Addressing the gender gap: Women and burnout—like men, but not

It’s carried over to being online friends. Is she worried about this backfiring? Dr. Hunt says she does not initiate Facebook friend requests, though she accepts them all. “I don’t put anyone under pressure to be my ‘friend,’ but if they want me to be friends, I’m thrilled. Because I love seeing their kids, and I love seeing their weekends, and being part of their lives.”

It’s just one illustration of how work-life integration can be so satisfying, she adds. Moreover, it might help with avoiding burnout, she says, since building good rapport and having meaningful conversations with colleagues creates closer connections, provides support, and helps people feel valued.

Indeed, Dr. Hunt says, this is a leadership style in and of itself, one that many consider to be more “female.” Building strong personal relationships isn’t foreign to men, of course, “but it tends to be more prominent in women leaders.” Men who use this style typically find it a successful approach in female-dominated fields like pathology, where many technologists are women. “And guess what? They also enjoy it themselves,” says Dr. Hunt. “Because they’re also subject to burnout and need to find meaning in their work.”

At Mayo, Jennifer Ford, MT(ASCP),  SBB(ASCP), sees Dr. Hernandez building those types of relationships with his laboratory colleagues. (“He’s wonderful,” she says.) She also tries to build them herself; as operations manager, she oversees some 300 allied health professionals, including medical technologists, histotechnologists, phlebotomists, and processors.

The stresses on her staff can be acute regardless of gender, she says. When Arizona teachers went on strike earlier this year, the walkout affected “a lot of individuals in the lab as well as the hospital,” Ford says. Single moms were hit hard, she observes. Those whose children weren’t old enough to stay home alone had to quickly set up day care or decide whether to call in sick. “That’s a stressful situation,” she says. She likens it to a Jenga tower. “You take one little thing away, and it can come crashing down. We need to recognize that every day your life could be tipped one way or the other.”

Burnout manifests in a number of ways among allied health staff, including increased error rates, lack of attention, or so-called little errors creeping in. Some may stop following policies; others may show a shift in attitudes.

Certainly pathologist leaders can play a role in that. While individuals are responsible for their own work, she says, “It’s hard to work for a supervisor who isn’t engaged in their own job, right? You don’t have that trust, you don’t have that respect. It becomes infectious. If your leader is burned out, and they’re frustrated and irritated when they’re on the job, what are their workers going to see?”

Self-awareness is key, she says, though it’s rare. She herself tells her employees that March is a tough month for her and apologizes to them in advance if she seems to come to work irritated during that time frame. “It takes self-awareness to be able to have that conversation with your colleagues, sort of ask permission to not be OK.”

Being vulnerable also opens the door to other conversations. She says she’s the unofficial wellness champion within her department’s group. She’ll send email reminders about upcoming meditation sessions offered at Mayo, for example, or a weekend fun run. “I don’t want to say I inspire anyone,” she says, “but if I show them I can do this myself—that I can walk away from my office for five minutes to go climb stairs, for example—that tells them they can do it, too.”

She also tries to be supportive in other ways. “Sometimes I’m their ‘vent,’” she says.

She makes a point of extending her support to face-to-face conversations. When encouraging healthy lifestyles, for example, she’s aware that some might take it as judgmental. “I try to be good at reading body language. So if I’ve said something that may have offended someone, I try to step that back and apologize right away.” Technology doesn’t give her that chance, however. “I would choose face-to-face any day over a phone call or an email or a text.”

Places like Mayo Clinic may be the exceptions that prove the rule, however. Medicine remains a strongly hierarchical profession, says Dr. Hunt, one in which the top-down, male-dominated leadership style is reinforced by the recruiting process. “It’s a self-fulfilling prophecy. It might take decades to move the dial,” she laments. “I wish it weren’t.”

Physicians are taught that this is the route to career success, she says. In academic medicine, for example, “You could ask 100 pathologists how to succeed, and they’d give you very similar answers: start here, then move here, then here, and then here.”

