The Cause of Burnout No One Talks About

Have you ever felt a level of burnout that doesn’t make sense for the physical hours that you are working? Maybe just two days after coming back from a vacation you already feel completely drained, or maybe you are working “part time” but still feel a deep level of exhaustion after your 2 day work week. 

Today’s episode is a recast based on one of my most popular episodes and a Kevin MD article that I wrote. It’s a very undocumented and undiscussed cause of burnout- that once you understand it, you will already be on your way to recovering.

In this episode, you will learn:

• The science behind “white lies” and how harmful they can be for our mental and physical health.
• 6 signs that you are being and feeling inauthentic at work.
• How to start “burnout proofing” your career through practicing authenticity.

I’m so excited for you to dive in!

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Transcript

0:03

Welcome to the Life After Medicine podcast, where we help you create a fulfilling and non traditional career as a healthcare worker. I'm your host, Chelsea Turchin. In 2019, I left the hustle and grind of my OBGYN residency and set out to create a fulfilling career on my own terms. Now I'm a best selling author, career and burnout coach, and world traveler. Through this podcast, I'll show you how to enjoy your work, make an impact, and support yourself financially. Without all the stress and burnout you are currently experiencing. Let's get to the show. Are you a healthcare professional longing for a career with more freedom and fulfillment, but you're struggling to figure out a clear direction? What are you actually gonna do and how is that going to work? The reason you're struggling to find a clear direction is because you keep turning externally for the answers. You keep reading and rereading the same uninspiring lists of alternative careers for health professionals I have. been there. You are desperately asking career coaches and other clinicians what are my options? Hoping someone will hand you a list of options that you actually are interested in. And maybe you're Staying up late at night, scrolling to the 10th page of the Google search results, trying to find that unicorn of a career, but ultimately, you feel confused about how to find a new career path and you feel frustrated about the lack of good options. and hopeless. Like you're just trapped in medicine. But the good news is that you are not trapped. Although it may seem like it, you are just looking for clarity in all the wrong places because you haven't learned where and how to look for true clarity. That's why I've created the 5 Days to Career Clarity audio series. And during this free audio series, which You can listen to just like a private podcast feed. I will help you figure out your direction so that you can be on your way to finding a career that gives you freedom and fulfillment. Over the five days, we're going to talk about the most common problems medical professionals are experiencing. Three questions that will help you figure out your direction. The biggest thing standing between you and your unicorn career. and the main principle that will help you get unstuck so you can move forward and build a roadmap to clarifying your career direction. By the end of the audio series, you're going to understand the crucial ingredient you've been missing to figure out what you want. You're going to feel more confident in your career direction, and you're going to know how to stop spinning your wheels and second guessing yourself so you can move forward. If you are ready to find this career that gives you freedom and fulfillment, then go to the link in the show notes and download this free audio series today. It's also, you can go to coachchelsamd. com slash clarity and find it there. And I'm so excited for you to dive in. Hello, my loves. Our new podcast comes out next week. And dang, I am so excited. I've been having such a really cool experience interviewing. So many of the listeners and really getting a feel for what we want to be about and what we want to bring in during this next era. And before we officially do, we're going to be doing sort of a soft launch through the month of December where each week I'll be sharing a new episode and we'll be talking about a different dimension of freedom that is really relevant. And by the end of December, we'll have everything in place. For the podcast, it's going to be the new theme song will be there, the new cover art will be there, but it's all going to happen a little bit gradually through the month of December. Each week, there'll be a new piece of the puzzle that is released because sometimes change doesn't happen as fast as we would like it to. Sometimes there is this liminal space, and this is something that a lot of my clients have been experiencing recently, this idea that sometimes The old thing has ended, but the new thing hasn't quite started yet. And in some ways we're in that with the podcast as well. And so I'm excited to take you guys on this journey of being in the liminal space as each week We release a new episode and we release a new layer of what's to come. The title's gonna change, the theme song's gonna change, the cover art, everything's gonna change. And change is scary. Change is so hard. And it does require a letting go of the old. And that's what we're going to be doing through this month, and we're going to be walking into 2024 with a whole new era, with a whole new energy, and I'm so excited for that. This week is still another recast episode. This episode is something that aired back in August of 2022, and it's actually something that I wrote a KevinMD article about as well. Which got some great traction and this