The Origins of Your Practice Overwhelm - the Drivers of the Whirlwind

Posted by Dike Drummond MD

Let me show you the origins of the whirlwind of practice overwhelm that is responsible for today's 63% physician burnout rate.

In the last post, we showed you the nature of this battle for your heart, mind, body and soul ... and why we are losing. 

In this post let me show you the forces that created your current Practice Whirlwind ... the hidden drivers of every keystroke, mouse click and frustrating meeting you must attend in your current job.

If doctors are the "frog in the boiling pot", this is the fire underneath. 

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The chaos and overwhelm of your current job is simple to understand when you realize your job was never designed for you.

  • It was not constructed to meet your practice goals
  • Or match your career desires
  • Over 90% of physicians were never involved in the design of their current job description

If you don't understand who is in charge right now and learn how to take back your practice ... burnout is basically inevitable at some point in your career. 

Watch To Learn:
The Origin Story of Your Practice Whirlwind


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Stop Physician Burnout:
The Origins of Your Practice Overwhelm - the Drivers of the Whirlwind



Last time we talked about what does the 62% prevalence of physician burnout mean about the state of the hearts and minds and bodies and souls of the doctors across the United States of America and the rest of the world.


And what I'd like to do is frame it as a conflict between your choice to be a LIGHTWORKER allied to the forces of light in the universe as we battle the forces of darkness, illness, suffering, death, dying and family members crazed attempts to deal with those things, versus the day-to-day WHIRLWIND of your job. Because it's like jumping into a WHIRLWIND every time you go into the office or the hospital or wherever else you practice stuffs coming at you from all direction.

Right now, the WHIRLWIND, the chaos, the overwhelm of the modern practice of medicine is overwhelming your urge to be a helper and a healer and make a difference and have meaning and purpose in your day-to-day practice of medicine.

Now, depending on how beat down you are, you may notice different kinds of voices in your head, because he may be dissatisfied with your job right now. But you might say to me, but dike,” I'm not burned out.

And let me just say, let's check.


Because burnout actually has three classic symptoms. So let's just check.

1) Symptom number one is emotional and physical exhaustion, your physical energy account is below zero. And what this means is you're exhausted in a way that doesn't respond to rest. And oftentimes, a little voice in your head is going to say something like, I'm not sure how much longer I can keep going like this. That's symptom number one, exhaustion.

2) Symptom number two, is a lack of compassion. They call it compassion fatigue. And this means that your emotional energy account is below zero, you'll often notice it because you're way more cynical and way more sarcastic and cracking dark jokes and making fun of your patients and other people that you're supposed to be taken care of.

So exhaustion, cynical and sarcastic.

3) The last symptom is when you start to hear in your head, something that says, “What's the use, I'm really not making a difference here.” This is when your spiritual energy account is below zero, when you've lost your connection with the purpose in your practice. And it's really difficult for me, and I don't see this often. But when I see it, my heart breaks just a little bit, when the little voice in your head is actually saying this phrase. “I don't know why I became a doctor in the first place.”


And I hope that you're not experiencing that right now. Most of the doctors I work with as a burnout coach are in the situation where they say “I still love my patients, I still like being a doctor, I just really really don't like this job.”

So there we have it, the WHIRLWIND of your practice against your urge to be a LIGHTWORKER, and the WHIRLWIND is winning at this point in time.

In the next video, I'm going to show you our three part process that we've honed in simplified since 2010. When I started as a burnout prevention coach, to help any doctor take their practice back, get much more of what you want out of your practice, rather than just a pure dose of WHIRLWIND - triple scoop of WHIRLWIND - every day.

But first, it's important that we dive into the components of the WHIRLWIND. Where did this WHIRLWIND come from anyhow, and I'm going to take medical education, medical school residency and fellowship and set it off to the side, because it's a different form of stress and burnout. Let's talk about when you're in practice.

The WHIRLWIND is outlined and designed and mapped and created by your job description.

For most American doctors that are employees, you interviewed with an employer that was in a region you wanted to work in and needed somebody in your specialty, and they reached in and pulled the job description off the rack is what they call in the legal business boilerplate. Standard. The same for everybody.

Real quick, just real quick. What role did you play in designing your current job description? Were you involved in any way in designing your current job description? Yes or no? The answer is usually no.

So what ends up happening is you take somebody else's job description, and you attempt to color inside those lines. Do what they want you to do?

  • What made the job description.
  • What is the job description for inside a company?

The job description is to make sure that the physicians fulfill the bill business model of the organization. It's to help the business reach its goals, its goals.

Again, what role did you play in your job description? Is it designed to help meet your goals for your practice? To there is difference between a job and a practice practices, what you want to do job is how it fits into your employer's business model.

Okay, so we've got the WHIRLWIND. Major component is the job description. Let's go one step deeper. What creates the job description? What are the drivers have the features of the job description?

Well, the job description remember is set up to reach the business goals for the organization that employs you. What drives those business goals? It's the revenue model, how they make money.

And most doctors in America are employees in a fee for service, multiple payer environment. Why is that important?

Well, how do you make money and fee for service? What's the revenue model? You make money on volume. That means you're always going to be pushed to see more patients, you make money on volume, and you make even more money, if you can do it without a whole bunch of resources? So there's a disincentive to give you the staff that you need. Are you with me sound familiar? There's certainly a disincentive to scribes because those would cost more money. And right now, in a situation where across the nation there are support staff shortages, there's going to be a tremendous different disincentive to restore your MA or any other support staff you used to have before COVID Because that adds to the expense side of the ledger.

Now, all is not lost, you can reestablish take back components of your practice, even at a fee for service multi payer system. Okay, you can take back some control over your practice. And what I want to do is help you do it before burnout takes you out. Here's what I mean.

Okay, so you got this job description made by forces outside your control that you didn't participate in? And what are the odds that that particular job description is aimed right at your ideal practice? What are the odds? Well, that word begins with the letter Z. Yeah, it's zero.

So what typically ends up happening is this, you're working hard trying to do it, everybody expects of you, coloring inside the lines of this job description. But because it's not built for you, doesn't take you into account at all, it becomes more and more uncomfortable, more and more draining as time goes by until you get to a point where you say "I can't take it anymore."

You're so miserable, you have to change. Either change this job, to a different job, or change how you work here, to take back your practice, at least in some aspects.

That I can't take it anymore is burnout. Burnout is here, to take you off of the cookie cutter of someone else's job description, and put you back on to a path with more purpose.

There you go. The WHIRLWIND versus your LIGHTWORKER essence.


  • The WHIRLWIND as a working Doctor, is your job description.
  • Driven by the revenue model of your employer.


You can still care about meaning and purpose and satisfaction, you can still play your role as a helper and healer within inside that system. But especially here in the post COVID reality, you're going to need to have active measures support you, you're going to need to actively be creating your practice going forward.

Like Play Doh, you're going to be have to be molding it into something that is more ideal for you. Or in time, burnout is basically inevitable.

That's it for today's lesson. In the next lesson, I'm going to actually outline 1-2-3 the steps that we use to teach doctors how to identify their ideal practice and begin marching in that direction step-by-step, day-by-day to a new level of satisfaction.

Until then, keep breathing and have a great rest of your day.




What did you learn from this lesson?



Tags: stop physician burnout