In this episode of The Career Rx we’ll discuss:

  • The top 5 causes of burnout, according to the top expert
  • What leaders can do to prevent or mitigate burnout – because burnout is about the workplace, not the people doing the work!
  • Tool to tackle the core causes of burnout – you don’t have to have a leadership role or title to start with these
  • What your boss really should be doing – and it’s probably not what you think.

What can leaders do to prevent burnout? No matter if you’re a leader by title or by behavior, there are several things that you can do to tackle burnout within your organization.

As we all know now, burnout is not about individuals – it’s about the workplace environment. So we’ve got to focus on that environment for solutions. And admittedly, unless you’re the CEO, you’re still in the boat where you as an individual are being asked to solve an organizational problem. This isn’t fair, but it is reality. So, in this episode, we’ll dive into 5 well-documented causes of burnout and how you as a leader (whether official or not) can make a positive impact.

There’s a common thread throughout this episode about good communication for clear mutual understanding across teams, as well as up and down the leadership ladder. Make it a point to work on this, and addressing the rest will be much easier.

So what are the top 5 causes of burnout? Per Dr. Christina Maslach, one of the foremost burnout researchers and one of the creators of the Maslach Burnout Inventory, they are:

  • Unfair treatment at work
  • Unmanageable workload
  • Lack of role clarity
  • Lack of communication and support from their manager
  • Unreasonable time pressure

Burnout is an extremely important topic to address. I hope this episode will inspire you and equip you to be a powerful proponent of change in your organization.

“We know that burnout is not something that is about you. So you can set boundaries all you want and you can fix your calendar all you want – and I hope you will! – but no amount of doing that, or yoga, or mindfulness, or resilience training, or team building or any other personal solution is going to fix this problem.” – Marjorie Stiegler

In this Episode:

[00:43] Burnout in the workplace is an epidemic. Listen to learn more.

[02:02] What burnout is really about, and why it’s not the people who need fixing.

[03:41] The top 5 causes of burnout.

[04:58] What does it mean to be unfairly treated at work?

[06:15] How professional branding relates to treating people fairly (hint: this is huge)

[08:17] You truly cannot do it all. And you shouldn’t.

[09:00] Managing up, prioritization, and calibration of expectations

[11:25] Is it ever good to say ‘that’s not my job’?

[14:52 The magic of a good “RACI”.

[15:07] Why communication is key to managing burnout.

[16:45] Why ‘open door’ policies may make things worse

[19:40] How to set the boundaries, norms, and expectations for working and being reachable

[24:05] Have you taken the free 5-Day Schedule Detox?

[24:42] You won’t believe the response to this physician’s committee resignation!


Links and Resources:

Burnout is About Your Workplace, Not Your People by Jennifer Moss


Schedule Detox

Episode #5: 6 Secrets to Setting Successful Boundaries at Work (not a magic burnout fix, but also important!)

Episode #25: How to Make a Career Change for Doctors

Blog Post: Save Your Breath About Your Burnout

Blog Post: I Said “No” To Everything For a Year…Here’s What I Learned




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Thanks for joining me on this episode of The Career Rx!

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Episode 35: The 5 Top Causes of Burnout and What Leaders Can Do About Them

Hey there, welcome to the career prescription. I’m your host, Marjorie Stiegler. This podcast is all about the important stuff. They don’t teach you in medical school, about how to treat your career, like the business it really is, and how to be strategic about your success. I’ll show you how to use modern strategies to get ahead, create your own path and do more of what you love. Every episode is inspired by questions from listeners just like you. So be sure to subscribe. And of course, send me those questions, so I can use them on a future episode. so you don’t miss anything. Be sure to always check the show notes on my website. Are you ready? Let’s get into it.

Hey there, welcome back. Today we’re going to be talking about burnout and what leaders can do to prevent burnout. I’ll talk about the top five reasons for burnout. burnout, as you know is not about you. It is about the workplace environment. And so we have to start treating this problem differently. So I’m going to talk about those five reasons for burnout and what leaders can do. And whether you are a leader by title, or you’re just kind of leading from within, or leading by your behavior. I hope that you can take this podcast episode and really use it to change the culture in your workplace. It’s so so, so important.

Now, I’ve talked previously about boundary setting and a prior episode. And if you didn’t catch it, it’s worth going back now. So I’ll leave that link in the show notes. And I also want to invite you to take my free five day schedule detox, which is brought to you by transformed mastery retreats for women. Anyone can take the detox. You don’t have to be a physician and you don’t have to be a woman. It is delivered in five email lessons totally free, very, very quick, incredibly effective for taking back control over your calendar.

