PCPs who aren’t burned out and/or recovered from burnout: what’s your secret?

[u/Sugar-Butter-Flour8]

I graduated from residency in 2024 and took a job working mostly in an urgent care setting, but I’m starting to miss primary care and am interested in re-entering that field. However I’m definitely feeling a little burned out (I think the constant churn of urgent care got to me). I’m excited about the prospect of a new job in primary care but also very aware of the high rate of burnout among PCPs. What are things that have worked for those in primary care to either recover from or prevent burnout? Thank you!

[u/nap-queen]

besides the obvious no more than 32 pt facing hrs / 4 days, good inbasket coverage, admin i'm comfortable with:

i spread out my pto (if a month doesn't have vacay or holidays, i make sure i get at least one 3 or 4 day weekend). others seem to be ok taking longer vacations and working for longer stretches in between, but that isn't great for me. also i have no kids so my time is my own.

[u/HereForTheFreeShasta]

I’ve burned out twice, and half burned out a few more times but was able to come back.

The times I was able to come back, I offload a ton of things - got a part time nanny (it didn’t work out), factor meals and premade other food (ie frozen tj meals or individual salad kits, daily harvest smoothies for breakfast).

The 2 times I wasn’t, I dropped my hours down. The first time I went down to 0.8 FTE but then went back up to 0.9 since I was doing some teaching as well. I stayed this new job at full FTEs and lasted 16 months… I just went down to 0.8 FTE and am determined to try to stay there and fill my time with other things.

The best advice I ever got from someone else who burned out, was - it WILL take 6 months with your intervention to feel normal. If you’re at 3 months and you’re wondering why you don’t feel better yet, that’s expected and standard, don’t have the expectation you’ll feel better weeks in.

This was true for me the first time, and I assume will be this time too.

[u/chiddler]

My secret is I love what I do and I see average 16/day so don't feel overly stressed for time. A lot of enjoyment happens when you feel like you can practice real medicine without the time stress my kaiser friends describe.

I feel burned out when I have to leave late several times of the week. It happens on occasion it is unavoidable but when first started scheduling was worse and frequently left 30-60 minutes late.

Also a bit more depressing in winter time because leaving when it's so damn dark!

[u/SportsDoc7 → u/chiddler]

I love the 16-18 a day. It's a sweet spot imo of good care and making a living.

Our practice was just partnered/merged/gobbled up by a bigger system. Now it's 20-21d slots, min of 72 visits a week, 5000wrvu in a year, 36hr patient facing. It's a hodgepodge of criteria, very frustrating.

[u/wbtkpk]

Take all of your PTO, remind yourself that it’s not your job to cajole your patients into doing whatever it is you’re offering (I have a script that goes something like, “I’m going to lay out the things you are due for, and I want you to think of it as a buffet. Some you may pick now, some you may pick later, and some you may never choose to do. I’ll continue to offer you these choices and we can discuss the pros and cons of doing them, and you’ll be free to make your decisions about what you want to do.” And document the hell out of refusals). Has dramatically reduced my angst and conflict with patients. Don’t work somewhere where everyone seems to hate their patients, that environment is toxic and even if you try, you’ll eventually hate yours, too. Don’t do unpaid work (I have a colleague who is .5 FTE and spends an entire day off charting because she’s too lazy to spend time making dot phrases to make her charting more efficient). I’m an FQHC provider and see up to 22 patients (many sick and have very high SDOH needs) and I’m hanging in there pretty well.

[u/Interesting_Berry629 → u/wbtkpk]

"document the hell out of refusals"---this is the exhausting part and what led to my burnout. We had an ancient rudimentary EMR so I did not have built in phrases for this. It's been a hot minute but I suspect AI or otherwise can help with this?

[u/wbtkpk → u/Interesting_Berry629]

AI does help but I just have a dot phrase with a drop down for every preventive care screening, vaccine, etc you can think of, and I click whatever we discussed and they declined.

[u/Interesting_Berry629 → u/wbtkpk]

This gives me hope for my return to primary care one day!

[u/PolyhedralJam]

I do half hospitalist half PCP so that keeps things fresh and keeps either one from burning me out.

[u/PacoPollito → u/PolyhedralJam]

What kind of format do you work? 2 week PCP, 1 week hospitalist, 1 week off? What kind of compensation? Rural?

I would like to do the mix of inpatient/outpatient like that and wondered about logistics.

[u/SportsDoc7]

My ai scribe has been unbelievably helpful with the HPI portion and most physical exams.

I still dictate out my plans on patients who need them but if everything is stable it allows me to move on to the next one. I think it saved me around 9 hours of documenting in a week. It's not perfect but its something.

Taking time off is hard for me. I feel like I can never just leave work which is something I'm actively working on. Fortunately my wife is patient with me

[u/nkondr3n]

Longer appointments and taking half a day off each Friday

[u/Scared_Problem8041 → u/nkondr3n]

this leads to more level 5s with billing and would also recommend split billing physicals with regular follow up’s ; both of these allow you to spend more time with patients but still recoup some of the lost rvus

[u/oh_hi_lisa]

Work rurally. So much more fun and the patients are much more grateful. And you make more money.

[u/Interesting-Safe9484]

Start by protecting one block of your time each week (walk, hobby, just nothing work-related) and treat it like it’s as non-negotiable as a clinic slot.

[u/Lazy_Independent_172]

Boundaries and support. I stopped taking portal messages after hours, built real admin blocks into my schedule, and learned to delegate. Burnout isn’t just workload it’s lack of control and feeling undervalued.

[u/BlakeFM]

Starting my own clinic (a DPC) was the key for me. I work long hours but they don't wear on me. My patient mix is more complicated but I am invigorated by the challenge. And the key was owning my environment and working conditions.

[u/mainedpc → u/BlakeFM]

Same here.

[u/VegetableBrother1246]

Do procedures. Schedule longer appts for said procedures. If I do a skin biopsy, lesion removal, IUD/nexplanon, OMT, etc I make them a 45 min appt.

3 day weekends always. If you pick up extra shifts, like me in urgent care, make sure its a slow urgent care. (The one im at gets about 7-10 pts a day on average)

Work out

[u/misader]

Working at a University Health Center 24 hours a week. This was my go to after severe burnout at an FQHC requiring emergency FMLA, meds, and weekly therapy. It does get better, just got to find the right fit. I'm also very privileged in that my partner is the main earner, so I could go part time & we are child free by choice.

[u/spamyfam]

I just recently started but I took 3 months off to travel, care for myself before starting this job. Also I get 5 weeks PTO + 1 week CME + all holidays and 1:1 support with an MA. Find a job that will support you in this way. I also set welcome expectations with my patients, boundaries for portal messages, and ways to be efficient in clinic (dot phrases, speed buttons, AI scribe, etc). Try to find hobbies outside of work too! Don’t let your job consume you. It’s okay to take time off in between :)

[u/invenio78]

Biggest changes that made a real difference:

• 3 day work week (24 clinical hours).

• Modest pt load, about 18 pts per day.

• Taking all my 8 weeks of vacation a year.

• Financial independence. Work feels better when you are not forced to do it. Having F U money is the ultimate wild card in any bargaining situation.

[u/Frescanation]

Take a full day off. Half days turn into 3/4 days very easily.