Got time for a Coffee Break?

In these transcripts of live conversations, we chat about what’s on our minds in medicine – for patients, providers, and loved ones alike.

In this week’s Coffee Break, we’re talking burnout and empathy: how we got here, what we’re doing, and how to combat it both in and outside the hospital.

Lin: You know it's funny with burnout… a lot of the approach has been band-aids, like, “let's get you snacks and free food, access to dry cleaning.” But I’ve never found that these solutions really address the source of burnout. I don't really care about the convenience of dry cleaning or doing wellness. I care about how many MyHealth messages I have, how many lab results, CT scans, MRIs, complex pathology.

Sales: Yeah. And from what I’ve seen, burnout can start even before medical school. But we need all the doctors we can get.

Lin: Yeah. Being a doctor becomes your entire identity. But we recently started a Stanford Medical Chorus, and over 100 people signed up – so we know there’s a demand for activities [outside of medicine]. There just needs to be a catalyst for being able to just sit there and explore.

Sales: And I think there’s pressure to be busy, because unlike decades ago – when a single person could know basically everything there was to know about medicine – now, there’s all these medical advances to constantly keep up with in your specialty alone. But the expectation to know “everything” is the same, so I wonder if there’s a mismatch between what’s expected and what’s feasible?

Lin: Yeah. There’s more data and more responsibility with patients. The fact that we have all these new tests is a great thing for more accurate diagnoses. But it can contribute to burnout – no one wants to miss anything in the patient, so you spend a lot more time with the data and explaining it to them. It’s great for the patient, but challenging for the provider. I imagine its challenging for the med students, too, being in the clinical setting and being watched over by attendings.

Sales: Yeah, it’s a lot of pressure, especially when you’re just starting out. You’re doing a funny little dance where you’re trying to exercise all the skills you’ve learned in your 8 months of med school, and trying to do right by the patient and not miss anything, and show true empathy, and admit when you don’t know something – all the while knowing that you’re being evaluated.

Lin: I liked your comment about empathy. I feel like when I’m burnt out or in a rush, that’s the first thing that goes.

Sales: Exactly. I feel like true empathy is one of the most important things I’ve learned about in med school. Spontaneous and authentic empathy rather than performative empathy, which can become the default when you’re burnt out and driving on autopilot. But I’ve noticed that sometimes, all it takes is meeting one really great patient interaction to remind me of why I decided to med school in the first place. 

Lin: Yeah, that’s why I went to primary care. It’s that one patient that really gets you through the day and makes it all worthwhile. I think that's why we're in this, right?

Sales: Yeah. I met some wonderful patients in the middle of my exams week – you know, at a time when I was feeling tired and stressed – and we chatted about how excited they were to leave the hospital and reunite with their pets, start cooking again, go to dance classes again, and I felt so rejuvenated… that some people really can bring joy to your life in medicine.

Lin: And that’s a feeling that never goes away. You’ll see patients time and again and they’ll give you that feeling. Of course, you’ll see patients who make the day difficult, but I think that the balance is in favor of those patients who you have a developed rapport with. You feel like there’s a connection there, and that’s what pulls you through.