However, having said all that, we know that burnout is not something that is about you. So you can set boundaries all you want and you can fix yourself. Calendar all you want, and I hope you will. But no amount of doing that type of thing, or yoga, or mindfulness or resilience training or team building or any other personal solution is going to fix this problem. This is an organizational problem, a systems problem. And therefore, it’s incumbent upon our organizations and our leaders to fix it from within. And as a leader myself, not only as someone who has acted in a leadership role, but someone who has people who report to me directly in the sort of managerial sense. I do have some experience with this that I want to share with you. It’s been very, very eye opening, how I have deployed some of this, especially in the COVID era, and how it has turned out.

You know, before I dive into these five reasons, the top five reasons for burnout I should point out these aren’t my ideas. This comes to us from one of the foremost experts on burnout Christina Maslach, a social psychologist, and Professor Emeritus of Psychology at the University of California Berkeley. And she is one of three people responsible for the gold standard for measuring burnout, the Maslach Burnout Inventory MBI. And she’s also the co author of the areas of work life survey. And she is described in the Harvard Business Review article that I’m going to link to in the show notes which inspired this episode. And in that article, she discusses a survey by Gallup of 7500 full time employees and describes the top five reasons for burnout. So I’ll tell you what they are, and then I’m going to tell you a little bit about what I think of them and what you might do with them. So here they are.

The top five reasons are number one, unfair treatment at work. Number two, unmanageable workload. Number three, lack of role clarity, number four, lack of communication and support from your manager. And number five, unreasonable time pressure.

So what a list this is great, I think everybody listening is probably thinking Yes, yes, yep, yep, yep, I have those things, right. Those are the kinds of things that wear us down, that are not fixed by, again, any type of workshop or, you know, spa day or self help or anything that you can do inwardly, and certainly not by those kinds of, you know, resilience workshops that they add on to your evenings or weekends.

So that is not the solution to these problems, we’ve got to be able to do something from within the problem from burnout, as is described in this article is that it’s not, hey, what’s wrong with this person? Because, wow, there is something wrong with all of us.

It’s more, what is wrong with the organization and how can we put the responsibility on the organization to fix these issues? And how can we work at that in whatever sphere of influence we have?

So let’s look at the first one unfair treatment at work. So what does that even mean? It seems so subjective unfair treatment. And yet this is an enormous reason for burnout. People look around at their colleagues and they think that person has it better than me in some way. And that may or may not be true. We certainly know there’s a lot of inequity at work when it comes to, to financial reward. And there is quite a bit of bias that goes on in terms of, you know, benefits and assignments of preferences. So, transparency is incredibly important, super important. So if you are a leader or if you have any influence at all within your organization, to be sure that it’s very clear how people are rewarded financially, how people are assigned to different kinds of work, how people get bonuses, how they get their time off. This is incredibly important just to have complete transparency so that anybody and everybody can know exactly what would be expected of them in order to get whatever type of combination of those treatments they would most like.

This is by the way for you listening on an individual level, where the strength of your professional brand is super important. People, including your peers, and your bosses need to know what you bring to the table so that you can have a fair allocation of the assignments, financial reward time off, and so on. Keeping in mind that fair means equitable, but not necessarily equal or identical. What do I mean by that in clinical medicine, you know, well, as I do, that there are some people who are outstanding clinicians, but they don’t really have an interest in teaching. And yet they have academic jobs. They like those jobs. They don’t really want to do the teaching, but they’re providing amazing patient care. Then on the other end of the spectrum, you’ve got people who are doing a lot of research and research takes time and requires grant money. And they want to focus on that and much less on the clinical care, and perhaps less on the education, but they often need to be sort of subsidized.

They need financial support until they get those grants and so it’s easy for the clinicians to look and say that person is not pulling their weight because they don’t really know what that other person’s professional experience is, what they are doing on the day to day, they just don’t know. Then you have some people who have a lot of administrative activity, or you’ve got people who are doing quite a bit of speaking and traveling and other work on the department’s behalf. And during that time, you know, they’re up all night away from their families and perhaps not being paid the way you might within incentive if you were taking overnight calls in the hospital or something like that.

So you can see how people are dedicating themselves professionally in different ways that have different benefits to them, and different challenges. So it’s really unfair for any one of us to look across at a person who’s doing a different kind of work and make an assumption about whether or not that’s fair. This is also why it’s really important that people are very aware of what you’re doing what you bring to the table, especially if it’s slightly different from what most people are bringing to the table, so that assuming it is indeed equitable, right, there’s some sort of fair allocation going on that people perceive it as fair rather than perceiving it, as, you know, some sort of preferential treatment on one side or another.

