Clark Gaither MD: Are You Burned Out?

Clark Gaither MD is a board-certified family physician in private practice in Goldsboro, NC. He has been in the full-time practice of medicine for the past 24 years. Now, like many in health care, but actually not an uncommon story, Clark confronted burnout, and it changed his life.

I won't spoil it for you, but his website, Dr Burnout, gives you a little bit of a clue. His focus is clearly on burnout with a mission and a focus, summarised in his book, where he asks the question, "Feeling burnt out lately? Reignite is the name of the book. Transformed from burnout to on fire and find new meaning in your career and life."


Clark Gaither MD: Are You Burned Out? Introduction

Well, burnout. Burnout is today’s topic, and we’ve touched on that before with Dr Suzy Green from The Positivity Institute. But burnout is something which is affecting a growing number of people who become disengaged and disempowered and exhausted from their job. The great resignation is an example of this, but there are many in healthcare, for example, that feel burnt out, particularly after these last two or three years. But in business in general, and when we’re not just talking about health care, we’re talking about the finance industry, we’re talking about teachers, we’re talking about people in law. It’s a problem that cuts right across our community in this busy, busy time where our attention is constantly being vied for, where we’re not getting enough sleep, and we’re not looking after ourselves. We’re distracted. We are immersed in a virtual world. Its disengagement is a big and growing problem.

My guest today is Dr Clark Gaither. Now, Clark is in a board-certified family position in private practise in Goldsboro, North Carolina. Clark’s been full-time practise of medicine for the past 24 years. Now, like many in health care, but actually not an uncommon story, Clarke confronted burnout, and it changed his life.

I won’t spoil it for you, but his website, Dr Burnout, gives you a little bit of a clue. His focus is clearly on burnout with a mission and a focus, summarised in his book, where he asks the question, “Feeling burnt out lately? Reignite is the name of the book. Transformed from burnout to on fire and find new meaning in your career and life.” I hope you enjoy this conversation I had with Clark Gaither, M.D.

Podcast Transcript

Dr Ron Ehrlich: [00:00:00] Hello and welcome to Unstress. My name is Dr Ron Ehrlich. I’d like to acknowledge the traditional custodians of the land on which I’m recording this podcast, the Gadigal People of the Eora Nation and pay my respects to their elders past, present and emerging. I do this because First Nations people, I believe we have a great deal to learn from, particularly about connection and respect, which is very much what this podcast is about.

Dr Ron Ehrlich: [00:00:33] Well, burnout. Burnout is today’s topic, and we’ve touched on that before with Dr Suzy Green from The Positivity Institute. But burnout is something which is affecting a growing number of people who become disengaged and disempowered and exhausted from their job. The great resignation is an example of this, but there are many in healthcare, for example, that feel burnt out, particularly after these last two or three years. But in business in general, and when we’re not just talking about health care, we’re talking about the finance industry, we’re talking about teachers, we’re talking about people in law. It’s a problem that cuts right across our community in this busy, busy time where our attention is constantly being vied for, where we’re not getting enough sleep, and we’re not looking after ourselves. We’re distracted. We are immersed in a virtual world. Its disengagement is a big and growing problem.

My guest today is Dr Clark Gaither. Now, Clark is in a board-certified family position in private practise in Goldsboro, North Carolina. Clark’s been full-time practise of medicine for the past 24 years. Now, like many in health care, but actually not an uncommon story, Clarke confronted burnout, and it changed his life.

I won’t spoil it for you, but his website, Dr Burnout, gives you a little bit of a clue. His focus is clearly on burnout with a mission and a focus, summarised in his book, where he asks the question, “Feeling burnt out lately? Reignite is the name of the book. Transformed from burnout to on fire and find new meaning in your career and life.” I hope you enjoy this conversation I had with Clark Gaither, M.D.

Dr Ron Ehrlich: [00:02:36] Welcome, Clark.

Dr Clark Gaither: [00:02:38] Thank you. Good to be here.

Dr Ron Ehrlich: [00:02:39] Clark, we’re going to be talking about burnout. And I think you’re almost described as Dr Burnout. But I wondered if… Because your background is in medicine, I wondered if you could share with us a bit about your journey that’s brought you to this point.

