In the high-stress world of healthcare, burnout continues to present critical challenges for medical practice leaders. But what if our traditional approach to addressing burnout is actually making the problem worse? Steve Brewer, DHSc, MBA, FACMPE, Chief Operating Officer of GI Associates, offers a unique perspective that challenges how healthcare professionals think about workplace stress and mental well-being.
Drawing from his personal experiences, leadership insights, and psychological research, Brewer outlines how negative thinking patterns contribute to burnout. He offers actionable strategies for healthcare leaders to foster resilience, build positive workplace environments, and take care of their own well-being. Brewer discusses themes and strategies explored in his latest MGMA article: Can Focusing on Burnout Cause More Burnout?
Recognizing the trap of repetitive negative thinking
Brewer first explored how focusing excessively on burnout symptoms can deepen those very feelings. "The idea struck me one time when I was in some meetings and we spent most of the time complaining about dynamics that we were frustrated with," he recalls. “We were talking about how it was really compounding frustration and burnout, and we didn’t really do any kind of practice problem solving.”
This observation resonated across early-career leaders, clinicians, and even family members who quickly felt disillusioned in their roles. Brewer notes that human brains are predisposed to negativity bias, adding,
"Our brains are pre-wired to be on the look out for something that's going to go wrong," he highlights. Left unchecked, this repetitive negative thinking can become an ingrained habit that deepens stress and burnout.
Moving from awareness to positive action
Recognizing challenges such as "pajama time" (late-night administrative work) is essential, but Brewer emphasizes a more proactive approach. "You start with not being afraid to face reality," he explains, referencing transformational and adaptive leadership models.
Instead of falling into hopelessness, Brewer advocated pausing to acknowledge the situation, re-centering, and asking, "What are we going to proactively do about it in a way that personally fits with what our goals and values are?" He stressed the importance of making positive problem-solving the focus of conversations, preventing negative cycles from dominating team cultures.
The brain under chronic stress: What leaders need to know
When under sustained stress, the brain's architecture changes. As Brewer explains, "The neuron connections, receptors and different synapses actually get stronger … and it actually can shrink what’s called the prefrontal cortex." Neuroplasticity means the brain adapts to what it frequently experiences—good or bad.
"If we're always in crisis mode, our neurotransmitters like norepinephrine are quicker to release … and then just makes it quicker to react and go right to that negative part," Brewer warned.
Despite these strong reactions, Brewer highlights that some of these negative effects can be reversed with intentional practice.
Spotting depressive rumination before it takes hold
A concept Brewer discussed in depth is "depressive rumination," where individuals wake up each day expecting the worst. "I think of it as you wake up in the morning and then you’re like ‘I’m awake. Here’s the morning. I’m depressed. Today’s going to go bad and it’s not going to work out.’ Our thinking gets more narrow and then sure enough … they just have this self-fulfilling prophecy.” He says.
He likened this to the phenomenon where, after shopping for a new car, you suddenly see that model everywhere. "You’ve just become more attuned to that," he explains “That’s kind of how we attend to what we think about.” In the case of burnout, focusing excessively on negative experiences wires the brain to spot and amplify additional negativity.
Harnessing the "Broaden and Build" theory
Brewer introduces Barbara Fredrickson's "Broaden and Build" theory from positive psychology. According to Fredrickson’s theory, when we allow ourselves to experience positive emotions, our vision broadens and we become more open to relationships, new ideas, and creative solutions.
Brewer stresses that positive thinking isn’t about denying challenges but about consciously practicing gratitude, reframing experiences, and nurturing optimism. "These aren’t one-and-done kind of exercises,” he emphasizes. “It’s almost like any other exercise or fitness routine. It has to become things that you build on and practice."
Creating effective wellness programs without reinforcing burnout
Discussing workplace wellness programs, Brewer cautions against initiatives that inadvertently reinforce burnout narratives. To remedy this, he emphasizes creating environments that are naturally positive and supportive without constantly reminding people of their negative emotions.
“There’s structural things that we need to think about to give people the tools and the environment to be successful,” he says, adding, “We want people to be healthier. We want people to have better wellness, so we have these classes, and that burnout thing will start to take care of itself without always causing the calling attention to it.”
Rather than framing wellness initiatives as "combating burnout," Brewer says organizations should focus on promoting overall well-being, better work-life balance, and professional satisfaction. "When we get others around us to relax and enjoy some of their day, they become more creative problem solvers."
Healthcare leaders must prioritize their own resiliency
Brewer cites an MGMA Stat poll where fewer than half of healthcare leaders have taken steps to support their own resiliency. He warns that leaders often prioritize the well-being of their teams while neglecting themselves.
"Leaders are people too," Brewer emphasizes. He encourages leaders to reframe self-care not as selfishness, but as a responsibility to better serve their teams and families. Whether it's better sleep, healthy lifestyle choices, or openly discussing well-being, taking care of themselves allows leaders to role-model resilience and strength for their organizations.
Actionable takeaways for addressing burnout within your practice
- Acknowledge reality, then act
- Recognize and address depressive rumination early
- Counter chronic stress with positive practices
- Shift meeting dynamics toward problem-solving
- Design wellness programs focused on well-being, not burnout
- Practice and model the “Broaden and Build” approach
- Reframe leadership roles around building resilience
- Prioritize self-care as a leader
Resources:
- MGMA Stat Poll on Healthcare Leader Resiliency
- Barbara Fredrickson's Broaden and Build Theory research
- MGMA article: Can Focusing on Burnout Cause More Burnout?
- Connect with Steve Brewer on LinkedIn
- Email Steve Brewer at steve.brewer@giassoc.org
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