Begin Your Journey: Addressing burnout in women urologists

In this installment of “Begin Your Journey,” urologist Diana Londoño, MD, talks with host Scott A. MacDiarmid, MD, FRCPSC, about burnout in women urologists. Londoño is a urologic oncology surgeon and assistant clinical professor in the department of surgery at the City of Hope National Medical Center in Duarte, California. MacDiarmid is a urologist with Alliance Urology Specialists in Greensboro, North Carolina.

MacDiarmid: Do you have any thoughts on burnout in your female colleagues that is unique to them?

Londoño: Women tend to be more in the caregiver role. And even if we are working full time, we still get a lot of the child care responsibilities as well. So even though we are working, we still bear the brunt of a lot of that. Women are socialized to be people pleasers, and to take care of everybody and say "yes" to everything. Because if you say "no" to something, then you're not being accommodating to others, and you're not being helpful. Women are raised to be "good girls" and say "yes" to everything. So saying, "no," I think for a woman can be a big challenge. And then we worry about what [people] think, because that's why people don't want to say no; they're worried about the judgment from others. So when you don't learn to say "no," then you're overwhelmed with all these things that you've said "yes" to, and your plate becomes fuller and fuller and fuller than it already is. We can't be superheroes and do everything. We know compensation is very different; we get compensated way less than our male colleagues. And then when you start realizing this, this really adds to your moral injury. How could that be fair with all the other responsibilities you have, and then we're getting underpaid, and then you're doing all these things without compensation, it starts adding up, and then you're going to be chronically depleted, and then you're going to get exhausted, and then just spiral down to burnout, and anxiety and depression, and sadly, suicide. We know for women, rates of anxiety, burnout, depression, and suicide are much higher than men. There's a lot to it.

MacDiarmid: Any last comments from you before we sign off?

Londoño: Just really try to have awareness; figure out, what do you really need right now? Once you realize what you need, have compassion, stop the judgment. It's very easy that once you realize something you start judging yourself harshly. Just have compassion; say, "Okay, I'm trying the best I can." And then take action. Really make it a point to change something. And it doesn't have to be a huge, major change. Little changes really add up to a different destination. So maybe every day, you just change something a little different, or maybe you practice gratitude. What am I grateful for today? What went well today? Or today I'm going to say "no" to something, or maybe I want to say "yes" to something. So be aware of your needs; that's important, and really come from compassion, from love for the self - it's not narcissistic - and take action, so that you can get to the place you want to be.

MacDiarmid: Excellent. Diana, for someone who I know loves her family, loves her patients, and has gone from the valley to the mountaintop, thank you so much for coming on today. I'm so grateful to be your friend, and thank you for helping us create a world that lifts all of us up to serve our country as physicians. Thanks a lot.

Londoño: Thank you so much. Thank you for your book; there are so many good tools. Having your voice as a male physician coming forward and really being a big advocate, I am just really grateful for all the work you're doing, you're going to do, and I'm so grateful for your friendship and that we came together and are trying to do this work together with everybody else that is really passionate about it. So thank you.

This transcript was edited for clarity.