Feeling the burn? You’re not alone. The rate among medical practitioners is increasing, says American facial plastic surgeon Dr Steven Dayan.

Occupied but not present: have you ever been in such a situation? Maybe at a conference, talking with a colleague, in a staff meeting, at the theatre or during a dinner party? Your mind is elsewhere while you numbly rumble through the motions, thinking, wondering, interested in somewhere or something else.

Regardless of the distraction, your presence in the moment has been stolen; it’s taking away from the now to think about a future that may never happen. You are no longer engaging in the full breadth of the moment, and if sharing it with others you suddenly diminish your value to the moment and their perception of it. Eventually, you become a bore to not only yourself but others as well.

Likely, being occasionally distracted provides an evolutionary benefit to human existence, a survival mechanism to identify an immediately threatening situation or perhaps a split-second opportunity. But if continuously distracted from the moment, we lose the potential benefit gained by what is right in front of us. Despite continuing with the motions, the passion is lost and subsequently we lose presence. Practices and livelihoods are put at risk and a “burnout” phase has entered. If the creeping and malingering burnout can be recognised just before it slithers past the entranceway and into our lives, can it be averted?

Physicians are increasingly being subjected to burnout. A 2016 Medscape survey of more than 15,000 physicians in 25 specialties found that there has been an increasing rate of burnout. Plastic surgeons fell near the bottom of the pack (20/25), dermatologists were even less likely (22/25), and critical care specialists and ER doctors were the most likely to experience burnout, with 55% reporting feelings of burnout (1).

There are three tenets of any occupation that can lead to burnout: 1. a job that is centred around the clock; 2. an inability to control one’s own destiny; 3. a job that lends itself to a routine.

When completion of a work day is defined by a pre-set time then the progress of the day becomes measured by the movement of the clock hands and not the moments created within that time. When an action becomes monotonous, it no longer requires supratentorial input. A curious cerebrum goes elsewhere while a reflexive autonomic system caters to the task at hand.

Fortunately, when it comes to burnout, although admittedly biased, the aesthetic medical fields may be inherently more resistant than other fields of medicine. While performing an aesthetic procedure it is very difficult to not be present in the moment because we are aiming to achieve two outcomes that cannot be easily attained: perfection; and/or the ill-defined notion of patient satisfaction. In either scenario, it is different from other medical or surgical fields where endpoints are more clearly defined. In surgery an obstruction is relieved, an infection is cleared; in medicine blood pressure is controlled and blood sugar is stabilised. Such medicine caters well to protocols, evidence-based medicine, EMRs and flow charts.

In contrast, in aesthetics a procedure is completed when we feel that the patient will be satisfied with the outcome. This is a moving target which requires fluidity in our decisions of when to stop. Couple this with the common character flaw of most creative types that satisfaction in work is rarely if ever truly achieved. It is the reason many loved masterpieces are considered incomplete by the artist who created them. Hence, when in the act of performing the procedure, we are likely to be acutely present in the moment. It may contribute to the reason so many surgeons mention how much more they enjoy their surgical days over their clinic days.

Regardless, we all fall risk to being occupied but not present at some point in our careers, and that may be a higher relative risk today considering the emerging smart phone screen dependency.

What is the solution? During a travel adventure, I surmised an answer: When risking something of value, you immediately become acutely present in the moment. Whether jumping out of a plane, scaling a volcano or doubling down at the black jack table you can’t help but be completely present in the moment. A thrilling discomfort enters, your heart races, your mind sharpens and you are present. Nothing else enters your mind other than the task at hand.

So how does that translate to our professional lives?

My hunch is we have to make an effort to occasionally venture outside of a comfort zone. When exploring something that we are not used to, there is no routine to fall into. We focus more intently, our minds grow, new neurons sprout and relationships enrich.

