How Entrepreneurship Could Be the Key To Beating Physician Burnout

We became doctors to help people. But who helps us? 

As doctors, we pledge our lives to the health and well-being of our patients, yet, ironically, in that process we forget about our own mental health and well-being. As a result, many of us experience burnout. 

We have some standard ways to keep burnout at bay. We may vacation for a few days or weeks a year, offering us an opportunity to refresh and release the effects of stress. Yet, when that vacation is over, we are back in the same routine, facing feelings of burnout again. 

Publishing in The American Journal of Medicine, author Scott W. Yates, MD found that nearly half of all physicians experience care-impacting burnout symptoms. In every case, burnout was caused by systemic problems of the medical industry. Yates also determined that all physicians endure the condition to some degree. 

I can speak from experience. As an anesthesiologist and one of the first in the hospital, I would wake up at 3 am for a 5 am shift and the whirlwind that follows. Twelve grueling hours later (sometimes even more), there was scarcely a moment for a cup of coffee or quick bite. I often chose to work late, not wanting to burden other colleagues who I knew had plates just as full as mine. Physically and mentally exhausted and drained, the next day would see a rerun of the grind—a commitment which I passionately trained for. For many, that commitment can become a daily dread. 

This is a common physician experience, and one I empathize with. The question is this: Does it have to be this way? Is there a solution, a better way to not only sustain our professions but also thrive in them? What can act as the balm to the burnout many physicians experience? Before we explore how entrepreneurship can be that solution as well as practical tips, we must first understand why so many feel this weight.

UNDERSTANDING WHY PHYSICIANS FACE BURNOUT

To address any problem, we first need to understand it. Physician burnout isn’t just a phrase; it’s a deep-seated issue that affects our colleagues. But what leads to it? Why is this profession, one dedicated to healing and care, experiencing such a crisis? Let’s briefly unpack four of the primary reasons that I believe are adding to physician burnout.

 

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OVERWORK

Let’s face it: We are overworked. The healthcare industry, for all of its advancements and achievements, is notorious for its demanding hours. There’s no such thing as a forty-hour work week. The average physician works fifty hours. And as I mentioned earlier, many of us experience grueling twelve-hour shifts. These don't account for being on-call or unexpected emergencies. 

It’s not just the amount of work but also the intensity of the hours. Making critical decisions, handling emergencies, and dealing with the complexities of human health is a taxing experience. Sometimes it can feel like running a marathon, only it’s run day in and day out with no finish line in sight. 

LOSS OF JOB SECURITY

There’s a growing sense that our jobs are not fully secure. In an ever-evolving medical landscape, many physicians face institutional changes, mergers, and shifts in policies that can jeopardize job stability. Private equity companies are multiplying and private practices are going away. Gone are the days of becoming a doctor to be set for life. 

It’s becoming more and more common for doctors to lose their jobs with nothing but a ninety-day or thirty-day notice. No severance. No support on where to go next. I just talked to a doctor recently who was given a ninety-day notice that the practice was losing the contract for their hospital. We all know how credentialing in a transition doesn’t take a short amount of time. We have our families in one area, and it’s not easy to uproot. So what is my friend supposed to do? That’s a problem, and an increasingly common one. 

The looming uncertainty of job security can add to a tremendous amount of stress to an already demanding role. 

FINANCIAL BURDENS AND OBLIGATIONS

 While many physicians earn a decent wage, it’s essential to remember the hurdles we've crossed to get there. There’s staggering student loan debts, which are astronomical for a lot of people. There’s also overhead costs for those running their practices. I just talked to a doctor the other day, and his labor costs have skyrocketed since first starting his practice. Add to that malpractice insurance, possibly a mortgage, and the costs of continuous training. These all create a financial strain. 

When combined, these financial stressors take a large portion of our income. There still might be a perception out there that physicians are in the top 1% of income earners, but many of us don’t feel anywhere close to that. In fact, as I’ve written about before, many doctors end up living paycheck to paycheck to make ends meet. 

MORAL INJURY

Despite being one of the most profound causes of burnout, moral injury is perhaps the least discussed. 

At its core, medicine is a vocation. Most of us entered the field with a passion to help and to heal. However, when external factors—be it administrative burdens, inefficiencies in the systems, or constraints on time—prevent us from providing the care we know our patients deserve, it results in what’s termed a “moral injury.” I define a moral injury as the pain of not being able to do right by our patients due to factors beyond our control. 