Dr Clark Gaither: [00:02:55] Sure. It was in 2009. I went to my practise partner. It was just two of us in a family practise group. I went to my partner and I told him, I said, “If something doesn’t change, I’m going to have to leave practise medicine.” What was once a great source of personal satisfaction and joy and pleasure had really turned into drudgery and dread and was no longer enjoying what I was doing. I was looking forward to the weekend and dreading Mondays then I was shocked by it. I really didn’t understand it. I couldn’t understand how something I once loved had become so distasteful. And so that set me on a journey really to find out what happened and what I could do about it because I wasn’t ready to give up on medicine. I was just wanting to find out how I could make myself feel better.

Dr Ron Ehrlich: [00:03:53] Were you in general practise at the time?

Dr Clark Gaither: [00:03:55] Yes, I was at a family medicine practise in a rural city in eastern North Carolina.

Dr Ron Ehrlich: [00:04:02] Hmm. And, I mean, that is such an integral part of a community, I imagine, that feeling disconnected from it has all sorts of implications, just generally within your whole world.

Dr Clark Gaither: [00:04:16] It sure does. You know, I spent quite a long time, a lot of energy and resource getting into medicine. And I was only in my 17th year of practise. And so I was quite dismayed and disheartened about how I’d come to feel. At first, I really didn’t know what I was doing. I made some changes that I thought would help reduce my hours by taking a cut in pay, but at that point, I really didn’t care. I would pay somebody to make me feel better. So I paid myself by taking some time away from the practise. I started reading outside of medicine and started picking up old interests and old activities and hobbies. I was running more for exercise, and getting better rest. You know, I was doing all these things we asked our patients to do. And within weeks I felt better. It was only later that I found out after nosing around on the Internet, that I was suffering from what’s been termed professional job-related burnout.

Dr Ron Ehrlich: [00:05:27] And I imagine, and I’m sure these last two years haven’t helped. I mean, you’re talking about your background in medicine, health care. They have really been at the coalface, haven’t they? And these last few years. And I imagine that’s not an uncommon thought going through many health practitioners minds, particularly doctors.

Dr Clark Gaither: [00:05:48] Right you are. The burnout rates in medicine were very high climbing prior to the pandemic. The pandemic really served to amplify the hallmark of burnout and intensified the underlying drives and so now I worked for a state professionals help programme and so we saw a wave of practitioners after things began to loosen up and after the pandemic began to die down, we saw a wave of practitioners that were in trouble or troubled by drugs, alcohol, depression, suicidal thoughts and ideations and acting out in various ways. And it was all a result of the stress that they were under during the pandemic.

Dr Ron Ehrlich: [00:06:43] Mm hmm. I think another group that’s taken a big hit, too, are teachers and nurses who were really, again, at the coalface being asked to do things above and beyond.

Dr Clark Gaither: [00:06:55] The caring professions in general usually carry higher rates of burnout because of the emotional impact of the type of work. So yeah, medical, health care personnel, teachers, firefighters, police officers, social workers, all of those professions got hit pretty hard by the pandemic. But again, even before the pandemic, the burnout rates are high and climbing.

Dr Ron Ehrlich: [00:07:26] So let’s talk about burnout and how we define it.

Dr Clark Gaither: [00:07:31] Well, this was figured out in the 1980s by a very smart doctor, by the name of Christina Maslach. And she developed actually the Maslach Burnout Inventory, which is a screening tool for professional job-related burnout or job-related burnout in general. And that tool has held up since the eighties or for the last 40 years, it still has scientific validity and is very accurate at measuring burnout in any particular individual. And it measures three things. There are three personal hallmarks of burnout.

The first is emotional exhaustion, and that’s when the person becomes they feel like they’ve left it all out there. They’ve given all that they have to give or they have nothing left to give. They can no longer connect on an emotional or psychological level to the client, the customer, the patients, or their staff or colleagues. The second hallmark is depersonalisation. That’s a fancy term for the individual becoming cynical. They develop negative feelings toward those they serve and they develop negative feelings toward what they do. And they also disconnect from what they do and who they serve. So they no longer feel that sense of connection that they once did for their chosen job or profession. And the last hallmark is a lack of a sense of personal accomplishment. And that’s when the individual feels like no matter what they do, it’s not making a difference. It’s not make it feel like it’s not making a difference in the lives of those they serve. And it’s also not making a difference in their lives anymore. They no longer feel that intrinsic reward from the job that they’ve chosen to do. So those are the three hallmarks or symptoms of burnout. Emotional exhaustion, depersonalisation, and a lack of a sense of personal accomplishment.