Physicians are traditionally appreciated for their safe behaviours, reliability and routines but while such consistency may bring comfort, beware the complacency for it always leads to demise. In both our professional and personal lives we should make a concerted effort to step into that zone just beyond the ease that keeps us present. I am not advocating high-risk behaviours, but maybe consider hiring a new employee, a new internet plan, a new laser, adopting a new procedure, redoing the office, or studying a new aspect of medicine or art that can complement a career. Or perhaps something completely outside of medicine such as learning a new language, taking up a new hobby or adopting a pet.

As a medical society, perhaps this could mean welcoming in new talent, new educational platforms and exploring partnerships with those we never would have considered in the past. The more often we can venture outside ourselves and our comfort zones the more likely we are to be interesting, present in the moment and expand not only our minds but also our careers.

1. http://www.medscape.com/features/slideshow/lifestyle/2016/public/overview#page=2

About the author

Dr Steven Dayan is a facial plastic surgeon, professor and researcher based in Chicago, USA. He has published more than 110 articles in medical journals and five books and is a NY Times and USA TODAY best-selling author. Dr Dayan is an internationally recognised keynote speaker and has presented all over the world, including Australia.

5 tips to deal with a professional burnout

recent survey1 from the Australian Psychological Society suggests many Australians are affected by stress and susceptible to suffering from chronic stress and burnout. Findings revealed that one in three Australians report having a significant level of stress in their lives, while one in four say they experience above-normal levels of anxiety.

Characterised by exhaustion, lack of enthusiasm and motivation, and feelings of burnoutineffectiveness, burnout can have serious repercussions and lead to severe depression and anxiety. Periods of excessive and prolonged stress can also manifest physically and cause a faster rate of deterioration in health. Along with headaches, respiratory and gastrointestinal infections, and memory impairment, burnout can cause sleep disturbance and suppress immunity, significantly impairing quality of life.

“In this age of working smarter and faster, burnout can be easy to overlook, but if chronic stress is not addressed it can become very serious and lead to greater physical and mental health issues,” says Dr Samantha Clarke, a clinical psychologist who also runs Mind Body Resilience Retreats in Noosa and Byron Bay. Here are Dr Clarke’s top five ways to combat burnout:

1. Create movement in your day

It is part of our natural make-up to move but nowadays too much of our day is spent sitting for long periods of time in artificial environments with fluorescent lights. Engage in some movement, whether it’s a daily run, yoga class or a walk on your lunch break. Movement also helps to alleviate stress so we can re-set and come back to our work task with a clear mind and be more productive.

2. Take a break

Taking mindful pauses regularly at work is very important. Take five minutes to walk with awareness to the water cooler, to reconnect with your breath and your surroundings.

3. Keep values in mind

You will never have everything in balance but you can ensure that you are giving time and attention to other areas of your life that are important to you such as your family, friends and hobbies. Block out some time in the week for these aspects of your life as these focuses can be hugely restorative and help us come back to work fresh. Often when we are starting to get burnt out or feel stressed at work we become tunnel-visioned…but this is often unproductive.

4. Don’t forget the basics

Often when we are busy, stressed or down we start to let the fundamentals go, such as what food we are putting in our bodies, sleep, meditation and exercise. When we want to operate at our best we need to be sure to put in the right ingredients for optimal performance. Have healthy snacks prepared, don’t skip meals, and get eight hours sleep if possible. Unhook from technology at least an hour before bed to let the mind relax and assist with sleep.

5. Address barriers & reconnect with your meaning

This one might seem counter-productive but is possibly the most effective. Often people fail to step back and actually examine the barriers or difficulties they are having at work and address these systematically. Do you need support? Is there a better system that can be put in place to ease the load? How long has it been since you have had a holiday?

If we are not connected to our sense of purpose and meaning, work can start to become a cause of depression and unhappiness. What is it about your work that brings meaning for you? What are you passionate about and how can you reconnect with this?

1. https://www.psychology.org.au/Assets/Files/PW15-SR.pdf

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