From Burnout to Flourishing: A Conversation with MaryCay Durrant

Human fulfillment expert MaryCay Durrant argues that physician leaders are among the most susceptible professionals to burnout — not despite their training and dedication, but in part because of it. In this conversation with SoundPractice host Mike Sacopulos, Durrant draws on 30 years of organizational transformation work and a deeply personal connection to physician leadership to present a nature-inspired framework for resilience. She introduces her WORK model — Wake up, Orient, Reimagine, Keep nourishing — and makes the case that lasting change emerges not from system-wide mandates, but from small, consistent adjustments practiced in communities of trust.

This transcript of the discussion has been edited for clarity and length.

Mike Sacopulos: You've spent your career doing transformation work inside large organizations, touching thousands of senior leaders at companies like Deloitte, Pepsi, Johnson & Johnson, and Hyatt. But you've increasingly found your way into healthcare. How did that happen?

MaryCay Durrant: What I found in my mid-30s was that there was a vast difference in organizations or teams when leaders possessed certain qualities or orientations to the way they work — orientations that either created a vibrant, vital place where people thrived or created a desolate, dry place where people got into burnout. I became passionate about what could help organizations create places where human beings flourished. Because what I believe is that when we flourish in our work, we go home more fulfilled to our families and communities.

I really didn't start my career in healthcare at all. I found my way into it because the things I have discovered along my 30-year inquiry into this question led me to believe that people who are doing deeply purposeful, mission-field work — which physicians and physician leaders are doing — are most susceptible to the dynamics in our workplaces that cause burnout, cause depletion, and limit the ability to fulfill who we were intended to be. I've been really blessed in the last decade to have the opportunity to work with physician leaders and physician executives inside different kinds of healthcare systems.

Sacopulos: I understand you also have a personal connection to physician leadership — through your father.

Durrant: I am so immensely proud of my dad. I'm one of six children, and my father was a pediatrician. He dedicated his whole life, not just to the six of us, but to the wellbeing of children in the world. He went into administration because he saw systemic issues — even 40 years ago — that he wanted to help change. He was the president of the American College of Physician Executives and a board chair. So, when I had the opportunity to join you today, my dad was really proud to see that I had found my way into a community that he holds very dear.

Sacopulos: When you're helping healthcare providers flourish, you're really helping patients as well. Do you agree?

Durrant: It's one of the things I feel most grateful for about this work. I look at the care that physicians are providing and feel so moved by the inspiration of their work and the dedication it requires. I feel very proud that I can be a small part of helping them find resilience in difficult circumstances — and find ways of working together that help the whole care team be both more effective and more fulfilled. I like to take a little bit of that patient care home in my heart, as gratitude for the work I get to be a part of.

Sacopulos: You speak about a shift from doing and performing to being and partnering. Why is this shift especially important for physician leaders?

Durrant: It's both important and challenging for physician leaders. When you think about the process by which someone becomes a physician, that process requires an intentional focus on doing, performing — at incredibly excellent levels that require an immense amount of grit to get there. By design, physician leaders have learned that doing, performing, and getting all the work done is how they achieve the outcomes they care about.

And yet we are not machines. We work in a world that really asks us to be machines — to produce at the timelines of machines, to be independent and highly productive. At some point, that becomes the very thing that drains us from the being side: the part of us where our values, our compassion, our essence — the things we most care about in our heart and spirit — fuel us for the energy of doing. They get nourished and replenished there. If we're only focused on production and doing, we're going to deplete ourselves into exhaustion and into burnout. Learning to balance that — to weave space for the being side into our days — is the beginning of having the resilience we need to navigate the complex, difficult systems that healthcare is today.

Sacopulos: Medicine is both an art and a science. I think there's a primary focus on science, perhaps because we have better metrics for it. How do you measure success when you're working with leaders on the less quantifiable side?

Durrant: One of the measures I love is something I call return on energy. We all measure ROI in our businesses and think a lot about that. Return on energy is something we can check in with ourselves on every day — or even in a moment — and ask: are the things I'm doing, and the way I'm doing them, draining energy out of me like a colander with leaks everywhere? Or are they returning energy to me? And can I get curious about why — and what tiny adjustments I might make?