Dr Ron Ehrlich: [00:09:33] Mm hmm. I mean, this casts my mind to a study that was done by the Gallup organisation looking at engagement. And I know engagement in the workplace is a huge issue.

Dr Clark Gaither: [00:09:50] Right. And it’s the exact opposite of burnout. The three hallmarks of engagement are vigour, dedication and absorption. Our vigour is energy, which is the exact opposite of emotional exhaustion. Absorption is involved. And so rather than detaching, you get involved. And absorption is when you are so into your work that all else seems to melt away. And so the keyword for that is efficacy. People feel they’re efficacious in what they do. So it’s the exact opposite of a lack of a sense of personal accomplishment. So the engagement then is the exact opposite of burnout. And everybody wants to be engaged. And everybody every business owner was engaged in ways that, you know, demonstrate the vigour, the dedication and the absorption.

Dr Ron Ehrlich: [00:10:53] Mm hmm. Because I think people are very familiar with the term absenteeism. That’s an obvious one. You just literally didn’t show up for work. But presenteeism is another term that’s kind of somewhere. It is that part of the process. Presenteeism is is on the road to Damascus or on the road to burnout.

Dr Clark Gaither: [00:11:17] Exactly. I mean, people can put their heads down and grind away at a job they hate and a place they detest for years or even decades. But then, you know, they’ll put a smile on her face and they’ll fake, it you know, but inside they’re saying, “I hate this place and everything it stands.” Or the problem is, if they do that, then they can end up bitter and angry and resentful and it will shorten their lives. And so there’s no way to live in my opinion.

Dr Ron Ehrlich: [00:11:48] And yes, well, what you know, you’re out there looking not just in the health area, I think, nowadays, but what impact does this problem is having on business?

Dr Clark Gaither: [00:11:58] Well, it has a tremendous impact. I can speak for my business for sure, but there are parallels with any business. For the healthcare industry high burnout rates translate to a higher terminal rate. So if a business is turning over, churning your employees, there’s something wrong with that work environment. It’s probably a toxic work environment that’s driving people away. And by the way, 90% of burnout is caused by the work environment. Only 10% of the time do people burn themselves out. 90% of the time it’s the work environment. It also translates into… High burnout rates translate to medical errors. A one-point increase in the depersonalisation score on the Maslach Burnout Inventory translates to an 11% medical error rate.

Dr Ron Ehrlich: [00:12:51] Wow.

Dr Clark Gaither: [00:12:51] And so that can cause a lot of medical errors, employee dissatisfaction, patient dissatisfaction. On the other side, in the business world, it would be employee dissatisfaction, customer dissatisfaction, high rates of absenteeism, higher rates of an on-the-job injury, increased malpractice claims in the healthcare industry, or increased suits and the other industries. So there’s a high.. Employers, health care organisations, large provider groups. The. They are already spending a lot of money on burnout. They just don’t know it. And it’s not the way they would intend to spend it if they were a little better educated about the problem.

Dr Ron Ehrlich: [00:13:39] Hmm. That’s so interesting to hear you say 90% of the cause of burnout is the work environment. What are some features of a toxic work environment? I mean, people may be actually experiencing it without actually having the word toxic attached to it, but what are some of the features of a work environment that are toxic.

Dr Clark Gaither: [00:14:04] So, Christina Maslach also figured this out back in the eighties as she developed a tool for measuring this is called the Maslach Areas of Work Life Survey or MAWS, and it measures the six major employee job mismatches that create burnout. So a minute ago I talked about the hallmark symptoms, but these are the underlying causes and see if this might sound familiar. Work overload, lack of control, insufficient reward, breakdown of community, absence of fairness and conflicting values.

So there isn’t a single one of those that wasn’t being negatively impacted by the recent pandemic. Many providers were work overloaded. They were exhausted because they were called upon to work extra hours under unfamiliar circumstances. They were not to their liking most of the time. So everybody’s workload feels work overloaded at times, but in certain areas, in order to save money, companies have really loaded up employees with too much to do. There’s just too much on their plate, and nowhere is that truer than in medicine. Not only are providers supposed to take care of a long list of patient responsibilities every day, but now 30% of their day is administrative, which is something they don’t want to do and were trying to do now. So that kind of work overload has a negative impact.