“But there are many, many, many more pathways,” she says. “It’s just that those aren’t what we’re taught.” She cites a friend who excelled at selling cars (“He loved it, absolutely loved it”) and as a result of his success was promoted to dealership manager. Two years of misery later, he returned to the showroom.

For many people, this would be a tragic tale—call it Death of a Car Salesman. But Dr. Hunt points out that her friend is now happier than ever. “That’s part of avoiding burnout—having joy in your work and life.” In medicine, that means, among other things, “that we should be talking about this before we put people on traditional pathways.”

Pathways also have their ebbs and flows, she says. “There have been times in my career where I’ve been more burned out and then less burned out. It’s probably a sinusoidal wave.” Dr. Hunt suspects there’s nothing unusual about this up-and-down experience (although it may not strike everyone as a road to success), and she recalls reading about the notion of “hibernation” in one’s career, usually after a period of intense activity. “You need to have some less intense, less chaotic times when you can rest and recover.” Before learning about that concept, she says, she would think of these fallow periods as wasteful, inactive, and, frankly, pathetic, especially since physicians are trained to push through almost everything, seek promotions, and “write the next paper before you’ve even finished the last one.” Now she reframes them as a time of rejuvenation.

Dr. Drobena frames the cause of stress and burnout as the difference between expectations (both internal and external) and perceptions of reality.

“Some of us are more sensitive to it than others,” she says, “but if you get those two factors far enough away from each other, burnout can happen for anyone. I don’t like to make generalizations based on gender, but I find that men tend to more effectively compartmentalize their obligations. Survival for a working woman with a family can greatly depend on her ability to multitask, but that can also be her downfall.”

Dr. Drobena sees several options for handling the dissonance: modify expectations, modify reality, or modify perceptions. Using exercise as an example, she says that someone who is unhappy because they can’t meet their goal of working out three times a week, for 30 to 45 minutes a session, can modify their expectation and try to go twice a week, for an hour each time. They can change their reality by having their partner take over more child care tasks and using the extra time to invest in themselves. “Or you can change your perception of the situation, go when you can, and quit being so damn hard on yourself.”

All three approaches “are reasonable strategies to me,” she says.

Echoing Dr. Hunt, she also champions a definition of success that has satisfaction as its goal, rather than meeting someone else’s idea of what’s important. “If I focus on my own satisfaction, what I’m working toward takes on more meaning”—crucial to avoiding burnout—“and seems a lot less like work.”

Dr. Drobena has had her own experiences with burnout, which she eventually parlayed into a new professional tack: She’s currently pursuing board certification in lifestyle medicine. Recalling a time when she was exhausted, sick, and stressed, she says the final straw for her was continuing to work while sick with pneumonia. “It wasn’t immediately diagnosed, so I didn’t feel like it was acceptable to go home and rest just because I was ill. There wasn’t anyone else telling me that. It is just the culture of medicine.”

She says she now intends to approach burnout in a more holistic way, drawing on her longtime interest in the role lifestyle factors play in health and wellness. “It isn’t just our mental game that has to be in top shape. It is critical to nourish our body with real, healthy food, move it with intention, and rest it adequately. To continue helping others, we must begin with healing ourselves.”

And then there’s Dr. Hunt’s one-and-done parent volunteer experience, which offers another approach to dealing with stress and burnout.

She purposely picked a time-limited, one-time event: co-chairing the school’s uniform resale event. “I did it, and I did it well,” she says. “It was actually kind of fun.” But at a meeting to discuss the following year’s event, when a PTA board member suggested a volunteer role for one mother, another member quashed the idea. As Dr. Hunt recollects, “She said, ‘Oh, no, she’s too busy—she’s a doctor.’ I was sitting there, listening to this, and so I said, ‘Um, I’m a doctor.’ And they all looked at me and sort of gasped: You are?”

She laughs at the memory. “It was so strange. But it was eye opening, too. I really don’t need to volunteer. There are other people who can.”

Karen Titus is CAP TODAY contributing editor and co-managing editor.