episode is called The Cause of Burnout That No One Talks About because what I notice is some people have this level of burnout that doesn't make sense for the number of physical hours that they're working. And maybe you've experienced that too, like maybe just two days after coming back from vacation you already feel completely drained and you're like, how is this possible? I. Or, maybe you're in to work the day after the vacation, feeling I'm good! I'm recharged! And then you go to work and in just two days, everything is depleted again. Or maybe you're working part time two days a week but you still feel this deep level exhaustion. After your work week, then there's all these additional layers of guilt and shame of, I shouldn't be this tired. I shouldn't be experiencing this exhaustion after such little work. So today's episode is going to help you make sense of what's happening. About a very undocumented, undiscussed cause of burnout that once you understand it and you have language for it, you'll already be on your way to recovering. In this episode, you're going to learn the science behind white lies and how harmful they can be for our mental health and our physical health. I'll share six signs that you're being and feeling inauthentic at work. And how to start burnout proofing your career through practicing authenticity. I'm really excited for you guys to dive in and learn more about how to understand this cause of burnout and then how to start preventing it through practicing authenticity. Okay. So today we're talking about the cause of burnout that nobody talks about. And okay. So the reason it's probably not well talked about, my guess is that it's not that well understood. It might seem a little bit fluffier, so it might be a little bit more difficult to measure it and identify it and to talk about it. But, I'll tell you, it's something I noticed with myself. It's something I have noticed with countless clients. It's something that I posted about this on my Instagram, and someone on my stories told me I literally wrote a thesis about this, but then someone was, like, giving her trouble about publishing it. So it's this cause, and I think, so I think it's really important to talk about it and to put language to your suffering, because when you understand why you're feeling a certain way, there is a lot of power to that. There's a lot of power to really developing a deep understanding of why exactly this is not working for you. And I'll also tell you that as I've left medicine, and it's about to be four years since I made my decision to leave November, October November of 2018 was when I was really going through my leave of absence and all of that, and in the four years since I've left, I have developed layers and layers of new understanding around why Medicine wasn't working for me and with each layer of understanding, I feel this exhale. I feel this sense of relief. I feel this sense of it's not that there's something wrong with me. It's that this was never going to be. The right fit. And for you, it might not be that all of medicine is not the right fit, but it might be that this one setting or this one work schedule or this one specialty is not the right fit. And the more that you can really understand yourself, then you can know and feel so much relief around the fact that it's not me. I'm not defective. Not every person is meant to be in every work environment. And that the freedom and the relief that comes with that is just such a beautiful thing. And so that's why. I think it's important to talk about this. That's why I'm doing those career calibration sessions, that's like a 60 minute power hour with me to help you really get to the root of what is going on and to just feel that sense of relief of Oh, this is why it's not working for me. And it's usually much deeper than what you think. It's usually not the schedule is just hectic or my boss sucks or, it's like those things all contribute, but there's usually some specific things about you specifically of why it's not working for you. And once you know those, there's just so much peace and relief and freedom around all of that. So drum roll, please. The cause of burnout that I'm going to talk about today is Essentially, being inauthentic. And I talk about it in terms of putting on the mask of professionalism. And when I say being inauthentic, it's not a moral judgment. I'm not passing a moral judgment on you. I'm not saying that you're bad or wrong or you're a liar or you're not being your true self. No, it's just about how we've been conditioned to put on this mask of professionalism. And so let's talk about that. What is professionalism? What is the mask of professionalism? Essentially I'll say it in a brief form and then we'll go into more detail. So professionalism is this code of conduct around what's expected of you. What is that role? whAt's expected of you to fulfill the role of whatever health care professional you are? What does it look like to be a doctor? What does it look like to be a nurse? What are the things that society and in your professional field and the other interdisciplinary fields, what are the things that are expected of you in that role? And what I realized is we are taught this very explicitly, at least, so in, from my experience in medical school, we are taught this very explicitly about how doctors not just how they should behave, but also how they should look, how they should be. I remember being shown a video on professionalism during our very first day of orientation, and it was this what not to wear style, and it was meant to be humorous and funny, and it was showing these sort of over the top, cringeworthy experiences of medical students walking into exam rooms with their bra strap hanging out, or chewing gum