Dr Clark Gaither: [00:15:42] Lack of control. Large organisations tend to want to centralised control. And so what that does is it stifles innovation and creativity at the point of service. So people can’t adjust or make accommodations on the fly because there’s some company policy they would violate if they did so. And so the more and more control is taken away from, in my industry, the provider and given to somebody else who often isn’t even educated in medicine, some bureaucrat somewhere. And so this is very dispiriting to the health care provider. One provider put it best. He said, “Every day I go to work, I’m faced with a thousand tiny betrayals of purpose.” And that kind of sums up exactly the way providers are feeling.

Dr Clark Gaither: [00:16:40] Insufficient reward. A lot of their rewards have been taken away from a lot of folks jobs because they’re either too busy to enjoy a thank you from a customer or a patient, or they’re few and far between because the amount of time they get to spend with them is so short. Now the thank you’s get further and further out. And so a lot of the intrinsic rewards that have been taken away break down a community and everybody has to feel like they’re pulling on the same rope in the same direction in an organisation. And when everybody’s pulling in different directions, it doesn’t foster a sense of community or common purpose.

And then the next lapse is fairness. In order for an employee to feel like they’re being treated fairly, there must be openness and honesty and trust. And if those things are missing or if they’re lacking, people don’t feel like they’re being treated fairly.

And then the last one, conflicting values. That’s a big one that will drive people away more than anything. If the company you’re working for is asking you to do things that are kind of shady or sketchy, or maybe they’re actually asking you to keep the information from your customers or patients or sometimes out. Now, why? They honest people will not stay they would never leave that place.

Dr Clark Gaither: [00:18:06] So now those six things, those are…There are more than six, but those are the six major underlying causes of burnout in the workplace. And if you negatively it it’s not just the number that are being negatively impacted. It’s the degree to which they’re being impacted. You can impact all of them a little bit and nobody’s burning out. Or you can impact once severely like conflicting values. And people will be jumping ship by the busload. So it’s not only the number, but the severity of those six underlying mismatches.

Dr Ron Ehrlich: [00:18:46] Hmm. I mean, I think the first one, work overload is such an interesting one, isn’t it, particularly at this time of the bottom line, you know, cutting staff. Productivity is a very, you know, trendy word has been for the last 20, 30, 40 years, always pushing to increase productivity. I mean, I think it’s true in health care, but it’s also true in so many other industry. There’s a point of diminishing return in terms.

Dr Clark Gaither: [00:19:14] Right. I tell people this analogy all the time, a racehorse, you know, the jockey on a racehorse, they have a riding crop or a whip and they can, you know, whip the horse a little bit, make it go faster, and they might whip it harder and it might go faster still. But at some point, no matter how hard you whip that horse, it’s not going to go any faster. But it will start to slow down and become less surefooted. So you can only squeeze so much juice out of a limp and people are being squeezed now to the limit. And it’s one of those things where as long as the employee continues to try to accommodate more and more, there’s no incentive for the administration or boss to give them less. So sooner or later, the system’s going to break. I think it’s reaching a breaking point even now. And there’s going to have to be some sort of paradigm shift away from the way we’re doing business and medicine right now. And I know that’s going to happen because the current path that we’re on is unsustainable.

Dr Ron Ehrlich: [00:20:33] Hmm. Well, I think this is true business in general. It’s about do you take a reactive response to problems like stress in the workplace or are you proactive? What’s your experience in, you know, as you engage with different companies or people or groups? Are there many people leading the way, showing a proactive approach to this, or is it mainly reactive?

Dr Clark Gaither: [00:21:03] I don’t know. Again, I’m sort of locked into my industry of health care. I can tell you that only 5% of the healthcare, large healthcare providers in the country have advanced thinking along these lines. 95% do not. Wow. And so it’s rare to get a health care organisation to really stop giving lip service, to burn out and start actually doing something about it. Everybody wants to get together and talk about the symptoms or, you know, everybody agrees it’s real or it’s getting worse. I agree something needs to be done. And then everybody goes home and nothing changes and or they’ll focus on the symptoms. They say, “Well, our workforce is overly stressed. Let’s bring in some mindfulness people and some yoga people, time management people, and some resilience training.” And all of those things can help with the symptoms of burnout. But unless you correct those underlying causes, nothing’s going to change.

