Todd Shryock

 later today for the Fall Physician Bootcamp and make a difference for your patients and your practice.

We understand it takes more than the things you learned in medical school to run a successful business.

Our Fall event is bringing you all new curated resources to help your practice operate more efficiently, while also improving patient care. Our experts are here to answer any questions you might have about malpractice, membership medicine, remote patient monitoring, and EHRs.

Hear about current medical professional liability trends affecting health care professionals, learn to recognize vulnerabilities in your practice, and learn strategies to mitigate your risks and reduce the chances of being named in a lawsuit.



Debunking the myths of Membership Medicine

Learn the truth about membership-based medicine, and find out how a membership-based model can benefit both physicians and patients. Hear directly from a physician and patient on how their experiences in a membership model compares to traditional primary care.

Building a successful RPM program that captures the tangible and intangible benefits

Receive an in-depth review of how to build a successful remote patient monitoring program. Our speaker will provide attendees with a blueprint on implementing RPM in their practice successfully, followed by the benefits of RPM for providers, clinical staff, administrative staff, and patients.

Success by design: How EHR technology can ease the transition to value-based care

Learn how value-based insurance contracts can increase your revenue, give you more time to provide better care for your patients, and how to get started. Find out how documentation and reporting requirements are different in value-based insurance contracts, and how your EHR can make value-based success easy.

To register for the free Fall Bootcamp, click 

Articles

Providing beyond the classroom business training for physicians. Sign up now for today's free event!

It's not too late to sign up for today's Fall Physician Bootcamp

 Thursday, Sept. 15, 2022, for the Fall Physician Bootcamp and make a difference for your patients and your practice. 

Hear about current medical professional liability trends affecting health care professionals, learn to recognize vulnerabilities in your practice, and learn strategies to mitigate your risks and reduce the chances of being named in a lawsuit.

Providing beyond the classroom business training for physicians.

Register now for the free Fall Physician Bootcamp

Current economic conditions have created uncertainty for physicians and their portfolios. Inflation is rising and, as the Federal Reserve tries to keep it under control, so are interest rates. These uncertain times are new to many investors who are used to decades of stable financial conditions and may be wondering what moves are needed to protect their investments.

Medical Economics® spoke with Jeff Pratt, CRC, about how physicians should approach investing. Pratt is a financial adviser for Finity Group, a Portland, Oregon-based financial planning firm that specializes in working with medical professionals. Responses have been edited for length and clarity.

Medical Economics® (ME): How big a threat can high inflation be to an investment portfolio?

Jeff Pratt: Real returns are where the rubber hits the road. An investor might see a return of 7% on their portfolio in a given year. However, what if inflation for the same year was measured by the consumer price index at 9%? On paper, that’s a real return loss of 2% since the portfolio growth didn’t keep pace with inflation for the same year. Another thing to consider with inflation is overall consumer spending habits. In our current environment with inflation running a little hotter, let’s take a pound of coffee from the store as an example (of a) good that can be purchased. More likely than not, that pound of coffee from the store is more expensive today than it was six, nine, or 12 months ago. At the same time, most people are probably still buying the pound of coffee from the store even though it’s a little more expensive in the moment. Folks might not be happy with that, but the good is still being purchased. What if inflation gets to a point where instead of simply being unhappy with the price of such a good, consumers shift their spending altogether as to not purchase the pound of coffee from the store anymore because it becomes too expensive? Inflation can only outpace wage growth for so long before consumer spending is negatively impacted, and drop-off in consumer spending could lead to an economic slowdown.

ME: With inflation on the rise, what should physicians do to protect their investments, particularly if they are nearing retirement?

JP: Whether it’s inflation or any other factor, investors should remain focused on their long-term goals and be cognizant of not taking on risk — or too much risk, at the very least — they can’t handle. Let’s contextualize this. Say physician No. 1 is nearing retirement with a $5 million investment portfolio. Let’s also assume they anticipate only needing to draw $100,000 per year from their investment portfolio to meet their retirement lifestyle needs due to other income sources. Using just this vacuum of a scenario, this hypothetical physician No. 1 may not need to adjust much in their portfolio even with inflation on the rise.

We’ll continue in a vacuum scenario with only two inputs. Physician No. 2 has the same dollar amount investment portfolio at $5 million. To support their retirement lifestyle, though, they need to draw $500,000 per year from the portfolio. This is quite a faster drawdown and, if we saw a downturn in portfolio balance, would likely have a larger overall impact on retirement planning than (in the case of) physician No. 1. It could be possible that with physician No. 2, their portfolio needs to be repositioned but what if they say they only want to plan around a life expectancy of another five years with no preferences on leaving wealth to heirs and/or charities?