in the exam room with the patient or speaking like in a ballet girl accent and oh my God, what's wrong with you? And it was supposed to be these really over the top extreme examples of of course, this is what you're not supposed to do as a doctor. And there's some merit to these things and some of these things make sense. But really what was happening on a more subconscious subliminal level was these messages of there is a right way and a wrong way to be a doctor. There are words you're not supposed to say. There's a tone that you're not supposed to take. There are outfits that are not appropriate to wear. I remember I went out and bought like a whole new wardrobe after this. After watching this orientation video, I was like, None of my clothes are professional enough. I have to go buy this whole wardrobe. And I felt really singled out. Not singled out. Like just me in particular, but I was just like, Oh shit. I don't know if I am a person who is like good enough to be a doctor. I don't know if I fit all these criteria and these standards. I need to go be a whole new me in order to fit in as a doctor. And it's not like I had a bunch of inappropriate clothes, but I was just like, Oh shoot. Like I need to level up. And leveling up is not bad either. But if you're leveling up based on external expectations, instead of based on your own internal situation, that's a difference. You also, yeah, you learn that there's like a certain bedside manner that you must maintain. And that is done very explicitly we at least in med school. And I'm sure in other training programs as well, that there's these clinical exams. We had Osce's, they're these objective standardized clinical exams and you are graded. on your bedside manner, but it's just something that's really subjective. What it implies is you're being watched. The way you act is being watched. You're being monitored. You need to be this one certain way because you're being graded on it. You need to be this one certain way because there is one certain way to be. And I will acknowledge there is some merit to having certain standards, certain codes of conduct, certain expectations. But it's like, where's the line? Where's the line between this is completely unacceptable to society as a whole and this is one variation of your individual personality? Because, essentially, what I started to learn, and I think what a lot of us learn, both implicitly and explicitly, is there is a... Right way to be and especially like being a doctor I'll just name some of the expectations that I started to internalize. I need to have all the answers saying I don't know is not appropriate. I cannot say I don't know I need to have all the answers I have to be kind empathic and understanding at all times and it has to be done in this certain way Sassiness is not really appropriate. Calling it like it is, doing real talk being these certain aspects of yourself. Essentially, it felt like you have to be devoid of all the aspects of your personality that are not universally likable or universally... Agreeable and especially I would say that all of this criteria and these standards are harder to live up to as females as people of color as any other minorities in medicine because medicine was created as a very like Patriarchal profession it was created by a bunch of white males nothing wrong with those white males It's just like that's who it was created by those are the people who set the standards of like how you're supposed to be and so Women and people of color and any other minority who are trying to live up to this white male patriarchal standard of how we're supposed to be, it takes us a lot more energy and a lot more effort to live up to these standards. So yeah, we'll get into what this costs us. We'll get into all of that too. But I guess what I first want to make sure that we understand is what is professionalism? What is this mask of professionalism? And yeah, now since we've talked about that, so I'd love to know if anyone like relates to this, does anyone feel like this pressure to put on this mask, you're putting on your white coat or you're putting on your scrubs or you're putting on whatever your hospital costume is that you're wearing and you're putting your stethoscope around your neck and you feel like you're also becoming this other person, becoming this other version of you that may or may not be aligned with who you truly feel that you are on the inside. As Glennon Doyle talks about a lot in her We Can Do Hard Things podcast, feeling like your insides don't match your outsides or they, you need to do something in particular to force your insides to match your outsides. And that. That doesn't feel good. So let's talk about how this is harmful and we'll go through my experience, we'll go through what I've heard from my clients, and then also just like actual scientific studies on there's like the science of honesty and all of these things that actually demonstrate how harmful it can be when you feel like you have to be one thing and you have to be a certain way. So I just remember from my own personal experience working in medicine, I felt like I was constantly like calibrating myself. To the role of doctor like there was two different means there was Chelsea and then there was like dr Turgeon and sometimes it is helpful to have this alter ego that Helps you to rise up and be a bigger and better you But that's only if that alter ego is Representative of who you truly are on the inside and the best qualities of you that you're just trying to bring out That's actually an exercise I do with my clients and there's a whole book about this that Todd Herman wrote called the alter ego effect And there can be a really helpful Way to use this alter ego and use this persona to bring out