Physicians at Risk for Burnout

Dr. Kimberly Becher made national news as a cautionary example of how burnout can literally break a physician’s heart.

By James E. Casto

Kimberly Becher, MD (’11), who completed both medical school and her family medicine residency at Marshall University’s Joan C. Edwards School of Medicine, is one of only two family doctors in Clay County, West Virginia. Working at the Community Care of West Virginia clinic in Clay, the tiny county seat, Dr. Becher is all too familiar with the challenges of providing care to a rural population, especially one that struggles with a high poverty rate and widespread food insecurity.

She threw herself into the job, giving it her all, frequently working at the clinic seven days a week, making home visits to people who couldn’t drive to the clinic and taking on advisory roles with local government as it worked to address the county’s problems.

Dr. Kimberly Becher walks her dog in Clay, West Virginia. An avid runner, Becher has had to take a break from intense exercise after developing “broken heart syndrome.”

Photo by Maddie McGarvey

Although Dr. Becher knew the amount of work she was taking on was unsustainable, “she couldn’t stop,” recalled her husband Mike. “It was like, she was helping people, and if she didn’t do it, then no one would.”

Then her body rebelled.

In April 2021, Dr. Becher felt like she was having a heart attack. Barely able to see and with her blood pressure dangerously high, she quickly made her way to the hospital.

There, tests showed that she had takotsubo cardiomyopathy, a rare heart disease that causes the tip of the left ventricle to stretch. Another name for the condition is “broken heart syndrome.” Its causes are unknown. The condition usually occurs in older women who have recently experienced intense physical or emotional distress, such as the death of a loved one or a serious accident.

After her heart “broke,” Dr. Becher immediately stopped all the work she had been doing, no longer seeing her patients and quitting every community board she was on. As she recovered on bed rest for a couple of weeks, she tried to figure out what had gone wrong.

“I wasn’t tough enough to follow the path I’d set myself on,” she wrote in a blog she posted, “No one put me in this position. I applied to medical school, I sought a job in rural primary care and I poured my identity into it. Takotsubo’s is typically caused by severe acute stress, something traumatic and abrupt. Mine was just from going to work every day.”

Over time, Dr. Becher realized that she had been severely overtaxing herself by taking on so many roles in an effort to care for her patients and improve their lives.

A rural physician, Dr. Becher sees patients at the Community Care of West Virginia in Clay. After working through the pandemic, she experienced a serious heart episode.

Photo by Maddie McGarvey

“Why had I said yes to doing so many home visits?” she wrote. “Why did I work so hard to make food accessible in this town that I don’t even live in? Why did I keep saying yes to everything anyone asked me to do?”

Today, Dr. Becher is back at work, but on a far more manageable basis. And she’s telling her story, hoping her “burnout” will be a cautionary example for other physicians to heed. Her experience has attracted wide notice, including a lengthy article in The New York Times

“I am shifting my focus toward helping other physicians learn from my mistakes, which means I have to actually tell my story,” Dr. Becher wrote in her blog. “I am definitely a work in progress, and I am always on the edge of a cliff, at risk of jumping back and putting myself in a position to be hurt again. But at least now I know there is a cliff.”

I am shifting my focus toward helping other physicians learn from my mistakes, which means I have to actually tell my story .

As Dr. Becher notes, her experience is far from unique.

Even before the COVID pandemic, burnout was a significant problem among physicians. A 2017 study of roughly 5,000 physicians published by the Mayo Clinic found that around 44% experienced at least one sign of burnout. Similarly, a 2019 report from the National Academy of Medicine found that 54% of physicians and nurses were burned out.

“And it’s not just health care professionals who are at risk of burnout,” Dr. Becher cautions.

“Teachers, people in law enforcement and, in fact, anyone in a high-stress job should be on guard against burnout. If you think you’re Superman or Superwoman and can do anything and everything, you could be headed for trouble.”

James E. Casto is the retired associate editor of The HeraldDispatch and author of a number of books on local history.