Going back to physician No. 1, let’s say their life expectancy is 25 years but they also have huge goals of wanting to preserve as much wealth as possible to be passed on to their heirs/future generations? Any number of scenarios can be painted on paper as to address what physicians can do to protect their investments in a higher inflation environment. How to go about doing that, though, is going to depend on circumstances surrounding each person’s situation and goals.

ME: What are some investment types that can help protect against inflation?

JP: First thing that comes to mind is Government Series I Savings Bonds. Individuals can purchase these at the Treasury Direct website. The main things to be aware of with I Bonds is that each person is limited to purchasing a total of $15,000 per calendar year ($10,000 maximum electronic and $5,000 in paper bonds can be purchased). Once the I Bond is purchased, the money must be left in the bond for at least a year. Also, if cashed out in less than five years, then the previous three months’ accrued interest is forfeited. Because of this, Series I Bonds are most likely to be considered by folks with cash needs between one and five years out.

From a portfolio standpoint, it is important to remember that each inflationary environment is driven by a different series of factors or catalysts. There is no one-stop shop to inflation-proof a portfolio. However, within equities, investors may want to consider more of a focus on high-quality companies with competitive advantages that provide them with pricing power in their industries. The idea here is that these companies will be able to pass along price increases to consumers without significantly affecting demand or their profit margins. Fixed income typically struggles in an inflationary environment, but as an asset class it can still be an essential risk-management tool despite potential headwinds. Investors may want to look at shifting toward lower-duration bonds, which have less exposure to inflation and rising interest rates. As with any investment portfolio-related approach, though, it’s important to consider the whole puzzle and not just one piece of it. Some folks may be more impacted in their investment portfolio by inflation; others, not so much.

Every investor likely has goals, time horizons, risk tolerances and investment preferences unique to them. Take these considerations into account and be sure to maintain proper diversification that matches the investors’ specific time horizons and risk tolerance. With such an approach, folks might find they need to rebalance their portfolios back to their target asset allocation.

ME: With inflation rising quickly, some physicians might be tempted to start shifting around investments from stocks to bonds — is this type of movement a good idea?

JP: (It) depends on the goals and time horizons being considered. A physician approaching retirement who has continued to stay more heavily invested in stocks may want to consider reducing risk in their portfolio by increasing bond exposure. A physician who is young and doesn’t plan on retiring for 30-plus years may not need to do the same. Risk tolerance is always something that should be considered as well. The shorter time horizon a physician has on their money, the more conservative savings vehicle they might want to consider and vice versa. Someone with a long time horizon on an investment portfolio might find on paper they can or should be more aggressive with their investment strategy but if that’s not something they’re comfortable with, it may not be suitable to do so.

ME: If a physician was looking at retiring in the next three years, should they continue on that path or keep working so they can offset some of the losses to inflation they are likely to incur?

JP: A few questions to answer the question: If there are some losses in an investment portfolio due to inflation, are the losses projected to have a material negative impact on the retiring physician’s retirement income distribution strategy they want to start in the next three years? Is this hypothetical retiring physician at a typical retirement age of early to mid-60s? Older? Younger? What life expectancy are we planning around once the retirement distribution income strategy is started? The unique circumstances surrounding this hypothetical retiring physician could lead to both answers. It could be found that continuing on the current path is suitable. It could also be found that continuing to work is what’ll keep us on the highest probability path of success in relation to creating the retirement income distribution stream desired.

The right strategy can help protect your wealth and keep you on track for retirement.

Investing during record inflation

Editor's note: The information is this story was taken from a recent Medical Economics Bootcamp session. You can find the full video of the session

In 2019 and 2020, the Centers for Medicare & Medicaid Services created new reimbursement codes for providers to monitor and manage patient care remotely. Patients wear small monitoring devices connected to an app on a smartphone that sends data to the physician. Monitoring patients remotely can generate over $150 per patient per month. Remote patient monitoring (RPM) has been shown to improve outcomes for patients while much of the work is done by clinical staff, and it doesn’t require an excessive amount of time from the physician. With inflation hitting record highs and payers focusing more on positive patient outcomes, RPM is the perfect way to both boost revenue and improve patient outcomes. Not every patient is eligible for remote monitoring, but those with a diagnosis of obesity, diabetes or chronic pain usually are, along with patients who require pre- or postsurgical management. Now is the perfect time to see whether RPM makes economic sense for your practice.

