Burnout has been an issue for physicians long before the pandemic hit. The problem is many choose to self-isolate instead of seeking medical treatment. This rarely helps.

When physicians feel burned out, it’s time to take a step back and gain perspective. One way to do that is through the ABCDs of self-care.

The first thing you need to do is acknowledge you need help. Then reach out to a colleague, friend or loved one and fully express how you’re feeling. Being heard is a powerful part of the healing process.

Also, figuring out what’s causing the pain, exhaustion and frustration is vital. This will involve self-assessment and increasing self-awareness. Working with a colleague, mentor, coach and/or mental health professional can help guide the way to recovery.

Because burnout is multifactorial, often involving the healthcare system, EMR responsibilities, clinical processes and procedures, administrative tasks, and other factors, the solution is also multifactorial. It’s essential to meet with administrative chiefs, division chiefs and department chairs to find solutions to workflow issues, staff shortages and other hospital or clinic wide issues which are weighing heavily on many practices. Identifying the issues is important and helping to find solutions can be rewarding. Ultimately, physicians are responsible for themselves and need to take responsibility for their actions. But, healthcare institutions need to help to make the time and space for this self-care. Acknowledging the role the hospital or clinical practice can play in the solutions is key.

Breaks are important to gain perspective. They come in many shapes and sizes. It can be a week’s vacation that is long overdue or an unplugged weekend without thinking about work or being responsible for anyone else but yourself. Sometimes rest and adequate sleep help us to see things more clearly.

Breaks also help us gain perspective. Key questions to reflect upon include:

• • • What is working well in my job right now?
    • What is not working well in my job right now?
    • If I had a magic wand and could fix one thing, what would that be?
    • What brings me joy at work?
    • What does an ideal day at work look like for me?
    • How can that ideal day become more of a reality?
    • What concrete steps can I take to change my practice, workflow, administrative roles, or staff responsibilities to help increase job satisfaction?

It’s important to consider what’s in your control and what’s not. If something is not in your control, you can identify who is in control of that problem and help them find a solution.

What’s in your control is what you have the greatest ability to impact. Your own schedule is in your control to some extent. You can block off time for administrative work, research, or writing. Putting this protected time in your calendar and making sure no one books a meeting for you is important.

The projects you take on are also in your control. After taking stock of your time commitments and responsibilities, you may realize that you have no time for something new. Setting boundaries and learning how to say no will save you time and energy.

Other things in our control are our choices and actions around food, sleep, exercise, stress resiliency, social connections, and self-care. We can prioritize a walk with our friends and loved ones after work or on the weekends. We can work to be time efficient, and batch cook with family and friends on the weekend to prepare healthy meal options for the week. We can drink water to stay hydrated through the day. We can make sure we get seven to eight hours of sleep a night. When we’re well-rested and eat nutritious foods, we’re better able to think and create.

We need to figure out our priorities at work and at home, and make sure we are allocating adequate time to them. To help us dedicate time to the important things, we need to learn to delegate.

One of the biggest questions to ask yourself is, “What can I safely delegate?”

If there are tasks at work that are time consuming and do not require your expertise, then it’s important to let other people do these tasks. Many physicians have administrators, but no one teaches us how to utilize them properly. Spending time training an administrator to complete easy tasks will free up our time in the future.

This is true at home, too. If you don’t like cooking, maybe someone else in your family does. Or you can use a meal delivery service. Are children old enough to help with chores? If so, it’s an effective way to teach them responsibility.

But don’t delegate the tasks you love and bring you joy at work or home.

Dr. Frates is Clinical Assistant Professor, Harvard Medical School, Lifestyle Medicine Specialist and President Elect of the American College of Lifestyle Medicine