Practical burnout help

[Rosemary]

Hi! I'm a wife of a physician, long time reader first time poster. I was hoping to get some advice/perspective please on how I can help my husband I think he is burned out.
He's working from about 7am to 7-8pm daily (includes time to stay after work to finish notes) plus spends about 8 hours or another full day on it every weekend.
We've recently went on vacation and he was working every day of it for several hours a day to catch up on paperwork. He frequently says he's 30 plus charts behind.. he says he's inefficient in doing charts but it's probably also due to burnout - his hospital doesn't let him hire a scribe even though he offered to pay for it.
We are doing well financially, I'm also making good six figures in my job, our house is half paid off and mortgage was less than our annual income. We have 1M+ in net worth including equity about 5 years out of residency.
I keep asking him to cut back at work but he says that it's not linear and if he cuts back a little his income will drop by a lot.. I think we would be quite fine with less money if it buys more freedom..
I'm not sure what the plan is to be honest. We've been together since first year of his medical school so I've seen it all, but all this time we had hope that once the next step in training comes it will be easier.. And here we are and he is miserable, I'm miserable, we are not spending any quality time together as he wants to withdraw and scroll through his phone a lot and is pretty tired and irritable a lot. He's seen two psychologists already but they haven't been very helpful. I don't know what to do because I think it's all due to crazy hours and I love him and want to help but don't know how.
Any advice please? I'm lost on what else to try

[FIREshrink]

Sounds miserable and unsustainable, what field is he in?

He likely needs to meet with mentors he trusts in his specific field to see if he's doing something wrong.

[JBME]

You should get philosophical with him. What is he working towards? Why is he working so much? What is his and your goal? This might help:

https://thephysicianphilosopher.com/...der-questions/

[ObgynMD]

It’s ok to write B level notes. I try to give A level care and have made peace with my B level notes.

https://dexrandall.com - professional men’s burnout coach recommended by another life coach who specializes in female physicians.

[Nysoz]

I agree. Sit down and have a discussion about what and why you’re working towards something.

Ultimately everyone is working towards retirement or at least financial independence. You guys have a great head start already. Find out how much you’re actually spending now and how much you think you’ll spend in retirement.

Now you have your retirement number, figure out how much you need to save in order to get there. Without knowing your particulars I’m guessing that he can take a substantial pay cut and you guys would still be on track for possible early retirement if you choose.

Working less hours for less money for more years is way more sustainable than working extreme hours for a shorter period of time.

[Rosemary]

Thank you all so far! I agree it makes sense to figure out what the target is.. we have very young kids and it's not like we can take off and retire and travel the world until they are off to college.. I guess we could still retire before then, just wouldn't be able to live a very different lifestyle or move to another area. So a super early retirement is probably not in the cards.

Does anyone have recommendations for perhaps coaching resources? A lot of them are focused on female physicians but guys need help too sometimes

[Rosemary]

Or if anyone has tips for software, etc to deal with notes easier that would be much appreciated. I searched and found nothing on this forum. They have some dictation type software but apparently it doesn't work that well, freezes, etc

[ENT Doc]

Different job perhaps if they’re not willing to help him be more efficient?

You said young kids. Are you home watching them?

[Dontgetthejab]

Is he primary care?
the documentation requirements in order to bill have decreased this yr.
hpi: here to discuss labs, diabetes, htn.
PE: obese, chronically ill, nad, rrr no murmur, ctab
a/p:
diabetes-uncontrolled a1c 9. Continue metformin, start ozempic. Keep glucose logs. Rec low carb diet.
htn- cmp normal, continue losartan.
f/u 1 mth
99214

[Rosemary]

I'm also working full time but from home and we have a childcare arrangement.
He's not in primary care, it's outpatient specialty which is supposed to have good work life balance but doesn't.

Does it seem like it's just too many hours to you? He says he has 15 minutes per patient so no time to do paperwork during the day

[wideopenspaces]

Typically with burnout, symptoms are just present at work and when at home you still enjoy your hobbies and family and life outside work. So part of me wonders if he's depressed and struggling with motivation, focus, concentration, etc which is slowing him down at work. Has he always struggled with documentation, are others in his same job having the same problems? There are several avenues to explore but I'd consider a mentor, life coach and meeting with a psychiatrist as options. Also look at what cutting back would really look like from a practical and financial perspective. Just because you don't want to retire until kids finish high-school doesn't mean he wouldn't enjoy working part-time until they finish high-school to have more balance. I'm 7 years out of training and have worked part time the majority of it. Money isn't everything, that's for sure.

[Rosemary]

I think the way he is he's really smart but doesn't do well with very repetitive boring stuff which notes are, so naturally his predisposition is not built for that. For example I don't mind stuff like taxes, building spreadsheets and such things..
He says others are also working frequently on the weekends and according to him he's not up there in terms of super high rvus..

[FIREshrink]

He’s working 68 hours a week, 6 days a week. Hardly any of us would not hate that.

Is that normal for his specialty (doubtful)? he’s either doing something wrong or it’s a bad job (poor support, poor admin, patient population, whatever). He’s got to figure out what it is.

[Craigslist]

I'm also working full time but from home and we have a childcare arrangement.
He's not in primary care, it's outpatient specialty which is supposed to have good work life balance but doesn't.

Does it seem like it's just too many hours to you? He says he has 15 minutes per patient so no time to do paperwork during the day

I think people ask the specialty because people with similiar speciatiies can understand and may be able to give directed guidance kinda like how dontgetthejab did.

Also, maybe its not work, maybe hes unhappy with something else and its transferring to work. Maybe he doesnt like his life in general. Does he exercise? Does he drink/smoke? Does he need a cpap? etc. Maybe he doesnt want to hear whats wrong with him. Its way too hard to tell.

[Rosemary]

I do think he's probably depressed and has very little emotional reserve. I feel like I'm walking on ice sometimes as he has a short temper and overreacts to things, but I think it's lack of sleep and stress due to work..
I am not sure if it's the chicken or the egg here: lack of focus/motivation/burnout leading to being inefficient and long hours just to cope, which in turn leaves little breathing room and doesn't help things.