Understand the available codes for RPM and the proper way to use them.

Learn about the benefits of RPM for both physicians and their patients.

Gain a full appreciation for the reimbursement/revenue potential of a successful RPM program.

How remote patient monitoring can boost your practice revenue and improve patient outcomes

In a time when inflation is rising, medical practices must look at every way possible to boost revenue. When you can accomplish that with existing patients in a way that also improves their outcomes, you have a solution that is helping both patient and practice health. Remote patient monitoring (RPM) provides exactly that. “(RPM) is a revenue stream that is remarkably untapped, despite how CMS (Centers for Medicare & Medicaid Services) backs it,” Shari Kappell, CPCO, CPPM, CPC, implementation and billing manager at CoachCare, says.

RPM is when a patient uses a wireless device that’s able to upload data in real time to a health care provider so they can track and monitor their condition from their practice. The data are relayed using a mobile app.

The old way of seeing a patient was to start with an in-office visit, then schedule a follow-up appointment for months later. That might be all you see of them unless something major occurs. If it does, now you’re either seeing them in the emergency department or as an inpatient if they have severe issues that haven’t been checked in months. With RPM, the person is transmitting their vitals and information in real time. Staffers are assisting with daily monitoring, which might save a trip to the hospital because a physician can intervene faster.

“RPM has a lot of great benefits for the provider,” Kappell says. “You can improve your patient care (and) connectivity with patients, and it’s flexible and efficient. You can monitor your patients before their health conditions get out of control, which is one of the huge benefits of having a (RPM) program.”

Another bonus is that once the physician orders RPM, a junior staffer can monitor the data and only involve the doctor when necessary. “Patients feel like there is more of a connection with their doctor, even though they are not actually speaking to the provider face-to-face,” Kappell says. “Having that connectivity to your provider and your care team is promoting that next level of care for patients. Accountability is driving patients to have better outcomes by having them become more active participants in their health care decisions.”

For example, one CoachCare study on patients who are obese found 86% more weight loss at the patient level for those using RPM compared with those who were not, and those using RPM stayed on the obesity program 30% longer.

Most patients are eligible for RPM, and although those with chronic conditions are often the best candidates, acute patients can also benefit. An RPM patient will need to have had a face-to-face visit over the past 12 months, with telehealth visits also qualifying.

“It’s really based on insurance coverage, to get a basic understanding of where coverage is for your key payers, but for the most part, insurances are covering RPM,” Kappell says.

If staffing is tight or already overburdened, the monitoring function can be outsourced. Kappell says all devices must be FDA approved, so consumer products such as Apple watches are not eligible for use in a RPM program.

As CMS and other payers move to more value-based care contracts, RPM is the perfect tool for physicians. “It’s intervening prior to a medical catastrophe,” Kappell says. “It’s low cost to patients (and is) creating consistent revenue streams for providers. It greatly reduces the chances of patients having to go undiagnosed for months by giving real-time data to providers in their care teams.”

Monitoring patients remotely can generate over $150 per patient per month.

Summer Bootcamp: Remote patient monitoring economics

While many Americans may think the COVID-19 threat is over, the vast majority of clinicians are still taking it very seriously.

In a Becton Dickinson/Harris Poll, 93% of clinicians say they are likely to recommend a COVID-19 test when a patient is experiencing symptoms, and 96% believe that the right tools for testing are critical for timely diagnosis and care. And because COVID and the flu have similar symptoms, 87% indicated they are interested in purchasing a combination test for their practice.

“It can be incredibly challenging for medical providers to differentiate between COVID-19 symptoms and symptoms of other very common upper respiratory complaints, including influenza, allergies, the common cold,” said Jeff Andrews, vice president Medical Affairs, Integrated Diagnostic Solutions, BD Life Sciences, in a statement. “This is because many of these symptoms overlap and are present in several of these complaints such as coughing, sneezing and sore throat. The best way for clinicians and patients to know is to test.”

The survey found that about nine in 10 clinicians perform COVID testing, with almost two-thirds saying they conduct tests on site and 25% saying they send samples to a lab. For clinicians who conduct COVID testing, the average number of tests in the past month is 116.

They study also found that 92% of clinicians expect patients to question whether they have COVID-19 or allergies, and 86% expect a surge of patients that will require testing during the upcoming flu season.

