Physician burnout: definition and scope

What is physician burnout?

Let’s start by defining the problem.

The psychiatric definition of physician burnout is embedded somewhere in this word cloud. We do not mean to scare you, really.

Note that each of these words is a harsh description of a “depressive disorder that can paralyze you” or your colleagues.

physician burnout defined

One source estimates that at least 60% of the physicians in your practice group are experiencing burnout right now.  Look to the left.  The look to the right.

Dyrbe & Shanafelt have published several papers in JAMA and the Mayo Clinic proceedings, we recommend “Physician Burnout: a potential threat to healthcare reform (2011) and physician satisfaction and burnout at different career stages (2013)

Another source states that virtually 100% of physicians have experienced burnout at some point in their careers.  Look to your past.  Then look to your colleagues.

In subsequent slides we will share the statistics on prevalence by gender, specialty, practice group, and stages of your career.

The bottom line:  Burnout is high among professionals, and highest among physicians.  The costs are tragic.

Many physicians are NOT willing to consult with their insurer or employer.  You may require confidential consulting.

If so, please call us at 704.995.6647 today.  Or contact us.   Or schedule your initial consultation here.

Nothing is more essential than a physician’s ability to provide self-care, and care for others.

Physician burnout and engagement by specialty

How often have you heard a physician state “I just don’t have the energy to do my job any more.”

According to a national survey in the Archives of Internal Medicine (2012), physicians in the U.S. suffer more burnout than other American workers.

Burnout is typically defined as 1) loss of enthusiasm for work, 2) feelings of cynicism, and 3) a low sense of personal accomplishment.  Survey items include “I have become more callous toward people since I took this job” and “I feel burned out from my work.”

The 2014 Medscape Physician Lifestyle Survey reported an overall 7% increase of burnout reported, in just one year, from 39% in 2013 to 46% of all physicians in 2014.  That statistically improbable increase may be a result of increased attribution from variables such as reduced contact with patients, increased technological requirements for EMR and coding, decreased morale, decreased financial compensation.

So where do you stand?  Burnout rates vary by specialty.

(Source: Peckham, C.  Physician burnout: it just keeps getting worse.  Medscape.  Jan. 26, 2015.  Sorry in advance for this low-quality image, and the busiest slide in the deck… )


Every physician wants to know how they compare.

For those of you doing critical care and emergency medicine, you represent the highest level of burnout.

One factor is low autonomy or control over your schedule… perhaps because you are the “front line of care.”

For those of you in dermatology or psychiatry, with the opportunity to schedule office visits and regular patient schedules, please do not think that you are exempt from burnout.

These are averages and self-reported scales, so they are descriptive data.  Only.

You are each unique.

To assess your degree of burnout or engagement contact us here.  Or call 704.995.667.  Or schedule your initial consultation here.

Yes, we can help you increase your engagement level.

Physician burnout: how are you feeling?

Since the days of Hippocrates, physicians have been taught to ask this question…

“How are you feeling?”

And some will state to me, in confidential moments, that they are feeling depressed, overwhelmed, unexcited about providing care to others, unable to pay their lingering $150,000 residency debts or to save $250,000 for their children to attend a great college…

Part of the conflict is that physicians have always been taught to “heal thyself.”

As if healing is an easy process… or as if healing can be done alone.

Physician burnout is a critical issue. The costs are tragic.

According to a 2015 article in Medscape, called “Two sides of the physician coin: burnout and well-being” by Scudder and Shanafelt, some 40% of physicians admit regular self-medication.  Some of my clients state that number is more realistically at least 60%.  The drugs of choice range from alcohol to amphetamines.

In the same study, 15% of physicians have admitted to feeling suicidal ideation in the last 24 months.

Virtually 100% of physicians have experienced burnout at some point in their careers.

The most stressful burnout rate is mid-career, 11-20 years after residency, when over 50% of physicians complain of burnout.

We know that physician engagement is attainable.  And we know that physicians cannot talk to their employer or insurer about many confidential concerns.

Contact us today to help any physician.  We want any referrals.

Or call us at 704.995.6647.

Physician burnout: how are you feeling?

Or schedule your confidential initial consultation here. 

Fee ranges for coaching services

There is chaos in the executive coaching and leadership consulting industry.

The top 6 reasons for that chaos include  1) low barrier to entry by anyone who chooses to call himself an “executive coach,” 2) low accountability for the coaching process, 3) unclear business agreements and ROI, 4) proliferation of “certification programs” (often by self-congratulating organizations and/or universities that respond to perceived market opportunities), 5) digital overwhelm of choices at low cost and variable quality, and 6) clients or buying agents in organizations who fear taking action.     My opinion is that the chaos in the coaching industry can be reduced.

So here is my effort to reduce the chaos, by providing fee ranges and best practices.   Please forward this page to your colleagues.

