Physician Burnout: How One Surgeon Grapples with Work-Life Balance

Sharon Shiraga, MD, a surgeon at Keck Medicine of USC, discusses how she maintains the divide between work and home life.

Surgeons, compared to some other medical specialties, especially struggle with maintaining work-life balance due to our demanding working hours, high stress levels and steep performance expectations.

I categorize our stressors into three types. First, the unpredictability of our schedules physically makes maintaining regular work-life balance more difficult. We often work longer and more irregular hours, including early mornings, late nights, weekends and holidays — and are on call for emergencies.

Work itself is also stressful. When operating, we feel intense pressure to produce optimal outcomes. After surgery, we feel pressure over patients’ optimal recovery.

Finally, surgeons, like many physicians, grapple with the emotional impact of our patients’ outcomes. When complications or end-of-life decisions occur, they take a toll on our emotional well-being.

This triad of physical, mental and emotional stress can impede work-life balance. Too often we end up sacrificing personal time and leisure activities to focus on our professional responsibilities.

Is it possible for surgeons to balance not only their work but also their personal commitments and self-care? Yes, by keeping some key goals in mind.

Time management is critical.

Efficient time-management is crucial given our variable and inflexible schedules. I continue to work on communicating more efficiently and on leveraging tools like online calendars and apps to organize schedules, projects and events. I also try to set clear deadlines and priorities for myself, using time blocks between patient care to meet micro-goals or to take baby steps towards larger goals.

Practice work-life separation.

The intense emotions and pressure surgeons feel in their daily work can make it difficult to maintain boundaries between work and home. This is especially true when we’re handling difficult cases or less-than-ideal patient situations.

I try to make it a practice not to take home the emotional aspect of work. One of the ways I achieve this is by changing out of my scrubs or work clothes as soon as I get home. It’s that ritual of transitioning from work to home that serves as a mental cue that the workday is over; it’s time for home, family time and personal care.

Prioritize the activities you value.

In addition to being a busy surgeon, I’m the mother of two young children, so a lot of my free time and home activity revolves around them. I enjoy taking my kids to school and picking them up on days when I get out of work a little earlier. I like coloring, playing board games and reading with them. At this point in my life, my kids are my priorities. And although at times I can only spend short pockets of time with them, I make an effort to stay focused and present to ensure that the time is high-quality.

Recognize when you’re stressed.

Very rarely are work and home life truly balanced. I’m always struggling for some sort of partial balance. Generally, patient care gives me a lot of joy and fulfillment. Sometimes, however, work takes a heavier toll in life. It happens. When it does, I feel more overwhelmed and disconnected from work, and I might feel more resentment and impatience during my daily work.

At these times, I try to pause, reflect and be mindful of my emotions to gain perspective. I’m fortunate to work with a great group of surgeons here at Keck Medicine of USC who all value work-life balance. They recognize the need to intentionally carve out time for life outside of work. Working with my group makes it easier to set boundaries because I know that my group is supportive, similar-minded and is able to take care of patients of mine when I need to be away.

Remember that it’s okay to say no.

If I had to give advice on how to improve work-life balance, I’d say one way is to look within yourself to see what you can change. The second is to look without and see what you can change around you.

I’m still working to manage time more efficiently, to set boundaries and to tell myself that it’s okay to say no either at work or at home. Saying no allows me to devote my full attention to what I’m doing. When I’m at home, I try to give my family 100% of my attention and time. Similarly, when I’m in the OR, I give my patients 100% of my focus.

Care for patients by caring for yourself.

Data has shown that physician burnout is associated with an increased risk of adverse patient safety incidents and poorer quality of care. In addition to that, remember that our patients are smart and sensitive to their physicians’ emotions. They can tell when physicians do or don’t have their heart invested in the services they’re providing. This reduces their satisfaction with their care.

No perfect solution exists.

All physicians are dealing with increased stress, including longer work hours, physician shortages and increasing patient volumes and complexity. Non-patient work such as documentation and navigating complex billing and insurance systems can also take us away from patient care, decreasing our satisfaction in work. Finally, some stressors are largely out of our control. These include institutional policies, regulatory mandates and a perceived loss of autonomy in decision-making. This can all lead to feelings of frustration, disillusionment and burnout.

Remember that no perfect health care system exists, but there is one work environment that will be ideally suited to your unique situation. Don’t be afraid to prioritize what’s important to you and to make requests that help you mold your environment into one that supports you and enables you to be successful.

USC Surgery

Sharon Shiraga, MD, is a general surgeon for USC Surgery, part of Keck Medicine of USC. Shiraga specializes in minimally invasive surgery involving the stomach, esophagus and abdominal wall.

USC Surgery is a leader in research and technology to promote better, safer surgical treatments. We are a national leader in using minimally invasive techniques to give patients the best possible outcomes. We also perform a high number of robot-assisted surgeries each year, making us experts in this advanced technique.

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