Moreover, 66% say they would be willing to pay more for the ability to have digitally read test results, and/or the ability to automatically report results to health authorities (62%). Clinicians cited reliability of results (81%), cost (76%), timeliness of results (75%) and ease of use (69%) as the top factors that would make them more interested in using flu/COVID-19 combination tests.

PCR tests were viewed as effective by 99% of those surveyed, while 86% said rapid antigen tests are effective. However, 97% say a mixture of either rapid molecular or antigen testing with PCR confirmatory testing as effective for detecting COVID-19.

The vast majority (93%) say that reliable and widely available testing of all types is one of the most important ways to stop the spread of COVID. The same number agree that rapid antigen at-home COVID-19 testing is a good solution for patients who cannot schedule a time at a testing facility or doctor’s office, while 88% would encourage patients to purchase at-home rapid antigen tests for COVID-19.

The research was conducted online in the U.S. by The Harris Poll on behalf of and commissioned by BD and surveyed 300 clinicians whose primary medical specialty is family practice, general practice or internal medicine. The survey was conducted from March 28 to April 12, 2022.

Two-thirds report conducting on-site testing.

Poll: Clinicians say COVID-19 testing remains critical

Burnout has become as much a part of medicine as the stethoscope, with too many doctors feeling overworked, over-regulated, and underappreciated. The result is physicians retiring early, changing careers, or losing their love of medicine at a time when there is already a shortage of primary care physicians.

In the Medical Economics 2019 Physician Burnout Survey, 92 percent of respondents indicated they have felt burned out from practicing medicine at some point in their career, 68 percent said they are burned out right now, and 73 percent said they have thought about quitting medicine. Despite the prevalence and scope of the problem, only 13 percent plan to seek or have sought professional counseling.

Solutions are elusive, because the causes can vary by specialty, location, or practice, and doctors rarely have any control over contributing factors like regulations or EHR design. But that doesn’t mean all doctors have given up or are willing to tolerate the status quo. In fact, as burnout has become increasingly common among physicians, so, too, has the fight against it.

Here are the stories of seven health professionals and what they are doing to battle burnout in the profession.

Gabe Charbonneau, MDFamily Medicine, Stevensville, Montana

Gabe Charbonneau, MD, experienced burnout in 2009 when the demands of practice limited the time he and his wife, also a practicing physician, were able to spend with their new son. When the family grew to three kids, something had to change. His solution was to share a practice with his wife, so that one of them would always be at the practice while the other was with the kids.

“It was super scary, but the best decision we ever made,” says Charbonneau. “We gave up a massive amount of income and had to throw some material things overboard, but our quality of life went way up.”

From there, he began to think about how he could help other doctors fight burnout. “I met so many people who were intelligent, smart, and good doctors, but they were stuck with issues that were insurmountable,” says Charbonneau. “I had an idea that I needed to come up with something symbolic that would give hope to these smart people that they could get to a better place than where we were stuck.”

The result was an image of the Rod of Asclepius being lifted out of the ashes by a phoenix that he printed on a shirt and displayed on his website, fightburnout.org. The American Medical Association wrote an article about his efforts, interest in the shirts and the cause grew, and now he describes himself as “an accidental person who became an expert on burnout.”

He hopes that his efforts lead to greater awareness of the problem, and that employers will take a hard look at physician workloads and start indexing their burnout so they can measure progress-or lack thereof.

“Leaders often talk about well-being and burnout, but it doesn’t make it onto their financial spreadsheets,” he says. “They offer wellness classes and nice things that are supposed to be helpful, but there is no accountability for physician well-being. They can make a decision in the boardroom that can destroy their doctors, because they are chasing after every dollar.”

One proven solution for reducing burnout is to have physicians meet in a social setting outside of work to share experiences, where they can see they are not alone in their feelings and can share coping advice, he says. There is also a doctor-to-doctor peer support group on Facebook if no local group is available.

“I throw down the challenge that all of us need to start to help unravel this problem before we lose more good physicians and drive them out of medicine,” he says. “I know we can do better. As a society, we have to own this problem.”


Tyree Winters, DO, wanted to be a physician since he was five, with a great desire to help others. “But then you get out there and realize it can be a thankless job,” says Winters. “Even though you want to help people, sometimes as much as you do, it’s never enough.”

His loss of interest created an internal conflict: What do you do when you’ve wanted to be a physician your entire life only to achieve your goal and realize that maybe it wasn’t the best choice?