Dr Clark Gaither: [00:22:06] And so, you know, most organisations don’t want to hear this message. It depends on how it’s delivered. But in their head, they’re thinking they’re going to have to upend their organisation and change things completely about. And it’s not about that at all. In fact, small changes can make a big difference. And so the message I like to give is, you know, “Mr. CEO or Ms.. CEO, how would you like to decrease your turnover? I see your turnover, you know, somewhere between five and 10% a year. How would you like to get that down to three? How would you like to decrease employee complaints? How would you like to decrease patient complaints? How would you like to decrease medical errors and malpractice claims? Does that sound good to you?” And if they say bye and say yes and say, “Well, we’ve got a road map, I can lay out for you, that that can change, make needed change in the workplace that will cause all of that to happen. And there are plenty of papers and studies to prove it. Burnout, mitigation, and elimination alleviation is not only cost savings, it’s income generating. Everybody and everything gets better when people are getting relative in their burn down.”

Dr Ron Ehrlich: [00:23:28] I want you to say that last bit again. It’s not you know, that was that rolled off the tongue very well. There are just those that be… Go on. Give it to me again.

Dr Clark Gaither: [00:23:39] It is burnout mitigation alleviation elimination is not only cost-saving, but it’s also income-generating. And it’s simply because an engaged workforce is a better workforce than have burned out. This is just think about it in your head. Everybody’s pulling on the same rope in the same direction. Everybody feels like they’re being treated fairly. Nobody feels like they are overly working, overloaded, compared to somebody else in the organisation. They have some control over their book of business and their day and can make decisions on the fly. They can innovate. They can create. In other words, you’ve given them a place, a workplace to blossom using their own natural set of talents and abilities and work experience.

Dr Ron Ehrlich: [00:24:26] Hmm. Well, you’ve just listed out very quickly there some strategies for dealing with it. Now when you do get burned, when you do get by in for a proactive approach to burn out, what are some of those strategies you’ll start you know, you’ll go into? You mentioned them very quickly, some things there. But what are some strategies you use to deal with this issue when you get by in?

Dr Clark Gaither: [00:24:52] So again, I’ll refer to my industry, but the same blueprint or road map can be used by any business or any industry, and that is you have to survey your workforce annually using something like some tool that has scientific accuracy and validity and repeatability and has, you know, a record of comparison that you compare your data to.

So if we consult on a hospital, for instance, or a large medical group, we will go in and do the Maslach Burnout Inventory and give that estimate there. Every employee takes about 10 minutes to fill out. The results are blinded, so nobody feels like, you know, they’re going to say something or their responses are going to come under some sort of scrutiny that might garner them some sort of negative impact. That does because this group reports all the results are reported in aggregate. So then you find out that will tell you how burned out your organisation is compared to similar organisations. Then you apply the Maslach Areas of Work-Life Survey to see where the negative impact is on those six underlying drivers. And then you present that data and then it comes to the working group or the working session where you pick the worst two underlying drivers to say, “Okay, what can we do to increase control? How can we decrease the lack of control? What changes can we make in the workplace?”

Dr Clark Gaither: [00:26:24] I’ll give you an example. One hospital, it took the provider somewhere around 15 or 18 clicks to get to his landing page within the electronic health record system. It should take two at most, maybe three. It shouldn’t take 15. And so that was the easy fix that can be done. And it can have a mess of return because people don’t feel like they’re spending most of their day just trying to log in to the computer system to find their particular landing page. So you get everybody in the room because of all of the expertise, all of the experience and all of the knowledge about what the problems are already in the room. I’m an outside observer. I don’t know how things work in Hospital A, Hospital B, or Hospital C. And so once we identify the underlying drivers, we saw a brainstorming session of what can we do to decrease the negative impact on these two worst underlying drivers. And then you make some changes in the workplace. You put some different policies or procedures in place to reduce that negative impact. Then you wait some specified length of time. Then you re-survey and see if you move the needle. [00:27:49][84.1]

And this should be an annual thing. Just like we tell people to go to the doctor once a year, to get a check-up. Businesses should get this kind of check-up every single year because employees come, and employees go. The conditions on the ground change. So the negative impact on those underlying drivers may shift. And if you improve these, too, you know what’s next? What about this one over here? You got a little worse this last period. Let’s work on that one. And so you do this annually and it’s not expensive. It can be done very cheaply. Instruments, you can buy them online. You can survey 1000 people with three group reports for $3500-$3700. A thousand people. That’s not expensive.

Dr Ron Ehrlich: [00:28:20] No, no.

Dr Clark Gaither: [00:28:20] Especially some of the coin that businesses drop for seminars and, you know, things that have proven to be ineffective. I think it’s time they start spending some time and attention and resources on things that have proven to be effective.

