Many physicians are still thriving in an era of burnout and exhaustion in medicine. What are they doing differently? I've polled my community of thousands of clinicians and included their responses here (shared with permission).
Here are ten things thriving doctors do:
They insist on having time with patients and prioritize being present.
"I have learned to speak out when the administration starts pushing to increase the amount of patients to be seen in less and less time."
"The increasing pressure to see more patients in a shorter amount of time can be exhausting. What turns it around is the extra 10 minutes of really listening and empathizing with patients. It's the willingness to sit with them in the hard moments, to hold their hand, or offer to pray with them. Somehow, that time isn't 'lost.' It is worth it for someone to feel seen and heard. It gives me a renewed passion and reminds me that I have a purpose underneath it all."
"I focus on the patient in front of me, what is on their mind. Being present in each encounter makes it more meaningful for me and them. Many appointments end with a hug. I went into medicine to treat humans, not clicks on a computer."
"I take a breath before seeing each patient to remember to be present and remember we are often patients' most precious resource in a sacred space. What a cool job we have."
"I create relationships with patients, even in small ways. I find this to be the most rewarding part of it all."
They delegate tasks and have support.
"I have good office support with APPs, a pharmacist, and a psychologist. I love being a primary care doctor overall."
"I try to delegate administrative tasks as much as possible."
"I ask my social worker to help with issues they can handle, including counseling, financial assistance, and barriers to care."
"I have a team that helps me with telephone calls to patients and insurance companies and with paperwork for things like FMLA and other requests."
They leave bad jobs and also consider alternative clinical paths, such as direct primary care, locums, and urgent care.
"I started out with a bad job that was not a good fit. I learned a lot about myself, my priorities, and my boundaries. I got an amazing new job and a better fit for me."
"In primary care, many thriving doctors I know have left the fee-for-service model and moved to direct primary care. It's a new way to have your own practice, which I never thought was possible."
"I work doing locums and love it. I have more control over when I work and have more negotiating power."
"I switched to a direct primary care model, which made all the difference for me."
"I gave up the most stressful part of my job, which took me a long time to come to and required therapy and SSRI."
"I am still an employed physician but salaried and not RVU-based. That has helped."
"I was burned out in primary care and left it for urgent care, and I love it. I hate that I had to leave what I worked so hard to become. But I'm glad I could stay in medicine, at least. Now, I see people all day who can't get in to see their primary care physician. The system is so broken."
They take time off.
"I actually started taking vacations. I'm a human, too."
"I don't do any work on vacation."
"My family and I outlined what mattered, and one of those things was having vacation time with family, and now we take it."
They try to limit uncompensated time on the phone.
"Anything that will take me more than five minutes for a patient I make into a virtual visit, such as relaying complex lab findings or discussing new symptoms. It's on my schedule, so I remember to do it, and I'm also compensated for my time."
"I limit the number of patient phone calls. If labs are okay, send a message on the portal. Especially as female physicians, patients often feel they have more access to us, which can lead to burnout. If I received a message that was too involved, I encouraged the patient to make an in-person or virtual appointment."
"An appropriate reply to 90% of inbox messages is the patient needs a visit. Working for free through a portal = devaluation and moral injury."
They try to finish work at work and use scribes and dot phrases.
"In my first job, my colleague told me never to take charts to complete at home because they were not paying me for that time. I have followed that advice, and after nearly a decade of practice, I continue to finish all paperwork during work time and leave on time."
"I try to finish a patient's note before seeing the next patient, so I don't bring work home. I also have several dot phrases to help, and I write short notes."
"I use an AI scribe to help me get more notes done so I don't have to take them home."
"I teach residents and try to model separating work and home. Leaving my computer at work was a huge (and difficult) habit to start. If I must bring work home, I try to keep myself to 15-30 minutes at a time WITH a timer. It keeps me on task and helps me feel less bad when I shut the laptop."
"I don't have Epic on my phone and don't do work at home."
"I spent a significant amount of time at the beginning of my current job creating templated and dot phrases for most of the diagnoses I encountered and for well-child checks. I also chart prep twice a week and come to work 30 minutes before my first patient to prep my notes with dot phrases. This has allowed me to complete notes within the work day most of the time."
"I don't check my email or EMR inbox once I leave the office--setting boundaries and keeping priorities in mind is important."
"I don't access the electronic health record after signing out (and that includes after Friday) unless I was waiting for a critical lab."
They set boundaries and are clear on priorities, including health, hobbies, and relationships.
"I say no when there's an after-hours non-urgent patient that wants an appointment, and I know I'm already emotionally drained or unavailable and won't deliver quality care."
"I wake up early to exercise and have "me time" alone without my child. I also prioritize going to bed early."
"I have lists to help manage tasks with priority categories. I like to use: Urgent/high priority, Urgent/low priority, non-urgent/high-priority, and non-urgent/low-priority."
"I started doing things that interest me outside of medicine, like learning ukelele. I also run at a nearby park during lunch."
"I say no to many opportunities that are not a good fit for me."
"I exercise and enjoy time with family and friends. I also schedule time to do nothing."
"I prioritize friends at work and little consistent things with them like weekly lunch dates."
They work less or have more flexible hours.
Many clinicians move to fewer hours or part-time work. However, "part-time" in medicine usually means they work 40 hours per week when clinical care, documentation, and admin tasks are considered.
"I went part-time, which has helped my well-being tremendously."
"I work four days a week and arrange my hours around my children. I'm able to drop off my kids at school two days a week and pick them up four days a week. I'm much happier after I changed my schedule."
"I cut back on my hours to part-time, which really helped after having kids."
They create shortcuts and sheets for common issues they encounter
"I have compiled all the resources in the community for my patients in terms of therapy and community events and a sheet ready to give out so I don't have to spend a ton of time on it during each appointment."
"I created a sheet for all new learners in my clinic to help with their education and streamline what I hope to teach them."
"I give all new patients a sheet with contact information and other useful information. This has saved us a lot of time."
They have self-compassion.
"Not everything will get done every day. And that's okay. Just do your best."
"I have to remember that I am human. I will work during the hours I'm at work and be with family and enjoy my free time when not at work, even when I cannot do everything or complete all tasks."
"Perfection is not attainable. I have empathy and compassion for myself as I have for patients."