The Guatemala Test: Leadership, Burnout, and What Really Matters

Leading Through Burnout: How Leaders Can Model Balance While Struggling

By Dr. Alen Voskanian

There’s a particular irony in being asked to speak about burnout while feeling underwater yourself—actively Googling “signs of burnout” between back-to-back meetings. As leaders, we advocate for work-life balance while struggling to achieve it ourselves.

Burnout doesn’t discriminate. It affects everyone from frontline nurses to corporate leaders across industries, and the summer season that promised rest and renewal often became just another reminder of how far we’ve drifted from our own advice.

The Systems That Burn Us Out

Before diving into personal strategies, let’s acknowledge a fundamental truth: most of us entered our fields with a clear purpose, only to find ourselves buried under bureaucracy that creates distance from our core mission. Leaders everywhere burn out not because we lose passion, but because our systems haven’t evolved to support sustainable work practices. Various inefficiencies create what I call “pebbles in the shoes”—small interruptions that accumulate into major issues over time.

We’re not burning out because we lack resilience. We’re burning out because we’re working in systems that need significant improvements.

Leadership Takeaway: Recognize that individual burnout often reflects systemic problems, not personal failure.

When the Expert Needs Help

Early in my career as a physician, I experienced severe burnout myself. I felt disconnected from my purpose and questioned my path in healthcare. That experience led me to make two major career pivots, each time searching for better alignment with my core mission.

Writing my book on physician wellness, Reclaiming the Joy of Medicine: Finding Purpose, Fulfillment, and Happiness in Today’s Medical Industry, was as much about my own journey as sharing strategies with others. But even after extensive research and self-reflection, I still find myself struggling with the same challenges I write about. The difference now is awareness of the patterns and having frameworks to navigate them.

The Mind, Body, Heart Framework

Burnout prevention can be organized into three interconnected areas that help me reset when the system feels overwhelming:

Mind: Reframe Perfectionism

The cognitive beliefs that fuel our unhappiness often center on perfectionism – the belief that anything less than an “A+” is failure. When you’ve spent your career being the best, a single negative review or complaint can feel devastating.

This perfectionism trap affects leaders everywhere:

• CEOs devastated by one negative board comment
• Managers paralyzed by a single team member’s criticism
• Executives who see any project delay as personal failure

Leadership Takeaway: Create “B+ is OK” zones where your team can deliver without overpolishing. Model this by publicly celebrating “good enough” solutions that move projects forward.

Body: Non-Negotiable Physical Practices

Physical practices aren’t luxuries—they’re necessities. I wake up early every day to go to the gym, not because I love 5 AM workouts, but because physical activity is non-negotiable for my mental health.

Essential body practices include:

• Regular exercise (scheduled like any important meeting)
• Proper nutrition and hydration
• Adequate sleep
• Mindfulness moments throughout the day

One simple practice: Every time I put my hand on a patient’s door handle, I take a deep breath and commit to being fully present. Every leader can adapt this – take a breath before entering any meeting and commit to being fully present.

Leadership Takeaway: Treat health habits as non-negotiable meetings on your calendar. Block time for exercise, meals, and brief mindfulness moments.

Heart: Stay Connected to Your Why

The heart represents our why—the passion and purpose that drew us to our field. For me, this means staying connected to patient care even as administrative responsibilities expand, because that direct connection keeps me grounded and energized.

Leadership Takeaway: Protect one activity each week that connects you to your core mission. Whether it’s mentoring, customer visits, or hands-on project work, maintain that vital connection.

Leading by Example, Imperfectly

The pressure to “lead by example” when you’re struggling can feel overwhelming. How do you advocate for boundaries while working 70-hour weeks? How do you promote self-care while skipping meals and losing sleep?

The answer, I’ve learned, is authenticity and vulnerability. I share my struggles with my team, acknowledging when I’m off-balance while still committed to the principles I believe in.

Concrete example: I’m careful about sending emails outside of working hours. I use the “send later” function to schedule messages for Monday morning, preventing my team from feeling pressured to respond on weekends.

Systems-Level Solutions

Individual strategies are important, but we also need organizational changes. My team has implemented several that made real differences:

Calendar Wellness

• Meetings are 45 minutes instead of an hour, with 15-minute buffers
• Friday afternoons are blocked for project time and thinking
• Morning meetings before 10 AM are limited to 15-30 minutes

Communication Wellness

• Established norms around email etiquette
• Reduced overwhelming message floods across multiple platforms
• Used BCC appropriately and intentional recipient lists
• Saved hours of unnecessary back-and-forth

Leadership Takeaway:

• Shorten meetings to create breathing room
• Limit after-hours communication with delayed-send emails
• Regularly audit workflows for small, fixable frictions

The Guatemala Test

Recently, I had to decide on a mission trip to Guatemala with my son. Despite my overwhelming workload, I chose to go. This decision crystallized my thinking about evaluating opportunities against core values.

The Guatemala trip aligned with my ‘why’ in multiple ways:

• Medical service (professional mission)
• Time with family (personal priority)
• Opportunity to model priorities for my children (leadership example)

When I measure requests against these core values – helping others, being present for family, and staying true to my medical mission – decisions become clearer. It reminded me that the antidote to burnout isn’t just rest, it’s realignment.

Your Next Right Decision

Balance isn’t a destination; it’s an ongoing practice. There will always be seasons of intensity and seasons of calm. The key is being intentional about both.

For leaders, start here:

Start small and be consistent. Perfect balance is a myth. Instead, aim for alignment with your values and purpose.

Prioritize the non-negotiables. Whether it’s your child’s recital, your morning workout, or simply taking a breath before each meeting.

Acknowledge the struggle. Struggling with these challenges doesn’t make you weak or hypocritical—it makes you human. Sometimes the most powerful way to lead by example is showing others it’s okay to struggle while striving to do better.

The system may need disruption for significant transformation, but we don’t have to burn out while working toward improvements.

This week, choose one decision that honors what matters most to you, even if it conflicts with your inbox or calendar. Maybe it’s blocking Friday afternoons for thinking time, saying yes to your child’s recital despite the competing meeting, or taking that trip you’ve been postponing.

After all, no one remembers how many emails you sent, but they do remember how you made them feel—even when you were running on fumes.

What’s your Guatemala Test?