your best self that is there under the surface. This, the professionalism mask, is not that. The professionalism mask is suppressing the parts of yourself that you feel like are not acceptable within the profession or the role that you play. So for me, for example, I felt like before I walked into a patient's room, it was like I had to pause. And gear up for what I was about to do. It was like I had to take a deep breath and really tense up and get myself ready for who I was about to be, and then to I was playing a role, like I was, like, acting, and I was doing this Dr. Turjan sort of a thing, and I had to be this certain way and I didn't feel like I could relax. I felt very tense. I felt like I was gonna, and this is where you can get some imposter syndrome. No wonder we all feel imposter syndrome in the medical field. We're literally trained to be imposters. We're trained to act a certain way and disregard ourselves. We're trained to not really love and accept who we are, but that we need to be this one standard. We need to be this certain way, and we need to get ourselves to that standard. Of course, everyone feels like an imposter because we're literally walking around. Being imposters all the time because we're trying to live up to this certain standard of like professionalism And yeah so for me I would feel like I would just like pause before going into the rooms and just try to like Muster up the like who am I supposed to be again? And it just felt like I was constantly on edge I was really tense. I couldn't relax because I just didn't know how to be me. And I've had similar stories from my client, someone I worked with last week, or maybe the week before, who was talking about she just has this really great sense of humor that she feels like she's not allowed to use with her patients. That she has all these jokes she wants to say and these ways she wants to break the tension or maybe point out the obvious or point out some of the things that it's hey, This is not going to work if you keep doing things in this way, but she feels like she can't, right? And another thing that can keep us from feeling like we can just be who we are and say what we want is the emphasis on these patient satisfaction metrics. And not that we should go around and be like assholes to patients, that's not what I'm saying, but we feel like we have to be agreeable and likable to everyone. In order to have these scores that maybe affect our compensation, maybe not, but we're just constantly calibrating ourselves to our audience and to who's directly around us, and we don't get to relax. So yeah, so that one client, she was like, I have all these jokes that I want to say, these things I want to do, this kind of way I want to be, but I don't feel like I'm allowed to be that version of me. I have to be this sort of stiff, kind of vanilla Doctor version of me who doesn't really have much personality and doesn't have much flavor. And then she'll go afterwards and she'll call her friends and be like, Oh my gosh, this is what I was going to say. This is how I was going to do it. And this is what I was going to talk about. And then she has her outlet there, but she doesn't get, doesn't feel like she gets to have that. in her day to day interactions with patients. And because of that, she's feeling stifled. She's feeling like she's suppressing herself because she literally is, right? She has this impulse to make a joke or say something. And she's no, not the time, not the place. Don't do that right now. I had another client who loved fashion and she likes to wear these like ridiculous tops and these shoes and these. She just loves to express herself through really over the top fashion. But she, and she would wear things sometimes to Grand Rounds. She would give Grand Rounds in these crazy outfits, and she felt I'm being judged. This is not appropriate. People would comment on it. People would say things, essentially Yeah, that's not professional. That's not what a doctor should wear. And it's not like her boobs were hanging out or anything. It's not like there was actual inappropriateness. It was just like, oh, doctors are not supposed to have a fashion sense. They're just supposed to really cut and dry, really standard things. And I had, I remember I had an attending who had her head shaved. And that was, People would talk about oh my gosh, have you seen her hair? She like dyed her hair. This person got a tattoo. And there's a lot of just like judgment around our appearance and around what looks professional and around what is not professional. And this is like society as a whole. It's not just medicine, but I definitely see in medicine. There's this like more stifling mask of professionalism. Another one of my clients. She had this certain like real talk persona of she just likes to call it like it is and she just likes to. to say certain things and be a certain way. And she felt like she couldn't be that way with her patients. She had to be this like straight laced, compassionate, caring, empathic. And it's not that she wasn't caring and empathic and all and understanding. It's just that she was exhibiting those qualities in her own way. And so essentially what it all comes down to is at the end of the day, feeling stifled, feeling muted. Feeling like you don't get to express your personality and none of these instances in and of themselves may seem like, like, why is that such a big deal? Who cares if you don't get to wear the clothes that you want to wear or just say whatever comes to mind, but it's the fact that it all adds up, right? Every moment that we abandon what is real and true for us. In favor of what's expected of us, that is this subtle breach of our own personal integrity. And that takes energy, right? It takes energy