CMDA's The Point

Avoiding Burnout

January 27, 2022

by Amy Givler, MD

Apparently, Medscape does a yearly survey on physician burnout, and the one that just came out asked 13,000 physicians from 29 specialties about their personal experience with stress and signs of burnout. Being in the midst of a global pandemic, it won’t surprise anyone that burnout rates are rising.

Being a family physician, I looked at my specialty’s statistic first. In 2021’s survey, 47 percent of family physicians met their definition of burnout. In this year’s survey, the number has jumped to 51 percent. The numbers are even higher (quite alarming, actually) for critical care and emergency medicine physicians, but since they represent 1 percent and 6 percent of surveyed physicians, respectively, and family physicians represent 15 percent, all the numbers are sobering.

I read these numbers and ache for my fellow physicians. Being in a pandemic means more sick patients, more stressed medical facilities, more confusion on what exactly is the current right thing to do. Add to those stressors patients believing false medical information and a general increase in human crankiness, and burnout becomes understandable.

Understandable, that is, but not inevitable.

How do we resist burnout? Here are three things I do, in order of growing importance. So, I’ll start with #3:

3. Staying Thankful

I am generally a peace-loving person, but some quirk of my personality really enjoys post-apocalyptic literature. That’s the genre where most of the world’s population is wiped out and we follow the struggles of the few survivors. And so I watched with pleasure the recent HBOMax 10-part series “Station Eleven,” based on the book of the same name by Emily St. John Mandel. Only one out of a thousand people on earth survive a devastating flu. Twenty years later, how are the survivors surviving?

With almost no modern conveniences, that’s how. Horses pull cars, people protect themselves with knives, there is no electricity or phones. Watching it, I realized how much of my comfortable life I take for granted. The COVID pandemic has changed my life, but my family’s house still has heat and air conditioning, our cars still have gas and the grocery store still has food. Am I thankful for these things?

Years ago, I read an otherwise-forgettable novel where the protagonist was transported back to Colonial America. I remember she had nothing from her former life but her clothes and a single safety pin in her pocket. That safety pin was a source of wonder to the young man she met. Ever since I read that book, I can’t look at a safety pin without thinking of that scene—Am I thankful for safety pins?

In the beginning of this pandemic, there was a panicked buy-up of toilet paper, and store shelves became bare. Many laughed at this, but not me. This isn’t an item I want to be without. I am thankful for toilet paper.

God has given me so much—and I don’t mean just the “stuff” I’ve already mentioned. I have my life—a priceless gift—and my relationship with Jesus, the greatest gift of all. When I thank God for these many gifts He has given, my eyes turn from me to Him. May I always remember “the surpassing grace of God” upon me, and join Paul in exclaiming, “Thanks be to God for his inexpressible gift!” (2 Corinthians 9:14-15, ESV).

2. Focusing on the Doctor-Patient Therapeutic Relationship

I finished residency in 1989, and a few years later I read an article that changed my professional life. It had been written 60 years before that, and many of you are probably familiar with it. It is “The Care of the Patient,” and in it Francis Peabody emphasizes “the vital importance of the personal relationship between physician and patient in the practice of medicine.” Some highlights:

“The treatment of a disease may be entirely impersonal; the care of a patient must be completely personal.”

“Just because he is an interesting case he does not cease to be a human being with very human hopes and fears.”

“The good physician knows his patients through and through, and his knowledge is bought dearly. Time, sympathy, and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”

That last phrase you may know, even if you didn’t know who first wrote it. Reading that article for the first time stirred me to remember why I went into healthcare in the first place—to make a difference in particular people’s lives by helping them back to health. That meant—I now knew—getting to know them as individuals and making a human connection so I could speak into their lives. I had to care about them so I could care for them. I had lost sight of that in the intensity of my time-starved residency.