Okay, number two, unmanageable workload. Well, this sounds obvious, nobody can do unmanageable workloads. And on my team, I’ve established a weekly check in for projects and tasks. So we go through all of the things that a person is doing early on in the week, and we figure out okay, what are the long term what are the short term what what needs to get done, and anything that doesn’t fit into that week for that person based on whatever the work circumstances current life circumstances, we subject it to what I like to call a prioritization exercise, and that’s my job as their boss to help them figure out what needs to be prioritized.

Obviously, you cannot do all the things all the time in the same amount of time. It’s my job to protect the folks who report to me, while I do want to continue to lead and inspire and encourage their productivity, and I want them to, you know, have great performance and success, but I also need to protect them against burnout. And so part of my job is to help them with that prioritization exercise if there’s too much.

And the other part of my job is to do what’s called managing up. Which is to calibrate the expectations of the leadership, the people above me, above them and above the rest of us to calibrate their expectations of what can actually be accomplished on this team. And by when, especially when many things or many seemingly important things are equally important things are happening at once. It’s just unrealistic.

And so it’s important to recognize that for what it is and really engage in a prioritization exercise. You’ve heard the saying that if you have a lot of priorities, you really have no priority. You cannot have multiple priorities. You may be able to work in a large work organization and have a couple of priorities. But you can’t say that every single thing on a person’s to do list is of equal importance, or equal urgency.

And so that is really where the leadership comes in, you’ve got to be able to engage with your employees or with your teams about what is most important and what other things are not. Now, another quick plug for branding, I’ve got to tell you, if you’re working in an organization, where what they value and what they prioritize means that the things you love are always sort of de-prioritized, they’re always at the bottom of that list, then you may not be in the right place.

So either you are not presenting the work that you do in such a way in such a sort of branded light, that your bosses realize its value and they realize its importance and therefore they do want to give it that priority. Or you’re just not in a good match but somebody else somewhere else.

Other organizations will value that. And again, remember, not all your colleagues want to do what you’re doing. So it’s a matter of finding that right place where you can do the work that you love that is valued. And that is a priority in the workload and other things can be de-prioritized. And in a transparent way, it’s still fair, right? That is sort of the, the ideal we’re all striving for.

Okay, number three, lack of role clarity. You know, I think it’s kind of easy to feel like you know, your own job, but where this seems to get us into, into feelings of burnout is when you don’t know about each other’s jobs. So I very often see people not only doing what you know, falls within their scope of their work, but also a lot of things that fall within other people’s scope of work.

Now, don’t get me wrong. I’m never suggesting that you sit there and say, hey, that’s not my job. But it’s nice to know when other people’s jobs are intended to support your role right when there are things Other people are supposed to be doing that help to make you more effective. And if you don’t know who those people are, or you don’t know what they’re doing, they don’t know you need them, that can lead to burnout.

So it’s important to know what you can expect from your colleagues and your teammates, as well as anybody you manage that’s reporting to you, and what you can expect from people across your organization, maybe that don’t report to you, what is the scope of their work?

So this role clarity is all really, really important. A lot of things can be delegated or shared, even if you aren’t officially a manager. Really, really important.

Also, what is your boss’s job? I think that’s important. I’ve been talking in this podcast episode about what I view my role as boss to be and also what I view my boss’s role to be, you may have a different expectation so might your organization so it’s important to understand that expectation.

And one tool we use in my team is called a RACI, and it stands for responsibility, accountability, consult and inform. It is literally a spreadsheet that lays out who is responsible for getting the tasks done right, who is actually responsible for doing a specific task? Who is accountable if that task doesn’t get done, that person might be the manager of the team, a project manager, a committee chair, in contrast to the responsible person who sort of been delegated or designated to get something done, there’s usually a person sort of above or behind that team that is ultimately accountable for making sure that all the responsibilities are taken care of. So that person is usually in more of a manager role. And if the original designee who was responsible can no longer meet that responsibility. The accountable person has to find a substitute. Then we also have a consult column right? Who do we need to consult with who else should be aware of what we’re doing? Whether or not we are going to need their endorsement or their decision? We should be discussing with them super important across your organization for all the right stakeholders to at least have some awareness. And when we’re talking about consulting with them, it’s a bi directional activity, right? We are still going to get it done. But we want to know what they think. And then the final column is that, inform, this is who am I going to just tell about the output. This is an even bigger group of stakeholders. Or it could be a, you know, group of folks on your team who simply aren’t involved in that project. But they do need to know that it’s happening. But they don’t need to necessarily give their input. And they and they don’t need to have any specific deliverables around it right, but they need to be informed.