to repeatedly calibrate yourself to who you're supposed to be. It takes energy to repeatedly suppress all the things that, that are coming up for you. All the things you want to express and you feel like you can't because it's not the place or time, you have to suppress it. To constantly worry about maintaining appearances. These are all things that are energetically exhausting. They're energy drains and they can lead to Burnout. Because inauthenticity leads to burnout. And it's not, again, it's not just anecdotal experience for me and my clients. There's actually studies in, there's like a whole project called the science of honesty. And they've done a lot of studies on How white lies impact our physical, emotional, and relational health. And I will argue that all of these examples of not being who you are, all of these examples of inauthenticity, are essentially little white lies. And again, it's not a moral judgment. It's not saying Oh, you're such a liar. It's literally just that's what it is. If you want to say one thing, Withhold the truth in a way that doesn't feel authentic and you say something else entirely or you like agree with something even though you don't agree with it. Even if you're just like validating the patient's experience and then not saying like what actually is true for you, like anytime you are not speaking your truth, that's a white lie. There's an energetic cost to that. And so in this study, in one of these studies, and there's been a lot of studies on it, I just one of them that I read they interviewed participants and they had them track the white lies that they told, and they had one group of the people make an honest effort, make an effort to tell fewer white lies. And the participants who successfully told fewer white lies, they had at least four fewer mental health complaints. So that means things like feeling tension, feeling melancholy, feeling stressed. They had less mental health complaints. They had less physical health complaints. Things like headaches, sore throat, fatigue. And they also reported improvements. in their personal relationships. They reported that their social interactions were smoother. So they reported greater feelings of connection and fewer feelings of isolation because every lie that we tell isolates us because it splits us into multiple pieces and then only one of, one part of us gets to be known or no parts of us get to be known. And so being inauthentic is a version of a white lie and white lies are harmful to your physical, emotional, and relational health. So this is the cost. Of the mask of professionalism. And I really do believe, and I don't think this has been studied, I'm not sure. I really do believe, I would argue, that this impacts people of color even more than I have any personal experience around. Because actually, now that I'm thinking about it, the clients who I've worked with who, who reported things like this, They were women of color. And so I can imagine. And then it's not just at work that you're doing this. It's everywhere all the time that you're having to calibrate yourself to like the standards of the dominant race and the dominant population. And so just essentially what it comes down to, we don't feel like we have permission to be our authentic, imperfect selves. At work, because we have to be who a nurse is supposed to be, we have to be who a doctor is supposed to be. We have to be these roles and these things that we are supposed to be. And that is exhausting. That is so exhausting. And that is a cause of burnout that not a lot of people talk about, probably because they don't know how to talk about that or they don't know how to address it. And so this is why, like for me, in my experience, what I've learned, authenticity is the key to career alignment. Having a career where you get to authentically... Be who you are. That's it's security. It's insurance against like never burning out Because that's how I feel currently in my in this work that I'm doing I literally feel like I get to be me and I get paid to be me Like my job is to be exactly who I am. I hop on calls with my clients. I'm just me I just feel like I get to relax into my chelsiness. I just get to be exactly who I am. I show up on these. I'm just being who I am. I show up on my podcast interviews. I'm just being myself. And that feels so good. It feels so freeing. It feels like I could go for days and days because I'm not doing anything. I'm just literally being myself. I'm not having to calibrate. I'm not having to suck up suck in and do a certain posture or be a certain way. I'm like literally not having to do anything other than just be myself. So I want to just talk about a few more things and then I do need to get out of here in a couple minutes because I have a sister circle call coming up. So what could this look like for you? How do you know if you are being inauthentic? I have a couple things that I've listed just so that you can know, and again, this is not to pass any moral judgment on yourself. You are not bad or wrong. You are perfect and wonderful. It's just let's check in with am I showing up in ways that actually are making my life feel worse? Okay. You keep feeling frustrated, rolling your eyes, bad mouthing policies, patients, coworkers, et cetera. So all of that, if you feel like you need to come home and vent about things. Usually that's because you're stifling something at work, right? So if you feel like you need to come home and have this released, if you feel like you need to call someone and say, Oh my God, this thing is going so wrong. That's probably a sign that you don't feel like you can express your full self at work. You can't say the things that you want to say. If you just have a sense that like you're stifling yourself, like