What nature shows us is that small adjustments made consistently are how adaptation, innovation, and change happen. So, it's not about changing the whole system — that's where we get overwhelmed and feel like victims. It's about small, trackable adjustments. I also think you can extend this to a team. Are we increasing or decreasing trust among this small team? There was a beautiful article on the neuroscience of trust that connected it to energy, productivity, and the vitality and quality of work. These measures aren't quite as easy to track as numbers on a spreadsheet, but they are quite tangible.

Sacopulos: Can you give us an example of a leader or organization where you were able to demonstrate that kind of improvement?

Durrant: I'll give an example from a pediatric system. This physician executive's leadership was really in the area of clinical care, and she was moving from being nationally recognized to internationally recognized. As her leadership and the demands on her expanded, she found herself burned out and exhausted in ways she couldn't fully understand.

We spent some time in nature with horses. Horses are incredible mirrors for us of the patterns we're not aware of — especially those we fall back on under stress. If you're standing in front of a thousand-pound animal that is at liberty to move, your nervous system will be activated, and you'll be reacting more from unconscious patterns. In the horse mirroring those patterns back to you, you have a chance to see them clearly — and with small adjustment in your leadership, you can choose something more aligned with your values and your essence, with who you really are.

By translating what came up with the horse into leadership behaviors, this executive was able to understand how certain patterns that were sufficient when she was leading at a national level were insufficient for someone with an international presence. We then took some of those same practices into a series of workshops with her team — really designed around how do we move from being transactional with each other to relating at a deeper level of vulnerability and trust? What we discovered is that each person needed something that nobody else could have imagined or guessed. If we'd stayed in transactional mode, we'd never have found it.

What I love is that this team started to behave more like a murmuration of birds — where one bird makes a small adjustment to its wings, and all the others sense what might be needed. And here's the other dynamic that came out: if a bird in that flight pattern needs rest, it never lands alone. Other birds land with it, stay with it, and then rejoin the group. This team started to create those natural movements of care — and the whole team became more resilient.

Sacopulos: You use a word I hadn't encountered before: "stuckness." Can you tell us about it and how physician leaders might use it as a compass?

Durrant: Physicians get this concept intuitively when they're providing care for patients — because they are trained to notice stuckness in the systems they treat, whether that's a cardiac system or the overall well-being of a human being. Those moments of stuckness that they observe in a patient — the things that are not working or flowing the way healthy looks — they see as data. That data helps them identify the source of the problem, get at root causes, and move toward greater health.

What if we turned the lens around and looked at the places of frustration and stuckness in our own leadership? Rather than looking at the whole healthcare system, look close to home — look at a place of frustration in your team or your relationships — and ask: what might that be showing me as an opportunity for making small adjustments in the way I'm engaging? What movement toward greater health might that lead to?

Sacopulos: Can you share a story of a physician who was able to bring their human spirit alive at work — and how you helped them accomplish that?

Durrant: I'll share two stories. The first: I was working with a physician leader who had a complex group of teams providing care, but they were disconnected and siloed, and care quality was being diminished as a result. We looked at what we could see in a healthy ecosystem in nature that might help translate into how they were working together. This gave us the language to talk about what maybe needed to be pruned, what needed to be weeded out in the ways they were relating — things that were perhaps uncomfortable to name directly, but through a nature metaphor, suddenly became accessible. At the same time, we did some work on building trust, because we know that things that are connected grow. The combination of trust-building and truth-speaking through nature's systems broke through old patterns and started to create new, healthy ones.

The outcomes were measurable: quality of care went up, retention improved. But what made me most happy was that a couple of people came to me and said, "I have a better relationship with my ex out of this. I have a better relationship with my aging parent. I feel more engaged with my community." How we relate in one place, we relate everywhere. As we start to make small shifts at work and see positive outcomes, it flows into other areas of our life.

My second story speaks to physician executives who might sense something isn't working but can't name what it is. I had the opportunity to work with a physician who was running a very large system and was sensing things were off but couldn't identify the source. We spent a day hiking and noticing and interpreting what we were seeing around us and what nature might show us about the system she was inside of. What emerged for her was a series of small experiments she could try over the following six months. After that time, a large disruption — something like a wildfire — came to fruition. And she was prepared to navigate it, because she had trusted that gut instinct, gotten outside perspective from a living system that is always moving toward resilience and adaptability, and used those clues to experiment. This isn't rocket science — it's simply looking a little differently at the wisdom of nature that's all around us.

Sacopulos: Physicians are not always the easiest group to work with. Have you encountered resistance, and how do you overcome it?