So this is super, super helpful to get role clarity, when we think about who around us within our department, or across our organization. Up down all around who can we expect to do what we need to know for any given project or any given set of activities, who’s responsible, who is ultimately accountable for delivering, who are we consulting with? And who are we informing Really, really helpful tool, the RACI for role clarity?

Okay, number four, lack of communication and support from your manager. In my view, this is so huge. I think actually, it’s your boss’s job to help you with prioritization. I’ve already mentioned that once and there’s a reason that it comes up again, this is truly one of the most important things they do. They are the one to set direction about what has to get done and what doesn’t. They are the ones who answer again to their leaders above them. So they know what is most important to the organization or to the group or to the business. And they’re the ones who are looking around at all of the talent, that’s you and saying, you know, this person, I really want to utilize them in this way or that way or the other way, hopefully, again, with transparency. It’s equitable and fair treatment, but they’re to identify your strengths and leverage your skills in the way that best suits the needs of the organization, and again, if you’re branding yourself properly, what you love to do is going to match something that the organization really values, or you’re in the wrong place.

This is going to really enable you to do that kind of work. So thinking about prioritization, how do we do that? If you are a leader, how do you do that? Now, of course, it depends on how many people you lead or how many people you manage.

But in my view, the boss’s job is to ensure fairness to ensure the manageable workload to establish that role clarity and to set some of the norms and expectations. And so in my team, one of the ways that we achieve this is I have a weekly one on one meeting with my closest core group of people who report directly to me. It’s a very brief touch point, and it’s just the two of us. I do this for everybody. I manage on a variable basis, from weekly to less frequently, perhaps monthly, depending on the relationship and what’s going on in the business right now.

But it’s more than just having an open door policy which says you can come see me anytime. This is an on the books meeting that requires us to get together. And what that does, I think is it breaks down that barrier of the employee or the person across the business, right who’s not directly an employee but might want to come to me. It breaks down the barrier of them needing to identify a problem that they perceive to be, quote unquote big enough for a meeting. And then having to book that meeting.

There’s sort of a psychological hurdle that goes on there. But establishing these regular touch points, even though they’re brief, super, super important for making sure that we have communication and support. That’s the entire purpose of that meeting. It’s not a performance review. It is literally for connection about, you know, what are you working on now that I can help and support you with? What kind of decision making input do you need? What kinds of obstacles Can I remove from your life, that’s my job as the manager. We also have a team huddle and this is multi directional communication. Everybody comes to this With what they need to share, it’s definitely not a unidirectional set of announcements for me to them. I know many of you feel like that’s what faculty meetings are like, right? It’s sort of a unidirectional series of announcements. And you can just get that in your email, you don’t need to be in a room for that. So I make sure that my team members understand what I expect them to do. That’s part of important communication.

We just talked about support. I think those meetings are about support but also in the meetings is my intent to help them understand clearly what I do expect them to do and very often that comes with specific instructions on what I don’t expect them to do. Now I don’t mean what I expect them to not do like that’s bad behavior. I don’t want you to do that. You know, like their child like I expect you not to sneak candy. It’s more of a don’t do something that is simply someone else’s responsibility, right because I don’t want that burnout. I do want clear accountabilities, I want clear roles, clarity, and I don’t want duplication of work, I don’t want a lot of people running around, running themselves into the ground doing all kinds of things when other people’s jobs are to do that very thing. So I do try to be really clear with my teams, what my expectations are in both short and long term goals. But I also try to really help them with their prioritization.

And I try to help them understand the things that I don’t want to fall to them. I know they’re a team player, I appreciate it. I applauded super, but they don’t need to, and they shouldn’t do all the things. Why? Because they’ve been specifically hired for a certain scope of work. They are uniquely talented and suited to do a certain set of things. I’ve got other people who can do the other things. Alright, number five, unreasonable time pressure. This is so important. People are working around the clock right now under circumstances that are just not realistic. That’s a setup for frustration for failure and for burnout. And again, in my view, this is for the boss to figure out Now, don’t get me wrong, it’s for the employee to communicate or the boss Can’t help. The boss can’t read everyone’s mind and doesn’t know everybody’s circumstances.