1.  Individual Coaching or Consulting Services.  Fees range from $3,000- $50,000 for 6 months.   Individual coaching may be defined as a customized leadership development process that enables leaders to practice new skills or behavioral outcomes.  Individual consulting may be a more directive style, where we provide expertise based on world-class examples or evidence-based recommendations to accelerate your leadership development.  The average executive coaching engagement is $25,000 for 6 months, about 40 hours.  The average small business coaching engagement is $6,000 for 6 months, about 18 hours.   Typically, an individual coaching process includes an intake, meeting with key stakeholders, written action plan with behavioral outcomes, clear measures of success/ KPIs, quantitative and qualitative assessments, satisfaction survey, and demonstrated behavioral outcomes at completion.   Be wary of anyone who offers a term of engagement shorter than 6 months, because behavioral change takes time.  Be wary of anyone who provides an hourly rate, because that is a transactional approach and it may be unethical (Do I really need to extend this coaching engagement if we have not met the desired outcomes within 6 months?)   Be wary of additional fees for assessments, a sample intake, books, materials, or excessive travel…  Only select coaches who provide tremendous value and exceed that promise.  Only select coaches who guarantee results for their services.  Only select coaches with many testimonials demonstrating clear behavioral outcomes.  Still confused?  Then call us for details or schedule a complimentary, confidential session here.

2.  Team Coaching or  Group Coaching.  Fees range from $1,000 per person to $4,000 per person for 6 months.  There is a trend toward providing coaching services that bundle clients together by team (e.g. the IT department in Houston) or by group (e.g. all district managers or all newly promoted supervisors.)  Many coaches bundle these services for one reason– because the coaches then make more money.  We all need to make money.  However, that is not a compelling reason to bundle valuable services into a commoditized market such as “online team-coaching modules…”  We do not recommend these online modules because there is no evidence that the results are significant.  There is conflicting data on the significance of team coaching engagements.  These programs must be customized for specific organizational needs,  they must have executive sponsorship, and they must have milestones for phases of success.  Yes, we can provide team coaching programs for any organization.   Contact us for details or referrals.

3.  Organizational Coaching or Consulting Services.  Fees range from $15,000- $100,000 per person for 6 months.  Fees vary by role of the leader (c-suite or a HiPo), geography (Asia or North America), and client expectations.  There is massive value to any organization if you can be guaranteed access to pre-qualified coaches in New York as well as Mexico City or Paris.  We are affiliated with CoachSource, the largest global provider of executive coaches, in over 1,000 in 45+ countries.  These service providers can provide breadth for any initiative in any geography, thereby increasing the likelihood of your organizational alignment or new program implementation.  If you are interested in a scaled solution for a specific industry or business need, then you need to select an organizational coaching service provider.  We have selected and managed  hundreds of executive coaches at multiple F500 global organizations since 2005.  Contact us for details.

4.  Organizational Assessment Services.  Fees range from $500- $28,000 per person.  Assessments range from an individual validated tool such as the Hogan Suite or DISC (there are over 15,000 validated assessments) to multi-rater, multi modal assessments with high predictive validity.  We can provide virtually any individual or organizational assessment.   Assessments are essential to leadership development.  Just as you would never go to a physician until the nurse provides your vitals, we recommend using validated assessment tools to measure behavioral changes over time.  We often provide assessments by themselves for your new hires or a newly promoted leaders.  We always include assessments in coaching solutions, as part of the process.  Contact me for details or referrals.

Since 1997,  we have seen tremendous changes in the business and leadership coaching services industry.  As a timely example, minutes ago I received a cold call from a “leader” in the sales coaching software industry.  I quickly learned that he knew less about the industry than he should, and I excused myself from the call.  You can avoid the chaos.

If you are interested in seeing trend survey reports from the coaching industry, or from our research on the relationship of positive psychology on business leaders and executive coaching, please contact us.

Now you have some pricing numbers and best practices.  So what is your next step?

  1.  You have to vet coaches.  Call 3-4 of the best.  Read their testimonials.  Make sure that they are working on their own professional development.  I have hired sales coaches at times.  And business coaches at other times.  The terms were clean.  Their value was tremendous.  I currently work with 2 of the best coaches in North America.  (Perhaps I need more help than most people.)  Make sure the consultants that you select focus on value, and guarantee their work.
  2. Take a small step:  Contact us.  Or call 704.995.6647.  Or schedule your initial consultation here.

There is no reason to be fearful amid the chaos.  

2014 Executive Coaching summary from the Conference Board

Hello friends,

I thought you may want to see some recent trend data for external coaching and internal coaching, by industry and size of company.


  1. After the recession, companies are investing more than ever in leadership development and key talent, with both external and internal coaching  
  2. 39% of these 140 companies use internal coaches for leaders who are lower in the organization, and over 75% use external coaches for their senior leaders (directors and above)
  3. The top 3 types of coaching remain 1) development-focused coaching, 2) performance-focused coaching, and 3) 360 debriefs
  4. Fees invoiced at a standard or fixed rate per engagement, rather than an hourly or variable rate, have increased from 26% in 2012 to 38% in 2014
  5. Hourly rates for executive coaching range from $600+/hour for CEOs and direct reports to $300/hour for directors and above; naturally, those rates vary by size of the company, industry, and level of the leaders
  6. The top 3 topics covered in coaching engagements have not changed for many years; they include:  1) executive presence/ influencing skills, 2) relationship management, and 3) leading teams and people development

If you should have any questions, please let me know.

Doug Gray, PCC,  CEO/Founder