The Burnout Girls

The Burn Clinic started when owners, Talia Sierra and Heidi Brown suffered their own experiences with burnout. In the midst of our own personal burnout crises, we were disappointed to find there was a lack of practical help and strategies available to providers suffering from burnout. There was a copious amount of research, but very few resources had anything to help practically apply strategies in a meaningful way. Since then, we have been incredibly fortunate to add Hope Cook to the team, another PA burnout survivor and incredible coach and leader. The Burn Clinic is about creating a community of support and decreasing burnout in healthcare professionals. Our mission is to reduce burnout in healthcare by applying innovative strategies toward the treatment and prevention of burnout in an effective and meaningful way and to help you find your fire. 

Talia Sierra, MPAS, PA-C
taliasierra@theburnclinic.com

I have been a practicing PA since 2008 with clinical experience in primary care and psychiatric settings. The majority of my clinical experience has been in community health and homeless populations. In 2012 I transitioned my career to PA education, while still working clinically one day per week. 
It is in PA education that I suffered a severe episode of burnout. 
​
My teaching load was heavy and time consuming. My clinic job, which was initially 8 hours per week, was bought out by a hospital and shifts then became 10 hours, which then became 13 hours, and then became 13 hours plus taking call to go into the clinic for another 13 hour day. So what was 8 hours per week had slowly transitioned to up to 26 hours per week. Sound familiar???

Entering the field of research was a steep learning-curve with many initial failures. I was not trained to be a researcher.  The amount of time required to perform studies, apply for grants, and publish was significant. Plus I was on most committees within my department. 

I was consistently working 10-17 hour days, 7 days a week in order to fit it all in. I was working every evening, every holiday, and every weekend.... and I had two toddlers at home!!!

When I received feedback that my publications were lacking and that my level of productivity was not enough.....I crumbled.
With everything I was doing, how hard I was working.....how was I expected to do more?!

I had no more to give. It literally was not possible for me to do more. There weren't enough hours in the day. 

I knew I was burnt out, but it wasn't until I was speaking with a colleague who was also struggling that I realized the severity. He confided that he was crying uncontrollably for unknown reasons, sometimes at inappropriate times. He described a complete apathy. He had no enjoyment, every day was just "fine" and without emotion, except for maybe frustration. He had no enjoyment. He described the severity of his symptoms and concern of his family. In listening to him, I knew he was depressed and needed help, but at the same time, I could also knew that I, myself, was experiencing everything he had described. I knew he was depressed from talking with him, and I had the same symptoms that he had......so, therefore, I knew I was also depressed. 

It was then that I started to spiral downward very quickly to the point where it was difficult to function. My husband did general contracting at the time and I often spent my days riding in the truck with him from job site to job site just bawling in his truck. I needed help.  

It was really difficult to take that first step but I eventually did reach out to a friend and I got the help that I needed. Because I did, now I can help other practicing clinicians avoid the downward spiral I found myself in, help them get back on track, and find themselves again.

---

Heidi Brown, BHS, PA-C
heidibrown@theburnclinic.com

I have been practicing as a psychiatric PA for over ten years. I did not realize I was burnt out out until about three years ago. I was suddenly deciding not just if I wanted to change positions or specialties, but if I wanted to stay in medicine.....or work at all, for that matter. It had all become too much, every little thing grated on me and every little thing became a mountain. Each day I had to prepare myself like I was going into battle and I'd slipped into this state slowly, day after day and didn't even realize it was happening until it was almost too late. It was a close call, but medicine is my calling. Just like you, I wanted to go into medicine to help patients and make a connection that can only come from being a provider. But years went on and I became disgruntled and disillusioned, lost my spark, lost my fire. This was heartbreaking to think the career choice I had made was beating me down when there was so much to it that I still loved. It’s now our mission to help other providers suffering from burnout, and ideally, keep them from ever having to get to that precipice. If that is where you are, or you just want to get a little more balance, let us help you learn how to change your work environment, change yourself, and change your relationships to love the work you have chosen. Let us help you light that fire.

---

Hope Cook, MPH, PA-C
hopecook@theburnclinic.com

I've been a PA since 2002, but it wasn't until I'd been working in dermatology for a few years that I experienced my first burnout.  I was working for a solo-dermatologist in a private practice.  Turnover was high in our small office and the doctor was quirky, but I was grateful to have found a coveted dermatology position during a recession.  I felt indebted to the doctor for teaching me dermatology and soon fell in love with the specialty.  It didn't take long until I became the "office fixer" for any problem--angry patients, management issues, hiring issues, advertising, etc.  Being needed felt great, but the appreciation wasn't there.  Office morale was low, so I attempted to fix it by reading personal development books and being the office cheerleader.  It wasn't until we hired a 2nd PA that my eyes were opened to how my SP treated me (and the new PA).  I watched as she belittled the PA in front of patients and talked about her to the staff.  I realized I'd allowed that behavior for years by putting up with it.  My concerns were validated when my SP hired fill-in dermatologists during her several overseas vacations.  For weeks at a time, I was able to work with amazing dermatologists who appreciated and respected me.  I also saw that I wasn't the only one who thought things were a little crazy at our office.  I knew that I had to leave, but felt trapped by my non-compete contract.  I thought I'd have to move my family to another town or quit working in dermatology.  I couldn't see how things could possibly work out, but I made up my mind that I was leaving.  Within a week, a PA at another dermatology office in town asked me if I was looking for a job.  I told her I was, but I didn't know what to do about my non-compete contract.  She said two words which gave me my answer: satellite office.  I put in my notice and started my new job working at the practice's satellite office.  My new office was the most organized and well-managed office I'd ever seen and had the nicest staff imaginable, including my supervising Physician.  That's why it came as such a shock to me when I got smacked with another wave of burnout three years later.  Two of our PAs got pregnant, but their maternity leaves weren't supposed to overlap.  However, one got put on bed rest shortly after finding out she was pregnant.  That left us down two providers in our busy summer months.  We all pulled together and saw their patients.  40 patients a day crept up to 44, then 48, then 50+ patients a day.  I felt like I was treading water and about to drown.  I hated to complain since the job was great in every other way.  I also felt ashamed that I couldn't "hang" when the other providers seemed to be doing okay.  I remembered my promise to myself to never let my burnout get that bad again.  I had a tearful talk with my office manager and told him I was completely overwhelmed with the patient load.  I told him I didn't have time to eat lunch, go to the bathroom, or research diagnoses.  I'd gone from an A+ provider to a B- provider and I didn't even care.  He listened to my concerns and took me seriously.  We made changes to my schedule.  Slowly things improved and I'm still happily working with this office.  

​