Dr Ron Ehrlich: [00:29:05] Mm hmm. Well, you mentioned 5% proactive and 95% not in this area. And I agree with you, probably translates through our community, and through businesses. Where does this change? I mean, how would or should an H.R. team approach this? I mean, what’re the drivers there?

Dr Clark Gaither: [00:29:28] How or who should approach it?

Dr Ron Ehrlich: [00:29:30] Yeah. I mean, how does a company turn that around? I mean, obviously, leadership needs by in.

Dr Clark Gaither: [00:29:36] Okay. First, there has to be a willingness to change. I don’t know who said it, but, you know, if you want some things to change, you’re going to have to change some things. And so just becoming willing, a little bit of education there. There is a great book, by the way. Christina Maslach wrote it called The Truth About Burnout. It tells companies and individuals what you know, what burn out is, what the underlying drivers are and how to address them. And so it usually takes somebody to sort of push the ball down the field. You know, you need a champion in an organisation. The National Academy of Medicine in America has recommended that all large health care systems hire a wellness…Just went right out of my head. Oh.

Dr Ron Ehrlich: [00:30:33] Director?

Dr Clark Gaither: [00:30:33] Thank you. Wellness director and give them a mandate and a staff and a budget. And some authorities led them begin to address this thing we call professional-related, job-related burnout in real terms.

Dr Ron Ehrlich: [00:30:51] It’s good to hear that a piece of research like that Maslach Research has stood up to so many years of scrutiny and is probably more relevant today than when it was first drafted all those years ago.

Dr Clark Gaither: [00:31:06] Sure. And if you get a group report, there’s a clearing house up, survey instruments, if you will, called Mind Garden – mindgarden.com. You go to mindgarden.com. And look at Maslach Burnout inventory it will pop up and I think for an individual report where you know the person’s name is on it and you get an individual report it’s like seven or 20. You can get a combination of Maslach Burnout Inventory and Maslach Work-Life Survey for like 20 bucks. If you get a group report where you know you’ve got a big group of people and the names aren’t shared, it’s aggregate data, it’s $3 a person. So it was very cheap. And in that report, it will compare your group to 33,000 other healthcare personnel across the country. So you know where you stand, you know you’re better off than that competitor group. You’re the same or you’re worse off than that competitor group. And so they’ve amassed this data over decades, and so they’ve got a tremendously large database and now they’re starting to break it out. It was health care providers like MDs, DOs, PAs, the nurse practitioner, that sort of thing. But now they’re starting to break it out into radiologists, cardiologists and you know, and they also have the Maslach Burnout Inventory for social workers and then the general pop and there’s three of them. There’s one for healthcare providers, social workers, because it’s a different crowd and then the general public. And so these tools are sitting there. There’s just tremendously underutilised.

Dr Ron Ehrlich: [00:33:09] Yeah. I mean, I think the statistics tell us that, you know, you said 90% of burnout comes from the workplace and I think Gallup did a recent survey showing that leadership, not surprisingly, I guess, was a major source of stress, or perhaps they could have added lack of leadership.

Dr Clark Gaither: [00:33:29] Yeah. And you have to be careful when you’re talking about burnout mitigation, the last thing you want to do, if you’ve got overworked, work-overloaded employees, the last thing you want to do is give them additional things to do. What you want to do is unburden them from some of the rules and regulations. And, you know, oddly enough, COVID or the pandemic has served to point out for a lot of businesses that people can work from home and can be productive knowing, you know, if they’re managed properly. And so a lot of people have rediscovered their joy for work if you will because they don’t have to fight traffic for 45 minutes in the morning and then worry about where or what they’re going to eat for lunch or how much it’s going to cost and fighting the weather and then 45 minutes back home in the evening. And so they’ve freed up an hour and a half of their day just in transit. Now, and so that should give businesses a little inkling that, “Hey, maybe what we’re doing now on the way we’re doing is not exactly working well. So maybe we should think about that some different way.

Dr Ron Ehrlich: [00:34:53] Hmm. And it has done that, hasn’t it? It’s legitimised work from home, which was always seen as a very soft option. Oh, come on. You know, you’re not in the office where we were working. It’s actually legitimised that. Do you think that’s been the great drive? I think we’ve used the term, the great resignation. I’m sure you’ve heard of that term.

Dr Clark Gaither: [00:35:15] I’ve heard.

