### Finding Purpose Beyond Burnout: Insights from Dr. Susan Landers’ Journey

Burnout is an increasingly prevalent concern in the medical field, worsened by demanding hours, ethical challenges, and the emotional strain of caring for patients. For doctors like Dr. Susan Landers, a neonatologist with extensive experience, the transition from burnout to retirement reveals significant insights about resilience, rediscovery, and the vital role of purpose. In a frank dialogue with KevinMD, Dr. Landers recounted her personal experiences, stressing that premature retirement may not always be the answer and highlighting the necessity for both systemic and individual approaches to address burnout.

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### **The Burnout Experience in Medicine**

Burnout stems from sustained work-related stress that drains emotional resources, diminishes satisfaction, and prompts professionals to reassess their purpose. Dr. Landers reflects on her own slide into burnout later in her career, particularly when, at 62, she was still engaged in 50-hour workweeks at the neonatal intensive care unit (NICU). Even with a lighter workload compared to earlier times, the pressure from night calls, ethical quandaries, and emotionally charged situations became increasingly burdensome.

One notably challenging case—a baby suffering from a severe birth defect requiring long-term dialysis—proved to be a pivotal moment for Dr. Landers. Although she believed that continued treatment was not in the baby’s best interest, differing opinions among her colleagues and ethical disputes left her feeling emotionally drained. “When you realize that you’re no longer making an impact and everything feels meaningless, that’s when burnout begins,” she shares.

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### **Early Retirement: Not Always the Answer**

The prospect of burnout frequently tempts physicians to consider early retirement as a remedy. Nevertheless, Dr. Landers cautions against the emotional hurdles associated with departing from a career that has largely shaped one’s identity and purpose. Upon retiring at 64, she entered what she terms the “loss phase” of retirement, marked by a deep sense of alienation and absence of direction.

Dr. Landers attributes her understanding of this journey to *Dr. Riley Moynes’ “Four Stages of Retirement”*, which encompass:
1. **Vacation** – An initially pleasurable respite from routine.
2. **Loss** – A phase marked by identity crisis and absence of purpose, which Dr. Landers found particularly challenging.
3. **Trial and Error** – Trying out new activities like writing, podcasting, and public speaking.
4. **Service to Others** – The phase of giving back, which she admits she has yet to fully achieve.

For Dr. Landers, retirement did not yield the immediate relief she had anticipated. Rather, it demanded continuous self-reflection and healing. Her advice to fellow physicians is straightforward: “Recover from burnout first; then determine your next moves. Avoid leaving medicine too soon.”

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### **Pathways Toward Burnout Recovery**

Dr. Landers points out several recovery strategies that were beneficial for her:
1. **Pivoting Within Medicine**: Shifting to part-time work in a different setting helped her emotionally recover while keeping her ties to the profession intact.
2. **Therapy and Support Networks**: Engaging with a therapist and reconnecting with friends and colleagues was essential in restoring her emotional health.
3. **Lifestyle Adjustments**: Consistent exercise, avoiding alcohol, journaling, and rekindling hobbies were crucial in rebuilding her resilience.

Crucially, she stresses that recovery from burnout is not a quick process. “If you’re dealing with long-standing burnout, it won’t vanish in a month or just through a single job change. It takes time,” she counsels.

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### **Lessons for Physicians and Healthcare Institutions**

Dr. Landers implores both physicians and healthcare executives to adopt proactive strategies against burnout. Throughout her career, she noted various trends and practices that could be transformative:

#### **For Physicians:**
– **Work-Life Balance**: Physicians should feel encouraged to shift to part-time roles or seek alternative positions within medicine without the fear of stigma or judgment. “Sometimes it’s crucial to step back to maintain your passion and purpose,” Dr. Landers emphasizes.
– **Invest in Self-Care**: Allocating time for therapy, physical activity, and meaningful social interactions can significantly enhance mental well-being.
– **Avoid Immediate Retirement**: Instead of seeing retirement as a way out of burnout, it should be approached as a distinct decision that must be carefully contemplated post-recovery.

#### **For Healthcare Organizations:**
– **Measure Burnout**: Medical facilities should utilize evidence-based tools to gauge and monitor staff burnout.
– **Invest in Wellness Programs**: Providing support groups, stress management training, and psychological resources can help doctors navigate challenges without reaching a breaking point.
– **Foster Open Conversations**: The stigma surrounding burnout remains a major obstacle to recovery. Organizations need to create an environment of transparency and support.

Dr. Landers cites successful initiatives, including the program at the University of North Carolina at Chapel Hill aimed at teaching physicians stress management, which is modeled after military resilience.