there is a There's a work you and a home you, and they're very different. And I understand sometimes you need to tap into different parts of yourself, like to be a mom versus being a physician. There's different parts we can access of ourselves. We're very multi dimensional human beings. So it's not saying you need to just be this one flat person across all areas. But if you feel like you have to like full on Role reverse or full on calibrate in a way that doesn't feel normal to you. Like you're doing it in like computing. What do I need to be? Who do I need to? Okay. And then go time. Then I feel like there's a work you and a home you that are just totally different and you wouldn't be allowed to bring the home you to work or the work you home like that. That's not even allowed. There couldn't be crossover. Then that means, there's probably some feelings of being inauthentic at work. If you ever have the feeling like you have to impress people if you're going into work and feeling like, I really need to impress them, I really need to prove myself, what can I do to impress them? Anytime you're impressing, you're hustling, you're not being authentic. And so these are just things to look for. These are warning signs, these are red flags that maybe you're not being authentic. And Okay, so there's a couple of different people who speak about this. Martha Beck is one of my favorites. She has a whole book on the way of integrity, and she talks about integrity meaning just being your whole self in all situations. And her, she has a really simple kind of mantra and a phrase that you can adopt to start trying to be more authentic in your everyday life. Say what you mean what you say, don't say it mean. Essentially don't say things that don't feel true for you, just do not say them. Anything you do say, make sure you believe that, you back that, there's truth behind it. And telling the truth doesn't have to mean being a dick or being like a jerk to anybody. Telling the truth, you can do it with kindness. Because, especially when you're telling your truth before you feel like you've been run over, because a lot of times we get unkind because we feel like we're being steamrolled because we feel like our truths are being violated. And so if you're just getting ahead of all of that and saying, actually, this is what's true for me, then you don't have to be a jerk about it. You don't have to say it means so. Say what you mean what you say, don't say it mean. And I think that's a really helpful mantra philosophy to take with you. Now, if you feel like there's a lot of layers to this, right? It's not as simple as just be authentic. There's a lot of reasons that we're not. There are actual repercussions for being authentic self. You might get fired from work. You might have this sort of person not want to be your friend anymore. You might have lots of things that fall apart in your life. That's what Martha Beck talks about, the way of integrity. Her whole life basically blew up when she started telling the truth. But she was like, it needed to blow up because I was here. here and I got a better life. Now, I'm not saying, Hey, just go crazy and blow up your whole life. I'm just saying, I really want to acknowledge that it's not as simple as like just be authentic and everything will work out and be great. No, not necessarily. There's a lot of layers to unpack around why you feel like you can't be authentic, like worthiness issues, like issues and worthiness things that we all have, like needing to accept your worthiness, needing to feel. Like safety, needing to feel like accepting your own yourself, knowing yourself, figuring out who you are so that you know what it even means to be authentic, right? You have to really know yourself, know thyself first in order to present your authentic self to the world. And so then there's like layers, there's deconditioning, there's looking at the shoulds. There's just a lot of layers to this work. And this is the work that I do with my clients. And I'm actually re changing the name of my coaching. It's called Authentic. career alignment. And so it's helping you be your authentic self and create a career that is in alignment with exactly who you are. Oh my God. And that feeling is so good and helping other people do that feels so good. So this is the work I do with my clients. It's always been the work I do now. I'm just like starting to realize it in a whole new way and developing an even better curriculum around that. And I do have spots opening. I have several clients finishing up with me this month. So if you are interested in doing some work around. Authenticity and really finding a career that is the right fit for you personally as like a whole human being and a career where you feel fulfilled. You feel like you get to be yourself and you get to make money being yourself. Best feeling ever. This is exactly the work we'll do together. And yeah, I'm happy to chat with you more about it. I do need to go right now because I have a call in two minutes that I'm going to get ready for. But Sending you lots of love. Thank you for joining me now and on the replay and yeah, let me know on the comments afterwards if this is something that resonated with you. If you guys have felt this way, I'd love to check in with how you guys are feeling. All right. Love you lots. Bye. I hope you enjoyed this episode of the Life After Medicine podcast. Make sure to leave a review and subscribe to the podcast so you never miss an episode. If you want to continue the conversation, share your takeaways, and connect with other like minded healthcare workers, then come join us in the Life After Medicine Facebook group. The link to join the group is in the show notes. I can't wait to connect with you further.