A Doctor’s Three Energy Accounts

When discussing the personal energy of a practicing physician, you must first discard any comparison to a battery. The Energizer Bunny stops when his batteries get to zero. But you never stop.

Rather than batteries, we have an internal “energy account,” which can actually have a negative balance, unlike a battery. Rather than keel over when we hit the zero line, our training has taught us to keep caring for patients regardless of our energy level. How far we are below zero is irrelevant when our training reminds us that the patient always comes first.

Sliding Into Burnout

Each of us has three energy accounts: physical, emotional, and spiritual. The different types of energy serve different purposes because we are more than just physical beings, especially when functioning as a physician caring for patients. When each account falls into a negative balance it gives rise to a different symptom of burnout, and each account is filled in a completely different way.

Filling Your Physical Energy Account

This account holds the energy you need for physical tasks. When this account is full, you show up eager and bright-eyed, bringing your “A game” to everything you do. You are dialed-in, energized, engaged, eager, in charge of all your capabilities, and having fun.

When this account drops below zero, you experience the first and most common burnout symptom: exhaustion. This may feel like dragging yourself from shift to shift, and even a weekend may not provide enough rest to recover.

This is the account we know best how to fill, yet it’s the one we were taught to completely ignore in training. Rest, exercise, and good nutrition are what you need. Each of these is in short supply as a resident. It is my experience that many physicians learn how to take care of their physical needs only when they are recovering from an episode of burnout.

Filling Your Emotional Energy Account

This account holds the energy you need to be emotionally available to your patients and loved ones. When this account drops below zero, you experience the second burnout symptom: compassionate fatigue. Draining this account is common for doctors because we choose to work with people who are sick, hurt, scared, and dying. We are present for some of the worst times in our patients’ lives. Our work is sometimes difficult, sad, and tragic. All of us can experience trauma in the process of our training and caring for patients.

Draining this account may cause you to feel cynical, sarcastic, and highly critical of the patients and family members you vowed to serve. Your feelings go flat, and you find it hard to care about or empathize with your patients (or even your own children).

To fill this account, grab some paper and a pen and make a list of everyone you love. Take some time. Make a good list. Look at all the names on that list one by one and ask yourself, for whom on this list has it been just too long since I talked to them? Visited them? Wrote them a note, or an email, or a text? Circle those names and make it right. Make a call, send a note, schedule a cup of coffee, or buy the airline ticket for a visit. Just do it. (It is later than you think.) When you feel you have spent enough quality time with all the people you love in your life, you have the energy you need to be emotionally present with everyone at work and home.

Filling Your Spiritual Energy Account

The word spiritual does not necessarily mean religious. If you have a religious practice that brings you joy and meaning, please keep it up. When I use the words spirit, heart, and soul here, I mean your ability to feel a connection with purpose or that you are fulfilling your mission as a helper and healer.

When the chaos of your day makes it impossible to feel that you are making a difference or serving a purpose, you will experience the third burnout symptom: Purposelessness. Christina Maslach called this symptom “lack of efficacy.” Your little voice puts you on notice when it says, “What’s the use? I am not really making a difference or serving a purpose here.” This is the burnout symptom that can break your heart and even cause you to walk away from your practice.

I have interviewed hundreds of physicians to answer this question and find ways to fill this account. What we discovered together is a true burnout prevention superpower, which I will discuss in a future blog post. But this practice-saving energy infusion hinges on what you do when a patient or family member says the magic words: “Thank You.”