Many of us feel like the system, at times, tells us how to perform our own job. Many physicians I know feel like glorified technicians. These experiences are painful for doctors as well as for their patients, as we constantly fight to do what’s best for them. 

ENTREPRENEURSHIP COULD BE THE KEY TO BEATING PHYSICIAN BURNOUT

So many of my fellow physicians are turning their lives around in as little as three to six months. They’ve taken the time to change their mindset and reduce burnout by reigniting their passions and giving back through entrepreneurship.

And this is backed by science. A research study conducted by the University of Amsterdam in early 2019 closely observed 348 entrepreneurs and 1,002 salaried employees over a span of six months. What did the findings show? In short, they seemed to defy the hustle culture cliches. 

Despite working longer hours, entrepreneurs studied were no more likely to experience burnout than salaried employees. In fact, on average, the risk of burnout was lower due to the “positive psychological effects of entrepreneurial work.” The authors of the study called this “psychological utility,” defined as a great sense of meaning, personal autonomy, and job satisfaction that amounted to a higher mental return on investment. 

One of the standout findings was that solopreneurs—those operating a single-person business—were at the lowest risk of burnout. In other words, entrepreneurs are happier because they have more control. As these businesses grew and took on employees, the burnout risk amplified. 

So, how does this research apply specifically to physician burnout? For physicians considering a venture into business, there’s a vital lesson to learn here: Start small. 

Add meaning to your life by pursuing your interests and passions outside of your medical career. Turn that into an entrepreneurial opportunity, and you will create ownership and autonomy over your work. As you grow, opt to contract expertise rather than hiring a full-fledged team—keeping autonomy while limiting your stress. 

Yes, you’ll be working more, but the study found a positive paradox of workaholism. While hustle culture is often blamed for burnout, it turns out that it’s not the primary culprit. The primary culprit is lacking a sense of control. Dr. Martin Obschonka, the study’s lead author, pointed out that high levels of engagement can actually protect entrepreneurs from burnout. Therefore, there is such a thing as positive workaholism, a term coined by the study.

As physicians, we often value freedom, innovation, and the thrill of the unknown. For many of us, the risks associated with starting up are not deterrents but avenues for empowerment. Remember, it’s not just about working hard but also about the passion and connection you have to the work. Entrepreneurial endeavors are deeply personal. Returning to your foundational “why” and revisiting core values can reignite the flame, offering the psychological stamina needed to push forward. 

By working hard and feeling connected to our work, we can contribute in more meaningful ways, ways that encourage us to keep striving for greater outcomes. Your rewards of entrepreneurship will lessen the burnout you feel as you continue to practice medicine. You’ll have more than one profession giving you meaning—and more than one income stream.

FINDING MEANING BEYOND WORK

It’s undeniable that deriving meaning from our work boosts our well-being. But placing our entire identity within the confines of our medical work can be a double-edged sword. What if your situation in medicine changed? Who would you be then? 

With entrepreneurship, you can diversify your identity. When one thing falters, another lifts you up. And even then, despite the many rewards of being an entrepreneur, it comes with highs and lows. You could be riding high, but an exit, a sale, or even a sudden shift can feel like the rug’s been pulled out from under you. 

That means burnout can be further curtailed by diversifying your identity beyond how you collect a paycheck. Just like it’s a principle of financial investments, diversification is also crucial for your investment in yourself. Become an entrepreneur, join a book club, or even volunteer. 

When you pursue meaning in your interest areas, as the study showed, different neural pathways will grow and build resilience. At the end of the day, your worth won’t be solely tied into your professional accomplishments. After all, you are multifaceted, have passions, share dreams, and are living a life beyond the office or clinic.

GOING INTO BUSINESS FOR YOURSELF

Of course, burnout is multifactorial. It’s just not as simple as one solution. But the overarching message from the study is clear: While entrepreneurship comes with its challenges, it also offers a unique psychological utility, providing a buffer against burnout. So, for all the physicians out there seeking more than just the daily grind, perhaps it’s time to consider the entrepreneurial path. 

Take actionable steps on your path. Consider joining the Passive Income MD community at our annual Physician Real Estate & Entrepreneurship Conference (PIMDCON) as part of your journey. Go to PIMDCON.com for more information. 

There’s a world brimming with opportunities outside the confines of traditional medicine. And whether you choose to embrace entrepreneurship or another path, always prioritize your well-being. After all, you cannot pour from an empty cup. 

Take care, stay inspired, and I hope to see you joining the Passive Income MD community!

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