Durrant: I have an immense respect for physician leaders and for what physicians do. I'll go back to my dad to answer this. My father had a hope around creating something for children's well-being that was very different than the system even 40 years ago. His passion, his care — all of who he poured into that — was unable to fulfill its potential because of some of the very training that had made him effective as a physician. What we've been trained to do well — to be logical, linear, decisive, to be the one in the room who moves things forward — that training isolates us. And as we elevate as leaders, it can become lonelier. We know that anything that is isolated is limited in its capacity to take in the creative solutions that problems require.

So, the challenge I run into is that training often has physician leaders ask, "What am I going to learn from nature or a horse? I have all this science and training." And what I try to do is be respectful of that, but also say: there is an art here, a dimension of humanity in yourself and in the people you work with and care for that is so much more than what science alone can see. Are you open to just exploring that a little? Some say no, and that's fine. But there's a growing number who say, "You know what, I feel better when I go out in my backyard and watch a sunset. I feel better sitting by the ocean." And so, I just say: take one more step — what if there's wisdom there beyond the feeling, that can actually give you insight?

Sacopulos: It sounds like these approaches can help address physician burnout, which is pervasive in healthcare. Can you describe how your approach works systemically?

Durrant: I think if we try to address burnout in the whole arc of a career or in the context of an entire system, it becomes overwhelming. But if we can look at how close to home we can address it, that's where our power for influence changes. Small adjustments compound over time into big movements we can't yet imagine.

So, the work model is to say: rather than the checklist-and-doing orientation, what if we took a slightly different approach to work every day? Each step of the model can help people begin to address the root causes of their burnout, and then apply that to the teams they lead. And importantly, how change happens in social systems — and in ecosystems — is through small communities of practice that network. Change doesn't happen because someone at the top mandates a new thing. It happens when people come together in small teams and form communities of practice, and then connect with other teams. That is how systems change. I really encourage a model of movement and network rather than mandate.

Sacopulos: Can you walk us through your WORK model and how physician leaders can apply it for themselves — and then model it for their organizations?

Durrant: The acronym is WORK. The W stands for waking up — and ideally waking up in wonder. Wonder can mean curiosity or something closer to awe. Waking up means noticing: the automatic ways we might be showing up at work, the depletion of our energy, the places we feel stuck. But it can also be waking up to something we love — remembering something we love. If we notice a particular patient, a kind of care, a passion, and then pause and say, "Where did this come from in my life?" — what we find is the magic of life. That if we hadn't been to this event, or met this person, or had that difficult experience that made us passionate about a particular kind of care, we wouldn't have the thing we love right now. Do that for a couple of weeks and you start to notice that all around you is a magic that is so much bigger than what logic and doing can create. Albert Einstein said it this way: the first and most important question every human being answers every minute of every day is, "Is the universe a friendly place?" When we access more wonder, we start to believe there's a flow of life we can tap into — and we soften our orientation so we're more receptive to feedback and to partnering.

The O is orient from the inside out. So often we orient to the checklist, the million things out there, the quality and control issues we need to address. But we forget the being side. When I get up in the morning, who am I — not as my title, but as a being? What do I care about showing up as today? What matters to me? What energy do I want to bring? Orienting regularly and noticing what's draining energy — and making small adjustments — is powerful over time.

The R is reimagine the way we relate. Look at the relationships around you in your work and ask: where am I in an adversarial posture, protecting myself from someone, and that's taking a lot of my energy? Or where am I relating transactionally, when we could be up to so much more if we moved a little closer to trust and partnering? I was talking to a CMO recently about the quality of their small network of deep trust, and how much that had given them energy for the hard work they do every day. We cannot achieve what we need to by simply powering through. We need to deepen our relationships.

And then the K: keep nourishing what matters. In the same way we might tend to a garden or to children — showing up for what we care about, consistently, in small ways — that's how the magic happens. It may not seem like it's enough to solve the big problems. But pick a small thing, work on it for a month, and then notice how your energy around it has changed. Notice the difference in your well-being. That gives us the motivation to keep revisiting the model.

Sacopulos: For members of our audience who would like to work with you — how do they reach you?

Durrant: I do several retreats where I bring physician leaders and executives together and really try to build that sense of community, so that people can go back to their systems with something to carry forward. I also do organizational work around cultures that embody these principles. The best way to find out about my work is my website at marykdurant.com.

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