By Annette Pena Bernat, ACA News Editor

After 11 years in practice, Dr. Greg* is ready to call it quits as a chiropractor.

 

Born into a chiropractic family, and raised to appreciate the importance of a lifestyle of health and wellness, it’s not surprising that Dr. Greg chose to become a chiropractor. But no amount of training or prior experience with the profession prepared this New Jersey doctor for some of the lesser appealing aspects of day-to-day practice.

 

“It’s just too much,” he says, explaining that he and his wife have had to take over all administrative duties for his practice following the recent departure of three front-office employees. Then there are the constant hassles that come with trying to get insurance companies to pay for services and watching with disappointment as patients ignore advice intended to improve their health. “I take it hard when people don’t listen,” he says.

 

Fed up and in need of change, Dr. Greg is now in the process of putting his practice up for sale. “I’m going to get away from hearing other people’s problems for a while,” he adds.

 

While everyone occasionally experiences a bad patch at work, the deep frustration that signals job burnout—like the kind experienced by Dr. Greg—is a more serious development that can lead not only to lower productivity, absenteeism and turnover but also to more troubling consequences such as sleep disorders, headaches, aches and pains, and even depression, anxiety and substance abuse. In fact, stress—which is at the root of burnout—costs U.S. industry $300 billion in lost productivity each year, according to the American Institute of Stress.

 

More serious than the financial cost is the loss of talented and caring professionals who are most often the victims of job burnout. According to research, health care providers are more susceptible to burnout because of the emotional demands of their jobs.

 

But burnout does not necessarily have to be a job- or career-ending crisis. Experts on the subject tell ACA News that it is possible for people like Dr. Greg to identify the root of their burnout and take steps to bring more peace and satisfaction back into their professional and personal lives.  

 

“Burnout is a response to chronic stressors that wear on a person over time—not acute ones such as a big event or a big change,” says Christina Maslach, PhD, a psychologist and author of Banishing Burnout and other books, who has pioneered research in the field.

 

Burnout, she explains, involves three factors:

Furthermore, according to the Mayo Clinic, you may be more prone to burnout if you:

 

Job burnout develops gradually, which sometimes makes it hard to differentiate it from normal stress; however, over time, the accumulation of that stress creates a sense of hopelessness about the job. Workers become sad, irritable and less patient with others, and have a hard time laughing about things. “People have described the feeling to me as an erosion [of themselves],” says Dr. Maslach.

 

For doctors of chiropractic, who care about their patients and believe strongly in the benefits of chiropractic’s drug-free approach, facing the realities of the business of health care and the public’s ongoing misconceptions about chiropractic can be especially challenging. For example, Dr. Greg says that he often felt like he was working against “the corporate machine” of big medicine and pharmaceutical companies when trying to convince his patients to take simple, proactive steps to improve their health.

 

The stress of working with patients who are in pain—or noncompliant—is amplified by the pace of modern health care, says Mark Sanna, DC, president of Breakthrough Coaching, a chiropractic practice-management group. “From my perspective, doctors who are five to 10 years in practice are experiencing a level of burnout that previously only doctors who were in practice for 25 or more years would experience,” he tells ACA News.

 

Part of the reason, he believes, is the incredible pace of change in the profession: documentation requirements, new codes, HIPAA rules and more. “[Doctors] aren’t able to organize the pace of change,” he says. “They tell me, ‘Nobody ever told us it was going to be alike this.’ You have to be a compliance expert, a practice management consultant and a coding expert.”

 

But the No. 1 cause of burnout for DCs, according to Dr. Sanna, will be no surprise to many: economic pressures from a reimbursement system that is often “non-supportive” of chiropractic. “It’s hard for people to just focus on being a great chiropractor,” he says.

 

As a result, some doctors lose the passion they felt when they first entered practice and dream instead of a quick escape. “I call it ‘Buyout Syndrome,’” says Dr. Sanna. “A doctor is just waiting for someone to come along, buy his practice and put him out of his misery.”

 

The feelings of despair, powerlessness and cynicism that are associated with job burnout make it difficult for people to see a way out—short of quitting. But sometimes it’s not the job at all that’s the problem; sometimes it’s some specific aspect of the job that does not “fit” the person in it.

 

Through her research, Dr. Maslach has identified six factors that influence how well an individual fits a job:

 

By breaking down burnout into manageable pieces, it’s easier to see what the real problem is, and how it might be fixed. “Think of burnout in parts. Make changes; be creative,” Maslach advises.

 

Dr. Sanna offers DCs the following suggestions for alleviating stress on the job:

 

Sometimes, even if things on the job are good, burnout is possible. Beware of monotony, says Peter Johnson, MD, who believes that health care providers—who he notes are highly intelligent people—need to budget for mental stimulation over their careers. “The mind is continually thirsting for newness. You get into a rut—you burnout.”

 

Dr. Johnson, who is CEO of Headway Lifesciences Resources, a company that matches people with jobs in the bio-tech field, became interested in job burnout when he found himself yearning for something new years ago. As a reconstructive plastic surgeon, he experienced a good deal of positive feedback, but over time even he felt the repetition of his work draining his mental energy. He eventually quit his job to start his own company. Taking risks, he says, is vital to avoiding job burnout.

 

“Diversify your stimuli,” Dr. Johnson adds. You can get involved in activities within your profession, or outside your profession, he points out; the point is to open yourself up to new ideas and new experiences.

 

For DCs, that might mean adding a new service or profit center in the office to spice things up, says Dr. Sanna. Or, you could visit a progressive chiropractic office and shadow another doctor for half a day to get new ideas. “Keep learning,” he stresses.

 

Dr. Maslach also suggests using skills in another setting—volunteering to work for a local sports team or teaching a class. “Do something with your skill in a positive light that will offset the negative aspects of your job.”

 

Maintaining balance between work and home life is vital to avoiding, and recovering from, job burnout. “Put boundaries on that life so work doesn’t swallow it up,” Dr. Maslach emphasizes.

 

While DCs may be more prone to burnout, their love of and belief in what they do is a true marker of hope—even for Dr. Greg. After his break, he plans to reopen a small, cash-only practice that incorporates chiropractic and other wellness therapies. To those starting out, he advises: “Work like hell in college and pay some costs so you don’t graduate with $100,000 in debt. Start small; don’t buy a bunch of unnecessary equipment. Keep your overhead small. Try to educate your patients, but don’t beat yourself up when things don’t work out like you planned.”

 

“I will always be a chiropractor,” he adds.