Dr Ron Ehrlich: [00:35:15] Yep. Is that what you’re seeing out there in the world?

Dr Clark Gaither: [00:35:20] I think there are still a lot of people that are able to work but have chosen not to. Of course, they may be suffering from a different occupational problem than job-related burnout. They may just enjoy not working.

Dr Ron Ehrlich: [00:35:36] Yes, it’s tempting, isn’t it?

Dr Clark Gaither: [00:35:37] At all. But, you know, it’s interesting, a lot of entrepreneurs became entrepreneurs because they got burned out at their job. They just couldn’t take it anymore. And they thought, is this why I’m working so hard? You know, is this all there is? And they went off and developed their side business and have done well with it. And, you know, somebody famously said, an entrepreneur is somebody who trades a 40-hour workweek for an 80-hour workweek. And it is true, entrepreneurs work a lot of hours, but, you know, why they’re able to do it and why many of them don’t burn out doing is because it’s what they love doing. That’s what they wanted to do all along. They should have been doing it.

And so I tell folks, if you’re in a toxic work environment, that won’t change and you’ve got skills and abilities in education, your skills are highly portable. They’ll go wherever you got it. Leave that place and go someplace that is more conducive to your natural set of talents and abilities and core values and moral compass. Or start your own business because you’ve got, you know, plenty of brain cells up there that could get you through. So don’t just grind away in a place you hate on a job test. If your is your life needs some change. If you can’t change your work environment, then change work environments. Hmm.

Dr Ron Ehrlich: [00:37:09] Well, I think you may have just answered my next question, which was how do you avoid burnout if you’re faced with it? Or how do you even deal with it? Would you like to flesh out that a little bit more? How would you avoid if someone’s listening to this and going, you know what, I think I’m there? Well, how. Well, I might be. How do I avoid it?

Dr Clark Gaither: [00:37:31] Well, sure. Well, I’ll first address the 10% who burn themselves out. They usually burn themselves out by workaholism. They work too many hours to the exclusion of all else. And what’s ironic is they might like what they’re doing so much. That’s why they work so much. But over time, if you don’t live a life in balance, it can burn you up. And so try to avoid workaholism and try to have a life of balance where there are other things that you’re interested in and other things that you do. You spend time with your family and friends. You explore, you know, the whole world we got out there and have some fun. You know, just don’t work all the time.

Another way people burn themselves out is by developing an addiction. If you’re addicted, you will never reach your full potential, ever. And so that’s one way a lot of people burn themselves out or they’ll have a bad social life or an endless string of toxic relationships that kind of slop over into their work where they’re always calling in and it just makes life difficult for them. So you want to avoid those things. So that’s how people burn themselves out. Now, as to the work environment, 90% of burnout is caused by the work environment. If you can get the attention of the administration and the big boss or CEO and deliver that message in a kind way that I was talking about earlier, in a way that makes sense, maybe, just maybe, it will take their interest and they’ll do something about the work environment. If you feel like you’re beating your head against a wall and they’re not going to change in fact they told you they’re not going to change, then you’ve got a decision to make. Do I stay here where I have no control, where I’m working overloaded, where I feel like I’m not being treated fairly? My values are conflicted. Or do you take your skills and your talents and abilities that go someplace else that better appreciate?

Dr Clark Gaither: [00:39:41] People can get into a burned-out mindset where they will place roadblocks in their own path. They’ll say to themselves, It’s too late for me. I’ve got too much time invested here. I don’t have the right skills to go over there. I won’t make as much money over yonder. They create the scenarios in their head, but it’s really part of the burned-out mindset. And none of that’s true. You got where you are through your efforts and your energy and your knowledge. You can go someplace else and start over and end up better off. And so I always challenge people. Don’t stay where you’re not appreciated in a job that you hate. Look around. Now, I don’t suggest that people leave, you know, A. Until they have a Plan B, you know, you’ve got to get your resume punched up and you’ve got to start working around that out some fillers, but you can do all of that and prepare to launch and find a better work environment that’s not toxic.

Dr Ron Ehrlich: [00:40:50] Hmm. I think that encouragement to engage with management in a very caring, calm way is a really important point there to not just assume but to actually approach it in that very calm and proactive and positive way. You know, it’s the way you frame a question or a statement that makes such a big difference, doesn’t it?