The breaking point came about five years ago. His mother had just passed away, and the next day, while trying to be both an administrator and filling in as a pediatrician, he diagnosed a child with a cold and offered the mother advice on basic care measures that would help. The mother was furious, telling him, “You don’t care about my child. You physicians don’t care about anything.”

“It was the perfect storm,” he says. “I was thinking to myself that I don’t want to do this anymore.” Winters accepted the fact that he was burned out and needed help, not only by seeking counsel, but also in identifying what his passion was. He found a different way to reach his dream of helping people.

“Even if I’m not seeing patients, I’m doing things like teaching and attending community events, using my medical degree to educate people to make an impact in their lives,” says Winters, who is medical director of the Healthstart Pediatric Clinic and associate program director of pediatric residency for Atlantic Health System. “That’s what motivated me to get over the feeling of burnout. I’m not immune to burnout, but I want to get up in the morning.”

Winters says medical students need to be educated on the challenges of being a physician and the risks of burnout. “They need to be able to seek help-not even professional counseling, but just surrounding themselves with individuals who are going through the same thing. There’s an unwritten rule where doctors are taught to believe if you are not able to handle things, then that’s a weakness. So people keep it to themselves and we need to get over that stigma.”

Winters says doctors don’t always recognize signs of burnout in themselves, such as apathy, or coping through alcohol or food. “They write it off as just having a bad day or just needing some sleep,” he says.

Physicians need to focus on what brings joy in their lives and find a way to escape from the rigors of their day. He recommends finding a couple of hours to do something that isn’t work-related, whether it’s exercising, binge-watching Netflix, or in his case, dancing.

“Doctors have to be able to step away and just live their life,” he says. “And don’t be afraid to be open and direct with your supervisor or department chair to tell them you are starting to feel burned out and that you are looking for advice. You might be surprised how a lot of institutions respond.”

ACP vice president for clinical education, Philadelphia

Smith leads the ACP’s efforts to demystify and build awareness about burnout, including how physicians can identify warning signs in themselves. “We need to fix the water clinicians are swimming in,” says Smith. “We know medical students are more resilient when they start medical school, but their risks increase as they complete their training.”

She says it’s important for doctors to recognize burnout in colleagues, because it can be contagious, spreading through an entire staff. “It is part of your responsibility to not only identify and address it when you see colleagues suffering, but to also help intervene and fix the overall culture.

“The overall causes of burnout are a workload where people keep adding more and more things to front-line clinicians, but nothing gets taken away,” says Smith.

Physicians should look for sudden changes in behavior in their colleagues as a warning sign that all is not well. “If someone who was outgoing and is now withdrawn, that can be an indicator,” says Smith. Missing meetings or conferences, or even not answering pages can also be a sign of potential burnout. Physical pain, difficulty sleeping, changing appetite or a crisis of confidence are other warning signs.

“They may have a lack of confidence in their work that comes from a sense of powerlessness because they can’t change things or make things better,” she says. “They may become more cynical, be quick to anger or have relationship problems or trouble getting along with family or friends.”

The ACP has resources on its website for physicians who feel burned out and has trained a cadre of 160 members around the country to fight burnout. “Our message is, don’t worry, you are not alone in this,” says Smith. “This is a common issue and a problem that everyone needs help with sometimes. We encourage them to reach out to a friend, a colleague or call their employee assistance line-whatever they feel comfortable with.”

In addition, the ACP is looking to patients as allies in fighting burnout. “The same things that bother doctors are bothering patients,” says Smith. “They want more time together. We think if we join forces with patients and patient advocacy groups to reform healthcare delivery, we might be successful.”

Internist and AMA practice transformation officer, Oak Park, Ill.

Brown says that many organizations are well intentioned when they set up mindfulness training or yoga classes for physicians, but that while such programs may be helpful in some regards, they can also contribute to burnout.

“Offering classes without fixing the working environment just sends the doctor home an hour later and exacerbates their time away from their family, and takes away time that could be used for exercise or sleep,” says Brown. “We also know burned out physicians write more prescriptions, send out more referrals, make more errors, order more tests, and have higher readmission rates. In every other profession, the higher the education level, the more control the person has over their day and the work they do, with the exception of physicians.”

Brown focuses much of her efforts on helping doctors find small solutions to free up more time. “They often say, ‘What can I do, I can’t fix the whole system?’” says Brown. “What I suggest is to begin by looking at their practice and the things they control.”

