On fire or burning out?

October 3rd, 2023

Torben Bergland, MD

I had decided to become a physician. In a few weeks, I would enter medical school. This day I was shadowing a cardiologist from church. He had kindly offered to give me a glimpse into a doctor’s day in the hospital. I was excited. It was my first day at a hospital in a white coat. I walked a step behind him into the morning meeting with all the other doctors. Then to the ward for rounds with the nurses seeing the patients, discussing symptoms, response to treatment, blood tests, ECGs, and medication. Later into the lab for cardiac ultrasounds seeing hearts beating, measuring their size, and assessing their function. As he diligently and considerately went about his work, I could see that he cared about his patients and that he was liked by the nurses and respected by his colleagues. He fit my image of what a good doctor would be like. Towards the end of the day, we had a little break. Another doctor, a pleasant man probably somewhere in his 50s, joined us and took an interest in me. When I happily and maybe with a hint of pride told him that I too would become a doctor, he countered with a penetrating question; “Can’t you find something better to do?” 

I will never forget that question, nor the man who asked it. “Can’t you find something better to do?” How many times had he asked himself that question? When was the first time it crept into his awareness? What was it like for him to get up every morning? To work long and tiring days, sometimes nights? Trying to uphold professional standards, serving the interests of his patients, the hospital administration, meanwhile being an agreeable colleague? All this, yet wishing he was not there. Maybe he did not know where he wanted to be, but at least he knew he did not want to be where he was.

This doctor most definitely was not on fire anymore. At some point as a student and in his early career, he probably was; with dreams, hopes, and ambitions. But now, he appeared to be burnt out; tired, discouraged, frustrated, disappointed, disillusioned, hopeless, possibly feeling let down and maybe feeling somewhat like a failure. What possibly started out as an important, meaningful, and challenging work, had become unpleasant, unfulfilling, and meaningless. The engagement that drove him through years of study, internship, and residency was gone. 

There are many like him in the workplace. What are the factors that make us prone to workplace burnout?

Person-job fit: Match or mismatch?

Christina Maslach and her colleagues (Maslach, Schaufeli, & Leiter, 2001) pioneered research on burnout and created a framework for understanding it. In their conceptualization of burnout, they focus on the potential match or mismatch between the worker and the work environment.  If the is match good, then the risk of burnout is low. On the other hand, if there is a significant mismatch then the risk of burnout increases. They identified six aspects of the work environment where a mismatch between what the job requires and provides on one side, and the needs of the worker on the other, may lead to burnout. One of them is workload, but there are five more that we typically may not think of.

1. Workload

We usually attribute burnout to an excessive workload over time. When we try to do too much in too little time with too few resources, eventually we become overstretched. A mismatch may even occur if the workload is reasonable, yet the skills, interests, or resources for the work are insufficient. Our energy and motivation are depleted, and our work efficiency and quality drops. Thus, we have a vicious cycle of diminishing work capacity and increasing unfinished work, and we are no longer able to keep up. Then, simply trying to work harder may worsen the situation rather than improve it, since it will just make us more tired.

2. Control

When we experience too little influence or too much responsibility in our work, we may have a crisis of control. We usually want to shape our work in the way we think is best in order to achieve the goals we are committed to. If we are forced to do things in a way we do not believe in, then our motivation is impacted, and it may be experienced as a threat to our dignity, and as a lack of trust and respect. On the other side, if we are given too much responsibility, if we lack the confidence, skills, and resources to fulfill it, then we may be overwhelmed with insecurity. 

3. Reward

Whenever we invest our hands, hearts, and minds into something, we want something to come out of it. That something may be money, but oftentimes the rewards we need and desire are on other levels. The satisfaction of having done something well, knowing that it has had an impact, being proud of it, and receiving recognition and appreciation from others, are rewards that may be far more valuable than money. Whenever the experience of reward is lacking, we may feel that we and our work are devalued.

4. Community

In order to thrive, we need positive connections with others. We function best when we are in a community with people we like and respect; when support, understanding, comfort, happiness, and humor are shared generously. On the other hand, isolation creates distance, or chronic, unresolved conflicts triggering feelings of anger, resentment, and hostility that are destructive to the community. 

5. Fairness

People need respect, self-worth, and dignity. Fairness communicates and confirms that. Cheating, corruption, manipulation, and abuse are upsetting and trigger fear, conflict, and distancing from colleagues and the workplace. When we or others are treated unfairly, then we do not perceive the organization or the individuals as reliable and trustworthy, and we distance ourselves emotionally.

6. Values

Inconsistency, conflicting values, or discrepancy between claimed values and actual practice places tension within organizations and among individuals. Mismatch in values may lead to considerable stress and alienation. The perception of benevolence and integrity in all aspects of operations is fundamental to healthy loyalty and identification.


It is recognized that the best places to work are “where employees trust the people they work for, have pride in the work they do, and enjoy the people they work with (Bush, 2018).” Our workplaces are something we create together. Whatever our roles or positions are, we may all contribute to building workplace cultures that uphold healthy work-life boundaries, honor the value and dignity of every individual, which cultivate community and practice fairness, and live benevolence and integrity as evident values. Then our workplaces may contribute to health and happiness, to keep us on fire, rather than burning us out.


  1. Bush, M. C. (2018). A Great Place To Work For All. Oakland, CA: Berrett-Koehler Publishers

  2. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job Burnout. Annual Review of Psychology, 52(1), 397–422.

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