The "Little Voice" Physician Burnout Survey

Posted by Dike Drummond MD

If your conscious mind is asking, "Is this what burnout feels like?" Your Little Voice already has the answer.

One of the things physicians ask me on our coaching Discovery Call is whether or not I think they are burned out.

They want a second opinion from a fellow doctor. That's a natural instinct and yet, my opinion is completely irrelevant in the arc of their life as a physician. The choice to change and grow has nothing to do with me or what I think or feel.

What matters is how YOU feel.

It's all about feelings. Burnout is not a rational process. It is not about ratings or scales or scores or someone else's opinion. Burnout is something you FEEL. Burnout is something your rational mind is always trying to talk you out of.  

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Your Rational Mind says ... 

The voice of your "rational" mind is laid down by the programming of your residency years. It says things like

  • Stay the course, don't rock the boat
  • Keep inside the lines
  • Do what you are told
  • You are strong and smart and they aren't gonna take you out
  • You're gonna make it
  • Hang in there, you just have to work a little harder

This voice does the arguing, the defending, the debating and convincing.

Your rational mind even developed little scare tactics like Imposter Syndrome. No matter how exhausted you became, you still didn't ask for help or for a break because, "What if they find out..." and start to suspect you don't have what it takes.

If you are over-stressed or not happy with your current job/practice, your rational mind often works hard to distract you from that deeper truth. 

How you really feel is stored in your body ... your feelings.

When it does come out as a voice in your head, it is a little voice, a quiet voice that tells the truth about how you really feel. It whispers its reality check over and over again until your rational mind gets too exhausted to shush it any more.

Everyone carries this little voice as your own inner second opinion.

So when a prospective coaching client asks me if I think they are burned out, I ask them to listen to what their little voice is saying right now. 

What your little voice says can be used as a burnout survey.

It is as accurate as any evidence based tool in telling you whether or not you would benefit from making some changes now. 

This little voice survey is something I have done with hundreds of physicians at this point. There is a distinct four-part pattern to their responses. 

Your Little Voice Survey: Four Phrases

As you read on, notice ... which one of these little voice sayings would be enough for you to take notice and make some changes to your job/practice/career/life.

What would it take for you to stop tolerating your current situation?

Level One:

"I still love my patients, I still like being a doctor, I just really don't like this job."

This is the voice of stress. You are working too hard and your job is not a good match with your Ideal Job.

  • Despite the strain, you are still still dedicated to and connected with your Lightworker calling.
  • Your emotions and spirit are strong.
  • Physically, your current reality is taxing.
  • You are still feeling OK about your ability to help your patients and make a difference.

Let me be reassuring and sound the alarm at the same time. This is a warning shot across your bow.

  • You are not significantly burned out now AND making changes towards a more Ideal Job/Practice will make a quick and significant difference.
  • If you don't fine tune your job now, this could progress to burnout and any of the little voice statements below.

Level Two:

"I'm not sure how much longer I can keep going like this."

This is the voice of the first symptom of burnout - physical and emotional exhaustion. This is also the most common burnout symptom in doctors.

It is also the voice of the downward spiral. You are drained enough that your awareness and physiology are in survival mode. Just getting through the shift, week, month is the prime directive.

If we were to measure your quality of care and patient satisfaction and compare it to baseline, you are compromised. 

  • This little voice phrase should be a HUGE RED FLAG to make some changes.
  • Your job/practice will not change itself.
  • It is time for Active Measures to get back on a path with more purpose.
  • Unfortunately, most find a way to ignore this little voice and end up either chronically burned out or in a physical or emotional crisis - the brick wall. 


Level Three

"What's the use? I am really not making a difference."

This is the third symptom of burnout. Christina Maslach called it "lack of efficacy". It is a symptom of spiritual futility.

You chose medical school to become a helper and a healer and to make a difference in the lives of your patients and their families. You have lost that connection with the purpose in this choice. It is a spirit level wounding. 

If this is your little voice, you are also hearing the, "I'm not sure how much longer ... " saying too. 

With this level of exhaustion, separated from the purpose of your choice to be a Lightworker, it becomes very difficult to carry on.

Beware of drugs, alcohol, depression and thoughts of hurting yourself. Get help if you notice any of these.

  • With dedication and support, you can recover from this with some significant self-reflection and new actions at work.
  • And even this level of burnout can become a chronic condition for some doctors.

Level Four:

"I should have never become a doctor / gone to medical school in the first place."

This an even deeper separation from spirit. You are so far removed from making a difference that you doubt your choice to become a Lightworker in the first place.

This is spiritual and emotional heartbreak. It is a fracturing of a life you hoped to live when you made your original choice to become a physician.

You must beware of drugs, alcohol, depression and thoughts of hurting yourself. Get help if you notice any of these.

  • You can still make changes that will restore your faith in that original choice and your ability to make a difference as a doctor. 
  • And even this level of distress and despair can become a chronic condition in some physicians


This conversation between you and your little voice is always the one I want to facilitate.

Welcome it in, turn up the volume and give it some space to tell the truth - then listen carefully.

Take heart and take action:

Things can always get better.
And that change can only happen when you take new actions.


Let me close today with two sayings that always bring a head nod, despite the fact that they sting a little:

If you always do what you have always done, you will always get what you've always got.

You don't get what you want in life, you get what you tolerate.



  • What is Your Little Voice saying these days?

  • When is now the time to stop tolerating your current reality?



  • What did you learn in this lesson?
  • What will you do differently now that you understand this?

Tags: stop physician burnout