Practice Management

Compassion Fatigue: A Different Kind of Burnout

Set aside time to rest and recharge

A fatigued clinician

As rising rates of burnout among health care providers continue to cause concern, a similar problem known as “compassion fatigue” has also started to gain attention. A relatively new term, compassion fatigue is an “extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper,” according to Tulane University professor Charles R. Figley, MD, whose 1995 book on the topic essentially founded the study of workplace stress among human services providers.

Symptoms of compassion fatigue include recurring thoughts of a patient or situation, withdrawal from loved ones, apathy toward work or patients, increased substance use, or negative changes in behavior such as hypervigilance. Chronic physical symptoms like gastrointestinal problems or headaches might also occur.

Burnout tends to be characterized by physical exhaustion, whereas compassion fatigue is more emotional. “A big difference is that, in compassion fatigue, patient care doesn’t suffer,” says Jennifer Lycette, MD, a community oncologist, writer, and blogger based in Astoria, OR. “We continue to be there for our patients, but that’s when we and our families can suffer.”

Compassion and empathy are finite resources that can be depleted, adds Dike Drummond, MD, a former family physician who now leads a physician coaching practice called “It shows up as cynicism and sarcasm about the very people you are supposed to serve,” he says.

The way physicians are educated and trained leads directly to these kinds of problems, says Drummond. Health care providers are trained to always put the patient’s needs before their own, even if that means shortchanging the providers’ own personal and emotional lives.

Managing compassion fatigue requires making fundamental changes to the traditional health care mindset. “Acknowledge that you are human,” he says. “Recognize that rest is not a sign of weakness, and give yourself the ability to recharge.”

Each provider may recharge differently, but this process should involve allotting time for activities unrelated to work, such as exercising, getting better sleep, or spending more time with family.

“What you can’t do is have compassion lessons,” he adds, referencing classes that educate physicians on being more empathetic. “Compassion fatigue is a symptom of burnout. We need to treat the underlying burnout. That’s one of the foundational principles of medicine: treat the cause, not the symptom.”


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