May A. Kim-Tenser, MD, MHA, a neurointensivist/vascular neurologist and head of neurocritical care with USC Neurosciences, part of Keck Medicine of USC, shares her tips for combatting physician burnout.
Like all specialties, neurocritical care has its own unique demands. The neuro ICU operates 24/7, seven days a week. While we are not always physically in the hospital, we are on call as providers and are frequently awakened in the middle of the night, then return to round the following morning. For the most part, however, the schedule is not as demanding as it is for specialties such as transplant surgery or obstetrics and gynecology. In many ways, it resembles shift work: we are on service one week at a time. That week is intense, but when you are off service, you have the opportunity to decompress. That time allows for administrative work, research, education and fellowship mentoring.
Over the years, I have learned important lessons about managing my roles as a physician, division leader, wife and mother. Below are my key takeaways.
Delegating is essential.
I feel incredibly fortunate to work with such dedicated colleagues in our division at Keck Medicine. Recognizing each person’s strengths and delegating whenever possible are critical to building a strong team. Every member brings a core strength, and I try to leverage those strengths by empowering individuals to focus on what they do best.
The same principle applies at home. Because my husband and I both work, we divide and conquer household and childcare responsibilities. Often, we step back, review our schedules and ask, “How are we going to make this work?”
It has been especially helpful for one of us to take ownership of specific household tasks, such as laundry or grocery shopping. I have learned that when my husband is responsible for an area, I need to cede control and accept that I cannot manage everything myself.
Take care of your team’s mental and emotional health.
I often recognize burnout in team members when I notice changes in professionalism, withdrawal or a lack of mental presence or accountability at work. Someone may snap at a colleague without realizing it, or I may begin hearing complaints and think, “That’s unusual — that’s not who this person normally is.”
When I notice a change, I try to reach out. Everyone has personal challenges, and we often do not know what is happening in someone’s life outside of work. As division chief, I feel a responsibility to ensure that my team members are okay.
Not everyone is ready or willing to open up. Even within a close-knit division, some individuals are less comfortable discussing their struggles and tend to internalize them. Staying connected and reminding them that support is always available remains important. My hope is that, over time, we can foster a culture in which everyone feels comfortable speaking openly about challenges.
Recognize when you are becoming burned out yourself.
My husband is also in medicine — he is a neurointerventional surgeon — and we have three children. Our schedules can become extremely busy.
I recognize that I am becoming overwhelmed when I am juggling an extensive to-do list alongside meetings and administrative responsibilities. For me, burnout often shows up when I realize I have not been present for my children’s activities or when I notice that I have not been sleeping well or exercising.
When that happens, I know I need to reset. Exercise, in particular, helps me decompress and feel grounded, so I try to incorporate it into my daily routine for my own well-being.
Balancing work and home life is an ongoing process.
One important realization I have had is that balance is never consistent. People often say, “You can have the best of both worlds,” but the reality is that it is difficult. There is always give-and-take, and compromise is unavoidable.
It is especially important to remind physicians — particularly female physicians — that they are not expected to do everything. It is okay to miss a game occasionally or to not be fully present every single time.
My take-home message is simple: do not feel like you have to do it all, or that everything must be equal at all times. It will not be, and that is okay.
Lean on technology when possible.
I have gradually incorporated AI into my workflow to help simplify tasks. Keeping up with multiple medical journals has always been challenging, and finding time to stay current with new research can feel overwhelming. AI now allows me to convert journal articles into brief audio summaries that I can listen to in the car, which has been incredibly helpful. Journal clubs and conferences, such as the International Stroke Conference and the Neurocritical Care Society’s annual meeting, also remain valuable ways to stay informed about emerging and validated research.
In clinical settings, AI-generated notes based on patient visits have been useful. While I still review and edit these notes to ensure accuracy, the overall time savings have been significant. Educating and training providers to use these tools effectively will likely reduce stress and improve efficiency over time.
I have also used AI to explore new initiatives, such as planning the development of a new neuro ICU at another hospital. For example, AI can help model staffing needs for a 10-bed ICU, which is valuable during early planning stages.
Remember to disconnect from work.
When I am not on call, I make a conscious effort to fully disengage from work and focus on my family. In the past, I worked through weekends and checked email constantly — even on vacation. Now, I am more likely to say, “This can wait until Monday,” or avoid checking email on Saturdays. For me, that represents meaningful progress.
A physician who is not burned out provides better care.
The quality of care you provide is fundamentally different when you are balanced at home and at work. When you take care of yourself, you are more fulfilled and present professionally. Many physicians — especially women — feel compelled to care for everyone else while neglecting their own well-being. Being mindful of what you personally need to decompress is essential.
It is also important to have the time and mental space to truly listen to patients without feeling rushed. Most of us became physicians because we wanted to help people, and that includes understanding what is happening in their lives beyond their medical diagnoses.
When you feel balanced and fulfilled in both your professional and personal life, it ultimately reflects in the care you provide to your patients.
USC Neurosciences
May A. Kim-Tenser, MD, MHA, is a neurointensivist/vascular neurologist and head of neurocritical care/stroke, as well as vice chair of inpatient clinical affairs, for USC Neurosciences, part of Keck Medicine of USC. She is also a clinical professor of neurology and neurological surgery for the Keck School of Medicine of USC. She specializes in the diagnosis and management of patients with stroke and those who are neurocritically ill requiring admission into the neurosciences ICU. The neurologists and neurosurgeons of USC Neurosciences are leaders in treating neurological disorders, advancing the technologies and procedures for preventing, diagnosing and treating conditions of the brain, spinal cord and nerves.
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