How 5 orthopedic surgeons manage burnout


From focusing on hobbies to maintaining a routine with family, five orthopedic surgeons told Becker's how they prevent and manage burnout in their careers.

Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

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Please send responses to Carly Behm at by 5 p.m. CDT Wednesday, Sept. 21.

Editor's note: Responses were lightly edited for clarity and length.

Question: How are you preventing and/or managing burnout?

Philip Louie, MD. Virginia Mason Franciscan Health (Tacoma, Wash.): We all struggle with the idea of burnout in different ways. Similarly, we also build resilience and find joy/meaning in even more diverse areas. No class, set of workshops/presentations, or curriculum designed across an organization as a one-size-fits-all program will even start to unsurface the struggles of burnout or how to overcome this. But, here are three areas I focus on:

1. Spending time with family and friends. The people you love (and love you) the most will also provide you with perspective. They are reminders of what is most important in life — which is rarely the work that is driving you toward burnout. Time spent with them helps reset your perspective and energy. Make this a priority. 

2. Finding opportunities and time to simply rest and restore energy. The time and environment can vary widely, but taking time to bank up some energy is crucial. Our most valuable currency is not money or even time. It is understanding how to expend the energy we have in the time available. In this "go, go, go" world, we more commonly view energy as an endless resource and treat ourselves and others like human "doings" rather than human "beings." I try to take a few minutes each day to disconnect and rest/relax without interruptions. The work will always be there.

3. Establishing and maintaining new and old hobbies. We tend to be hyper-focused and driven in our field, with most of this energy devoted to our work lives (yes, even patient care). Direct some of this motivation and energy to other activities that bring you joy, as well as recapture some of that perspective and energy that is often lost during times of burnout.

Mark Flanum, MD. Orthopedic Physicians Anchorage (Alaska): The key is maintaining balance. It's not just saying, it has to be a practice in your life. Allowing time with family, regular scheduled exercise, time outside and periodic vacations are absolutely crucial in the high stress environment in which we work. Finally, it is crucial to have colleagues in your specialty with whom you can share your challenging cases and vent your stress.

Jason Snibbe, MD. Snibbe Orthopedics (Los Angeles): Managing burnout is critical to wellness and mental health. I think exercise is very important to stay strong and release stress. Spending time with friends and talking about issues in your life is important. I personally play golf with a group of friends. We communicate about stress, work and family. It is a great way to clear your mind. 

Lastly, make time with your family. I schedule a date night with my wife as if it's a surgery. Protected time that cannot be canceled. We get a chance to connect and regroup.
All of these pathways help minimize stress and improve your quality of life.

Anthony Melillo, MD. Bay Oaks Orthopaedics & Sports Medicine (Houston): Over 28 years, I have found the following has worked: 

1. I start my day at 3:30 a.m. and shower, make breakfast and read. It is the only time I have no demand from others
2. I go to bed at 8 to 8:30 p.m.
3. I workout on Wednesday mornings.
4. I play golf every Friday from 8 a.m. to 1 p.m.
5. I stopped taking ER calls 13 years ago (when I was 50). My health and family are more important than the extra money and midnight/weekend traumas.
6. I meditate when needed and surround myself with my four goldendoodles when I need an endorphin jolt.
7. My family and I try to do something together once a weekend.
8. I take a week vacation each year with my family and one week to play golf.

Andrew Chung, DO. Banner Health (Phoenix): With the healthcare landscape changing the way that it is and docs are constantly asked to do more for less, even for younger docs, at least for now burnout seems, to some degree, unavoidable.

Further, we live in a system that takes advantage of those that are continuously willing to give and traditionally romanticizes 30+ hour work shifts, 120 hour work weeks (slight exaggeration I know, but still true), and the "churn and burn" mentality. The truth seems, that if we allow it to, this system will suck the life right out of you if you are not careful. And soon enough, you're left looking back wondering what happened in other aspects of your life. I was fortunate to learn this quickly, talking to well regarded surgeons much wiser and experienced than me.

Not to say it's not important to work hard — it absolutely is — but it's even more important to work smarter than harder. Just like cars have governors to limit their top speed, we too, as surgeons often need to be able to set our own personal governor to know when and where to draw the line when it comes to work.

As much as possible leaving work to be done while at work, committing to your family, carving out time for things you enjoy, making friends outside of medicine, learning a new skill, and being financially savvy so you're not always going to be beholden to your job, are all personal strategies that I employ to avoid and manage burnout.

I hate to say it, but the reality is that nobody else cares more about you or your well-being than you yourself. So it's up to you to make it happen.

Above all, I let myself be reminded constantly why I do what I do. When that patient that wasn't able to walk, or had temporarily lost use of one of their limbs, comes back for their surgical follow-up, out of pain, with improved function, I let myself remember that that's what this is all about.

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