So it is I think, you know, part of your responsibility as an individual as an employee as a contributor to raise your boss’s attention, if there’s unreasonable time pressure that they’re not aware of. But it is the boss’s job, then to take that feedback, and to look at the organization and to push back on the demands from within the organization, that are sort of crushing their teams with unreasonable unrealistic time pressure. And it’s not just time pressure, but it’s sort of time creep, or this expectation that you’re available all the time. And one example for my team is, you know, the mission creep of having all of our devices and working from home.

Just because you happen to have your cell phone in your laptop at your house doesn’t mean you should be working or should be available to work, or that there should be any reasonable expectation that you respond at a given time. So I try to set the example for my team and to manage other people’s expectations about me, but also to give them permission to do what they need to do. I am fully in support of flexibility to get done, what needs to get done, and also to meet your own personal and family needs.

So I let people know I like to work in batches, there are going to be chunks of the day hours at a time where I turn off all my notifications. And you simply can’t get me you’re not going to get me on email, text messenger or any other way that you could ping me or message me. I’m not going to get that notification. I’m doing some work and I don’t want to be interrupted. Then after that, you can expect to reply in a certain order. And we have some rules about what constitutes an urgent communication and how they can get my attention for something like that. We also have internal rules about when meetings can be booked. I like to set my times from about nine to three doesn’t mean I’m working only from nine to three. I’m obviously working much more than that. But from nine to three, I’m available for your meeting. And if I’m booked today, I’m booked today, and if I’m booked all week, I’m booked all week. You can try me again next week, right that this is my baseline expectation.

Obviously, we try to have some flexibility and adapt when things are truly urgent. But this does put the onus on people to describe and defend what is truly urgent about it. And then again, I’ll do a prioritization exercise. And I’ll take a look at what doesn’t need to be on my calendar, I’m not going to let it just flow, flow, flow, and overflow, gonna have a really clear way to have some prioritization to have some rules. And by setting those expectations with my team, I am also empowering them to do the same thing, right? These are their hours that they’re available to have meetings with me. These are the hours that they are available to, you know, the expectation that they’re going to get an email or a text and then there are hours when they’re not. So at night after a certain time, and maybe it’s four o’clock, maybe it’s six o’clock, seven o’clock, I don’t know. You have to decide that for yourself, but after a certain time, unless you’re on call right you should simply be unavailable and there should be no expectation that you get Any of these messages again unless you’re on call, or that you respond to those messages. So by setting this up for my teams, we really hope to have some very clear boundaries.

What that also does is it empowers people who feel like working in a flexible way, who want to take, you know, larger chunks of the evening, for example, to be with family, but who want to make up for that time, you know, at the crack of dawn or something, when, when other people are not necessarily at their desks. I don’t mind if a person wants to send me an email at four in the morning. But don’t expect that I’m going to respond to it at four in the morning. And similarly, if I send you an email at seven or eight at night, I don’t expect an answer until the middle of the day, the next day or whatever is your sort of norm that you’ve established culturally in your group.

And this has to come from the leaders it just it obviously, again, listen to my episode on setting boundaries, there are plenty of ways that you can set those boundaries and as an individual that you can enforce them I believe that hundred percent, but I think also if we really want To help with burnout, we’ve got to do it as leaders from the inside.

So again, before I wrap today, I want to invite you to take the free five day scheduled detox brought to you by transformed mastery retreats for women physicians, we do have this retreat happening in 2021, despite COVID so pop on over the website, I will leave it in the show notes. And it’s If you want to check that out, anybody can take this detox. As I’ve mentioned, these lessons are super quick, incredibly effective. We’ve had people come through this detox that managed to not only get themselves out of certain activities, but get those activities canceled for everybody because it was finally realized they were a big waste of time, and only in having somebody be bold enough to to step down themselves. Did that even provoke anybody to give consideration to that activity as a whole and I’ve had people who wanted to ditch their administrative work and do all clinical, got some success just using the simple strategies and his five day detox.

Also had people who want to do the opposite, right, which is to do more of either administrative or leadership or committee work and less clinical work. And they too have been able to accomplish that. With these simple strategies in the five day detox. It’s really, really fun. It is again, totally free. I really, really encourage you to come check it out. I will put the link in the show notes.

That’s a wrap for today. Bye for now.

Thanks for joining me on this episode of the career prescription. Be sure to leave me a review on Apple podcasts or whatever podcast player you’re using to listen today. And definitely send me those questions so I can answer them and give you a shout out on a future episode. Bye for now.


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