grew and took on a life of its own. And I found myself juggling motherhood, my medical career, and my role as CEO of a startup (which had its own steep learning curve). In addition, I also became involved in setting up a local newcomer’s clinic. 

I sunk back into burnout as each of these roles pulled me in different directions and left me with no time for myself.

I see a lot of online discussion among burnt-out physicians looking for side gigs outside of medicine as a way to escape burnout. And I started contemplating as to why I seem predisposed to burnout no matter what I work on, medical or not. The following general themes came to mind:

1. Perfectionism kills physicians. I want to be everything to my patients, handle every issue that day, which leads to emotional exhaustion after 25 patients. A happy medium likely exists. 
2. Juggling more than two roles can lead to burnout. If my responsibilities are to be a mother and a locum physician, that's fine. But adding the role of CEO of a startup causes the tower of resilience to tip over. 
3. The bystander effect does not apply to most physicians. It’s in our nature to take on responsibility and attempt to create a corrective source of action when we see an issue. This is a great quality, but when taking on one too many commitments, that fine balance tips again.

Although it is a struggle for me to practice what I preach, I have learned a few strategies to reduce my own burnout — and I’m slowly learning to follow through.  

1. Don’t overextend yourself. Choose no more than two related professional settings to be involved in. I struggle with this one as I am currently involved in four different settings.
2. Do a great job with patient care, but realize that the difference between your 100% and 110% to your patient is minuscule, whereas that could save you a lot of personal emotional and mental energy. 
3. Exercise, sleep, and eat well. I had a vasovagal reaction the other day while performing a surgical assist that required me to stand for two hours. I had rushed in that morning after I breastfed with no breakfast or fluids on board. What was I thinking?
4. Live in the moment. Don’t delay spending time with your kids for another stage in your life when you’re more free — it will never come. Quality time matters more than quantity, so take that quality time each day to be present with your family.

If anyone has any tips/advice to share, please comment below!

Dr. Haneen Abu-Remaileh is a family and maternity care locum tenens physician and Founder of www.Locumunity.com. She is constantly between Vancouver and Seattle.

Image by Lightspring / Shutterstock