By GREG HAMMER, MD
Burnout among healthcare professionals is at an all-time
high. Its drivers include longer work hours, the push to see more patients,
more scrutiny by administrators, and loss of control over our practice. We seem
to spend more time with the electronic medical record and less time
face-to-face with our patients.
I have faced burnout personally. My son passed away at the
age of 29, which was beyond painful. At the same time, I felt burdened by the
growing number and complexity of metrics by which I was judged at work. Days in
the operating room and intensive care unit seemed more and more exhausting, and
my patience was becoming shorter and shorter. I was fortunate to have had a long-standing
meditation practice as well as sabbatical time that I used to decompress and
re-evaluate my career. Many of us are not so lucky. More than half of
physicians have serious signs of burnout, and more than one physician commits
suicide every day.
So many of us feel burned out these days because in our
rapidly changing profession we are asked to do more for less and with
inadequate resources. We suffer from exhaustion, self-criticism, and worry
about what will happen next to our practice, our families, and ourselves. If we
want to save our practices, patients, marriages- even our lives, we must
acquire personal resilience.
Fortunately, we can increase our resilience and happiness and reverse burnout by embracing a few simple principles—Gratitude, Acceptance, Intention, and Nonjudgment (GAIN)—that we can put into motion in our everyday lives at the hospital, at home, or wherever we are.
This starts with a brief meditation that we can practice
before we leave home each morning.
Many of us have tried meditation but believe we failed and
gave up trying to sit quietly, perhaps in an uncomfortable position, attempting
unsuccessfully to banish all thoughts from our minds. When we practice the GAIN
meditation, we sit comfortably and begin to focus on our breathing, slowing it
down, savoring the sweet air we breathe in and out without effort, as if by
magic. Focus on the breath is a mainstay of contemplation practices, including
We turn our attention to how grateful we truly are, to be
living where we do, safe and sound. We relish our loved ones – spouse,
children, siblings, and other loving family members. We feel appreciative for
our relative prosperity and health. We feel an inner smile as we sink into Gratitude.
We then contemplate thoughts of pain and suffering in the
world, including the suffering of our patients and their families. We did not
cause their pain and we cannot always cure it. We open our hearts to the sadness
we experience – we bring it closer and closer until we merge with it. We cannot
flourish by “bypassing” or suppressing painful feelings. As the Serenity Prayer
and many other teachings advise, we benefit from discerning between what we can
and cannot change. We then open ourselves to that which we cannot change and
accept it with intention. This may sound distracting and destructive. On the
contrary, once we truly bring those painful feelings close, we have begun a
process of healing. Acceptance.
The next step is to contemplate Intention. We can re-wire our brains to focus on the present, where
happiness lives, but this requires determination to do so. We have acquired a
“negativity bias” – we tend to hold on to negative thoughts while forgetting
positive, pleasant and experiences. When we prepare for sleep in the evening,
we often review the unpleasant events of the day rather than the favorable
ones. Let’s commit to thinking of three good things we experienced during the
day – enjoying a meal with a loved one, laughing at a joke with colleagues at
the proverbial water cooler, seeing a patient get better under our care. Doing
this takes no time at all – we can practice “three good things” while turning
down the bed linens or getting undressed. Our sleep is improved and that we
become happier quickly, as studies have confirmed.
The fourth pillar of GAIN is Nonjudgment. We are constantly categorizing everything we see and
hear as good or bad, too big or small, and the people we encounter as too loud,
poorly dressed, not smart enough. This process is exhausting, and it does not
lead to greater peace and happiness. Instead, we can simply consider the world
around us in a neutral way, tinted with a shade of benevolence. It dawns on us
that we do not need to judge everything. Doing so is meaningless and
We can sit with these thoughts of Gratitude, Acceptance,
Intention, and Nonjudgment in as little as 3 minutes. We can practice these
very simple principles as we go out into the world each day. We experience
gratitude for the privilege of taking care of our patients. We move in the
direction of accepting what we cannot change and use our intention to re-wire
our brains gradually toward happiness. We let go of judgments, one thought at a
The more we practice GAIN meditation in the morning and
throughout the day the more we find ourselves enjoying this present moment. We
get better and better at doing so over time – if we use our intention and stick
with the program. It is actually very easy!
I challenge each of you to try the GAIN practice for 30 days and see whether you feel happier and at greater peace. I have no doubt that you will.
Greg Hammer, MD is a pediatric anesthesiologist at Stanford University Medical Center and the author of GAIN without Pain: The Happiness Handbook for Health Care Professionals.
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