Addressing physician burnout: moving beyond the "loss of faith" analogy

A recent opinion piece in the BMJ, titled "When doctors lose their faith in medicine," by Dr. Peter Brindley and Dr. Matt Morgan, explores the phenomenon of physician burnout by drawing an unexpected parallel to clergy who lose their religious faith. This analogy, while thought-provoking, warrants closer examination regarding its applicability and the solutions it proposes.

Faith or Burnout

Two authoritative voices, then. Yet the premise from which they start — addressing colleagues who have lost “faith” in medicine — does not sit well with me. Their piece is indeed titled: “When doctors lose their faith in medicine.” I began reading it thinking it would address the many physicians who, unfortunately, abandon science to pursue alternative paths, similar to patients who lose trust in the preventive and therapeutic power of vaccines and conventional drugs and turn to the many gurus promoting other approaches on social media and beyond.

Instead, to my surprise, the article focuses on colleagues afflicted by burnout. The authors note that the definition of clinician burnout “is woefully imprecise but includes moral fatigue, lost meaning, and depersonalization and has been self-reported in around half of all practitioners,” according to a recent survey by the UK’s General Medical Council. But “burnout probably also equates with how often you greet the day thinking that you’re going through the motions and spend your shift asking what the point is.”
 
The Clergy Project, an Anglo-Saxon Movement

Even more surprising is the comparison the authors draw to an initiative previously unknown to me, perhaps because it is rooted in Anglo-Saxon contexts: The Clergy Project. This organization supports pastors, priests, rabbis, and other religious leaders — including Buddhist and Hindu monks, an imam, a former Scientology preacher, and even a representative of traditional Native American spiritual practices — who no longer believe in any supernatural entity. Many of these individuals find themselves effectively trapped in a professional and existential role that is difficult to leave.
Founded with the involvement of evolutionary biologist , known internationally for his outspoken atheism, the project helps clergy who have “come out” to rebuild their lives. It also aims to discourage younger members from following the same path.

According to the Clergy Project’s website, its goal is not to encourage clergy to remain in their roles serving communities despite a loss of belief, as Brindley and Morgan suggest in their BMJ article. In fact, only about a third of its approximately 1000 members continue in their positions after losing faith. That this model could be considered a “best practice” for supporting physicians experiencing burnout seems, frankly, a stretch. Do we really want to encourage doctors to change careers, potentially worsening workforce shortages and pushing their remaining colleagues further toward burnout?

Religion and Medicine

I am even more inclined to dissent from the religious framing of the medical profession in the article, which suggests it requires “faith,” is driven by a “vocation,” and involves a “mission.” I had assumed it was widely accepted that this approach is unfair and only increases pressure on healthcare workers, adding guilt and feelings of inadequacy. Doctors and nurses are professionals who deserve respect, recognition of the importance of their work, reasonable working hours, adequate pay, and the ability to perform their roles without being crushed by disorganization, bureaucracy, or even the threat of violence from patients and families.

Brindley and Morgan, however, place the issue on another plane: “Like some clerics, you might have once felt you were on a mission but now just want to get out. However, there are bills to pay, you’ve invested too much, you secretly (or conspicuously) crave prestige, and what else would you realistically do?”

‘Happiness A1c’ and Other, Less Useful Advice

After this “diagnosis,” the authors propose somewhat naive, DIY solutions to burnout. In a daring comparison, they suggest measuring one’s own happiness as one measures blood glucose in diabetics — not just daily highs and lows, but as a “glycated” measure over a longer time horizon. They call it “happiness A1c.”

This is followed by feel-good statements that could come from anyone, lacking specific expertise and slightly superficial: “No job is 24/7 fun” or “doctors aren’t the only professionals experiencing existential crises.”

Then come the practical tips, reminiscent of advice from online AI chatbots: Go outside, exercise, take a cooking class — in short, work less so you can work longer and regain work-life balance.

“Thanks, I never would have thought of that!” I wanted to reply, but when the next list of psychological advice arrived — seemingly drawn from memes and motivational posts filling social media — I suspected the text may indeed have been AI-assisted. “We should accept help from others, while realizing that happiness is an inside job. It likely means finding joy while understanding that it’s ‘okay not to be okay.’ You should not ruminate but you should ponder your new purpose: After all, purpose is necessary for career longevity. Just because the burden of being a doctor is weighing on you, it does not mean that you’ve failed. The job changes, you change; sometimes you win, and sometimes you learn. As Samuel Beckett wrote: ‘Try again. Fail again. Fail better.’”

While the BMJ article rightly highlights the severe issue of burnout, the medical community may benefit more from focusing on systemic solutions—such as improved working conditions, administrative support, and accessible mental health resources—rather than metaphorical comparisons or self-help measures that risk oversimplifying a profound professional crisis.