For example, Brown changed how she prescribes medication for chronically ill patients. It’s common to write a prescription for three months with one refill, so physicians are refilling the same prescription every six months. She suggests changing that to three months plus four refills, so that doctors are writing the prescription once per year. “If you do that, six months from now, the number of refills decreases by half,” says Brown. “With that extra hour, you can stop drowning long enough to see what else you can do.”

Another area to examine is the EHR. Brown says doctors need to look at all the notifications they are receiving. She turned off discharge summaries and notifications about tests that did not include results.

“I decreased my inbox by about 50 percent,” she says. “It doesn’t take any resources and doesn’t cost a lot of time. When you are at your wits end, this is something you can do tomorrow.” She also encourages physicians to seek peer-to-peer training on using their EHR more efficiently.
Whenever possible, make sure patients who require lab work have their labs completed before the visit. “That way when you see them, you’ll have everything you need to have a discussion,” says Brown.

“The greatest driver in preventing burnout is being able to deliver quality care, but there are so many obstacles that stop us from delivering it,” says Brown.

Urogynecologist, director of physician engagement, Rowan University School of Osteopathic Medicine, Stratford, NJ.

“If you do not have engaged physicians who have a vested interest in being there five years from now, you are not going to be able to provide a good patient experience,” says Adam S. Holzberg, DO, adding that healthcare organizations that want to improve their patient experience must tackle physician burnout. “Every study has shown that if you have engaged providers, the patient has a better experience and that results in better outcomes.”

Healthcare administrators must start by measuring burnout in their organization. They should do this by enlisting an outside company to survey the doctors, says Holzberg. “You have to be willing to then act on it and create an action plan,” he says.

Progress is possible when leaders take the time to listen. In a prior position, Holzberg helped move the physician engagement scores from the 24th percentile compared to the national average to the 73rd percentile in less than five years. “It wasn’t because we gave them so much more, we just listened to them,” says Holzberg. “We had good methods of communication.”

The organization created a blog to keep physicians up to date on changes. It included a way for doctors to make suggestions on how to improve working conditions. Doctors always got a response to their suggestions, even if they weren’t feasible. “You can say no with a good explanation-you would be surprised at how much they appreciate that compared to no response at all,” Holzberg says.

Listening is a great way to reduce burnout. “There’s not a lot that providers want,” says Holzberg. “They want to take care of patients, have a say in the plan for the organization, and have some recognition for what they do. They want to have the supplies and tools they need to do their jobs and do it without a lot of obstacles. If you pay attention to a lot of that, you will be surprised at how much difference it can make.”

Pulmonary/critical care fellow at Boston Medical Center



Swamy was a third-year medical resident working nights with two small children at home when burnout hit him. “I became very cynical and laughed about a lot of things-beyond the gallows humor physicians typically use to get by,” he says. “I was falling apart, getting less sleep, and I felt like I was failing with my patients and at home.” He says his work was becoming shoddy and he was being selfish and passing patients off to the next shift.

“It was unprofessional and a really bad spot for me,” he adds. “The big takeaway is, at the time, I could not have told you it was because I was burned out. I couldn’t recognize it in myself, and if I had done so, there were innumerable supports that could have helped.” When he rotated off that shift, his situation improved. Now, he advocates for doctors to look for signs of burnout in each other and to take action when they do.

He advises doctors who suspect a colleague might be heading for burnout to meet with them outside of work to discuss it. “Say, ‘Hey, is everything OK?’ or use other open-ended questions,” says Swamy. “You don’t have to say burnout, because people are often sensitive to that. They might be defensive in the moment, but it lays the groundwork to actually talk to them.”

Speak with them alone, he adds, and not from a position that implies they are unable to do their job. If there is no personal relationship, talk with someone who knows them better and tell them about your concerns. For residents, Swamy advises speaking to the chief resident, but choose your words carefully.

“There’s a big stigma speaking about mental health in medical culture, and burnout relates to that” says Swamy. “If you are in a world where you cannot show weakness and someone is very clearly suffering, the answer is not to go to their seniors and effectively say you think they are weak.

You never want to throw people under the bus.”

While he appreciates employers providing yoga or massages for physicians, those do not address the root causes of the problem. “I personally find a lot of wellness in running and doing yoga, but that doesn’t address the root cause of sitting in front of a computer going mad trying to click all the boxes.

“Burnout is a symptom of an incredibly broken healthcare system,” says Swamy. “It needs addressing, but the root causes are deep and pervasive."