- Health care burnout is escalating due to administrative overload and lost connection.
- Contemplative Care offers health care workers a way to rediscover compassion and combat burnout.
- Buddhist principles provide a structured approach to reduce burnout and enhance care.
Why are doctors burning out?
Health care workers are leaving their profession in staggering numbers in recent years.1 What is driving this exodus? And what can we do to stop the hemorrhage?
I have felt the pull myself as a family medicine doctor. There is no question that the health care system is broken on many levels. I experienced this firsthand. After practicing for nearly 20 years, the joy of working with patients was replaced with emptiness, and the call to heal was dampened by administrative burden and productivity quotas. I felt the human connection in medicine slipping away. And I watched mental illnesses, such as anxiety and depression, consume my colleagues, especially during the COVID-19 pandemic.4
What can we do about it? Change the “broken” system? It's probably the ultimate goal, but this will take years and significant upheaval. Our profession will not survive this—we must do something about it now. But what?
Learning From Zen Buddhist Principles
Pushing against an immovable wall is challenging; however, if we change our relationship with the wall, we might see a different partnership form. I started to consider this deeply when I began studying at the New York Zen Center for Contemplative Care in 2023. Here, health care providers are learning how to transform the culture of care through Zen Buddhist principles and ancient human wisdom.
The more we explore the broken health care system, the more we realize that the change we need to survive this crisis originates deep within ourselves. It is fueled by compassion—but not just compassion for what we do and who we serve, but also for ourselves. This is where it starts … and also where it ends. This is Contemplative Care.
Compassion is the emotional response to another’s pain or suffering, involving an authentic desire to help.3 This differs from empathy, which is understanding another’s emotional state (detecting and mirroring someone’s feelings). Compassion is the action part of empathy—it can be seen and perceived. Compassion also has the potential to grow and influence the spheres around us. It is “catching” in a way that drives culture change. And this is what will help sustain us as the broken health care system catches up with our needs.
The American Medical Association explicitly includes compassion in its Principles of Medical Ethics, stating that "A physician shall be dedicated to providing competent medical care with compassion and respect for human dignity and rights.”6 However, nearly half of Americans say that compassionate care is absent from U.S. medicine.2 This includes reports from both patients and physicians.
How do we fill this compassion gap? A roadmap would be nice, wouldn’t it?
Enter the Buddha.
The Four Noble Truths
In Buddhism, the Four Noble Truths exist upon which our awakening to enlightenment is built.5 The First Noble Truth is the simple fact that suffering exists. This is not hard to agree with. We see this in all aspects of health care when we work with the sick and the vulnerable but also when we feel the weight of our profession on our own well-being. This is part of the human condition; we are all in it together.
The key to awakening from suffering lies in comprehending its roots, as outlined in the Second Noble Truth. Suffering is a universal experience, manifesting in both physical and emotional pain. However, it's crucial to recognize that suffering differs from pain. Suffering emerges when we become attached to specific outcomes or resist the reality of our situations. By understanding this, we can see how our responses and attachments contribute to our suffering.
After realizing our role in suffering, it is helpful to know that there is an end to suffering as well—and this is known as the Third Noble Truth. The journey you take to shed this suffering is the Eightfold Path, which is the basis of the Fourth Noble Truth. Rather than run from our suffering, the path teaches us how to brace ourselves for it.
As a new student of Contemplative Care, I would like to serve as your guide through the path as we learn to infuse compassion into the care we provide patients and into our interactions with our colleagues while first and foremost providing it for ourselves. This path is a practice that takes time and reflection to build strength—much like medicine. And we practice for the sake of all beings.
As we conclude this introductory exploration of compassionate care through the lens of the Eightfold Path, we stand at the threshold of a transformative journey. In the upcoming posts, we will delve deeper into each aspect of the Eightfold Path, starting with "Right View" in our next discussion. This journey will guide us through the intricate layers of understanding, intention, speech, action, livelihood, effort, mindfulness, and concentration. Each post will not only explore these concepts in the context of health care but also offer practical insights on how they can be integrated into our daily professional practices. By embarking on this path together, we aim to cultivate a deeper sense of compassion within ourselves and in our interactions with patients and colleagues, ultimately fostering a more empathetic and effective health care environment. Join me as we navigate this path, step by step, toward a more mindful and compassionate approach to care.
1. Scott W. Yates. Physician Stress and Burnout. American Journal of Medicine Volume 133, Issue 2, P160–164, February 2020)
2. Beth A Lown, et al. “An Agenda for Improving Compassionate Care: A Survey Shows About Half of Patients Say Such Care Is Missing.”Health Affairs Vol 30, No 9 (Sept, 2011).
3. Anthony Mazzarelli, Compassionomics - The Revolutionary Scientific Evidence that Caring Makes a Difference. Stephen Trzeciak, 2019.
4. Samuel B. Harvey, et al. Mental illness and suicide among physicians. Lancet. 2021 4-10 September; 398(10303): 920–930.)
5. Gil Fronsdal, Steps to Liberation - The Buddha’s Eightfold Path. 2018.
6 “AMA Principles of Medical Ethics.” 2001.