Dr Clark Gaither: [00:41:19] Sure. And again, everybody’s in the same boat. You can say what without emotion and without any shaming language or blame me or ridicule. Or you can say, look, this is what I’ve observed. I don’t think you think that sounds right. But here’s what I think we can do. And then list those things that burnout mitigation alleviation elimination will do for an organisation and say, I think that sounds interesting, don’t you? Don’t you think that sounds interesting? And maybe it’s something we can look into because there are plenty of studies that show this stuff works. Everybody wants to. You know who wants to live a life where you’re just dreading getting up in the morning, going to work day after day, year after year, months after? Well, I mean, it just sounds like slow torture, so it doesn’t have to be that way. There are organisations and companies out there that get it.

Microsoft is one of them. They stop hiring, you know, a long time ago just based on educational background. And, you know, can you write code and if you can, you can work from home. You can come in. You know, they have dress-down days. They have all these cafeterias and all these things for employees that make the work environment so nice, nobody wants to leave, not willingly. So in North Carolina, the research trial parks, there’s a company called SAS Institute, and I don’t think anybody’s ever quit SAS unless they had a real good reason, because the work environment is so good. People feel like they’re on a team, a real team. And so there are companies around yet it. And like I said, I think more will as time goes by because the companies that get it will do better than the ones who don’t.

Dr Ron Ehrlich: [00:43:14] Mm-hmm. Well, I’ve often said that companies that focus on the health and well-being of their staff are companies people want to work with and companies that people want to work for. So, you know, it’s a win-win both ways.

Dr Clark Gaither: [00:43:28] Well, everybody wants to focus on the bottom line. I hear this, you know, well, we got a bottom line. We got to focus on. And I say your employees are your bottom.

Dr Ron Ehrlich: [00:43:35] Yeah. And this is the whole idea about return on investment. This is such a great return on investment, isn’t it? The focus on health and well-being of the team. Just… You give actually, you know what you’ve done here, Clark, is, you know, for that person wants to start a conversation you provided the structure and the science because of Christina Maslach’s work is still valid after 30 or 40 years. That’s probably a good structure to start a conversation with your employer.

Dr Clark Gaither: [00:44:06] Absolutely.

Dr Ron Ehrlich: [00:44:07] I want to ask you a final question. Taking a step back from your role as a doctor, as Dr Burnout. You know, focus on burnout because we’re all on a health journey in this modern world. What do you think are the biggest challenges for us as individuals on that health journey?

Dr Clark Gaither: [00:44:27] Self-care. People don’t take care of themselves like they should. And they know and they secretly know this consciously. It’s not a subconscious thing either. They know they need to get off the sofa and go for a walk. They know they need to drop some pounds. More than 50% of the chronic illnesses we deal with would go away if people took better care of themselves. And by the way, I’ll include physicians and a lot of health care personnel. And that group, health care providers are terrible at self-care. You think they would be great at it, but they’re not because they again, they kind of run around saying that everybody else’s needs rather than saying to their own. And so those things that we talk about really mean something. Get adequate rest, eat properly, keep your weight down, exercise regularly, get check-ups. I mean, just those around 50% of what we deal with can go away. Self-care.

Dr Ron Ehrlich: [00:45:33] Yeah. Clark, thank you so much for joining us today and sharing your knowledge and wisdom with us and thanks for doing that. And we’ll have links to your website and all of your material there. Thanks very much.

Dr Clark Gaither: [00:45:47] Well, you’re certainly welcome. It’s been a pleasure.

Dr Ron Ehrlich: [00:45:50] Well, I know that Gallup, the Gallup Poll has been done a few years ago, and I think they surveyed something like 142 countries and millions of people. And this is what they came up with was rather disturbing. And that is that only about 15% of workers are actively engaged in what they are doing. I think something like 65% or 68% who are indifferent are just showing up to work as a place to work and the rest are actively disengaged. So something is seriously going wrong in our work-life balance. Burnout is one manifestation of it.

And I think it is very interesting to look at the work of Christine Maslach, like who did a lot of research on this in the 1880s and nineties, and it has still stood the test of time. So there is clearly much in what she has uncovered and which Clark and Dr Suzy Green in a previous episode had been discussing and it might be worth us all going on to do that Maslach Inventory of whether you really are burned out or not. We’ll have links to that in our show notes and we’ll have links to Clark’s website as of course, as well, Dr Burnout. I hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well.

This podcast provides general information and discussion about medicine, health and related subjects. This content is not intended and should not be construed as medical advice or is a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences and conclusions.