Never in my 33 years of practice have I needed those lessons more than during this pandemic. For two years, my patients have had medical information thrown at them from friends, family, social media, government and the media. Is my voice just one among many? Actually, no. Among my long-term patients, with whom I have established a trusting doctor-patient relationship, my voice carries more weight.

Making that connection is valuable, even vital, as we move forward as a healthcare profession. Distrust of medical authorities is rampant, particularly in my north Louisiana community. Yet, my long-term patients who are highly hesitant to become vaccinated, for instance, will very often choose vaccination after I explain its value.

I may not be able to convince a casual acquaintance of the need to protect themselves from COVID, but my “success rate” is far higher in my one-on-one encounters in my clinic. This pandemic will end, but the doctor-patient relationship will remain.

1. Keeping the “First Thing” First

In Confronting Injustice Without Compromising Truth, which I commend to you for its brilliant insights comparing our society’s current definition of the words “social justice” with the biblical definition, the author Thaddeus Williams quotes from C.S. Lewis’ essay, “First and Second Things:”

“Every preference of a small good to a great, or partial good to a total good, involves the loss of the small or partial good for which the sacrifice is made. … You can’t get second things by putting them first. You get second things only by putting first things first.”

Williams describes three people: one who seeks people to like him, one who seeks happiness and one who seeks to not be anxious, but all three are unsuccessful in what they seek. Williams continues:

“Being well-liked, happy, and anxiety-free are not first things. They are second things. They are byproducts, not goals. Mistake a second thing for a first thing and you’ll lose not only the real first thing; you’ll lose the second thing too. …

“We don’t have to speculate about what Scripture makes the first thing. In 1 Corinthians 15, Paul states one of the earliest creeds of the first-century church: ‘Now I would remind you, brothers, of the gospel I preached to you…. For I delivered to you as of first importance what I also received: that Christ died for our sins in accordance with the Scriptures, that he was buried, that he was raised on the third day in accordance with the Scriptures.’”

The gospel, then, is the first thing. It is the thing, as a follower of Christ, I need to seek as of first importance, or else my life will start to flounder. I am God’s precious daughter, bought with the blood of Christ, forgiven of my sin. This is, indeed, good news. “…for he has said, ‘I will never leave you nor forsake you.’ So we can confidently say, ‘The Lord is my helper; I will not fear; what can man do to me?’” (Hebrews 13:5-6, ESV).

We’ve lived through two tough years. They’ve been stressful for everyone on the planet, but especially for those practicing healthcare. At this point, so many of us are fatigued, discouraged or facing burnout. But God’s good news, the gospel, is still good news. It’s very good news. May this be our focus, keeping first things first.

Amy Givler, MD

About Amy Givler, MD

Amy Givler is a family physician in Monroe, Louisiana. She and her husband Don met in 1980 at a CMDA student event her first year of medical school, and they have both been active members of CMDA ever since. Amy graduated from Wellesley College and Georgetown University School of Medicine, and she then completed her family medicine residency at the same indigent-care hospital where she now works part time. She also works at an urgent-care clinic and is the medical director for a Shots for Tots clinic. Amy loves to write and has written many articles and one book, Hope in the Face of Cancer: A Survival Guide for the Journey You Did Not Choose. She and Don have a heart for missions, and hope to do more short-term trips now that their three children have launched from the nest.


  1. Avatar Jeanie Mirich on January 28, 2022 at 8:51 am

    Thank you for getting at the heart of the matter. Your eloquent writing led me to prayer

  2. Avatar Eva Leonard on March 8, 2022 at 5:55 pm

    True and spot on in my experience. Thank you for putting these thoughts so succinctly in your writing.

  3. Avatar Byron Haney MD on March 8, 2022 at 8:29 pm

    With respect to burnout (physician abuse), the Lord answered my prayers and 3 years ago led me to Direct Primary Care. It has returned the Joy of Medicine back to my parents, my staff, my family and myself. In Thanksgiving for answered prayers.

Leave a Comment