In our recurring blog "Inbox" we share comments from physicians and practice administrators telling us what keeps them awake at night.
Editor's note: We work hard to write about issues that will help physicians run their practices in a manner that is both prosperous and efficient, while still delivering quality patient care. And we are delighted when our readers let us know what they are thinking. This month we are excerpting an article and slideshow that were written about the escalating problem of physician burnout. The articles have been edited for space and are followed by comments made by readers at PhysiciansPractice.com.
10 REVEALING QUOTES ON PHYSICIAN BURNOUT
Physicians are trained to be autonomous problem solvers. But that ability to function independently can be a downfall when it comes to dealing with workplace stress. Government mandates, awkward EHR technology, and quality reporting requirements are just making it harder to do what physicians do best: treat patients.
Most likely you have your own opinions about the stresses and challenges of being a physician. Don't be shy, tell us what you think in the comment section below. In the meantime, here's what our experts in the field have to say.
Stanley says: Medicine began as an art. We had limited diagnostic and therapeutic tools. An orange was an orange because it looked and tasted like an orange. Then Medicine became a science. The PDR grew; we had multiple sophisticated diagnostic tools, epidemiology studies, and effective therapy. An orange was an orange because the DNA sequence of the hairpin loop of the polyribosome was ACTG. This transition we all applaud! Now medicine is a business. An orange is an orange because I can do 47 tests and charge $607.35 to prove it is an orange: but I have to constantly reassure my patients and myself that we are more important than the computer. The humanism in medicine is gone and with it the satisfaction. No wonder we "burn out"! Nothing to balance the stress!
Tamzin writes: Medical care is not a proper function of government. I think the legislative, executive, and judicial branches should have to code everything they do. There should be a limited allowance for their "vacations." A citizen corps of checkers and monitors should shadow them daily. Also, no pay when they are absent from the job, and when they miss votes.
Government needs to be much smaller, so that they cannot hand out favors. The level of corruption in the USA is horrifying. Time for the docs to check out. Hey Hillary, you're being paged to the ER! There's a guy down here with DKA you need to see. And you, Obama, looks like an acute CVA in room 2.
David says: If you put anyone in a profession with high levels of responsibility and stress, erratic sleep patterns, decreasing appreciation and validation, high overhead and expense, and then put random amounts of money in their bank account from time to time, most people will quit and move on. Doctors tend to stick it out, after all, what else are we trained to do? No wonder we have personal lives that fall apart and we turn to destructive behavior to escape from all this stress. Something needs to change otherwise the profession that we hold in such high regard will be populated by doctors that are broken or those that don't care. Either way, it's bad news for our patients.
Brenda writes: Can we send this to Medicare and all the insurance companies, the Senate and House representatives, and our president? It took me 20 years to get control of my burnout and then reduce my practice to 250 patients with the MDVIP program. I now have a great life and practice.
David comments: I fight burnout by racing cars and chasing women. When I am going wheel to wheel with someone, I can't think of anything else. Adrenaline surge and complete escape. Yes, I have been in two wrecks, but that's another story.
Lee says: These comments are a sad commentary on the current state of medicine. Physicians are trained to be autonomous, are highly educated, and for the most part are very-well trained. Then they go out into practice and are subject to the nanny state, where regulations and unceasing directives that have nothing to with delivering quality medical care (except in government bureaucrat minds) are imposed. This creates an impossible situation for physicians to perform under. The situation is getting worse. Even physicians trained under the "new paradigm" are having trouble dealing with it, because the core mission of caring for patients is co-oped by doing what the bureaucracy wants. … Burnout is going to continue to accelerate. The system will eventually deal with this as the word gets out and the best and brightest no longer will go into medicine. The result will eventually be the selection of a new generation of physicians who are indifferent to patient concerns, but who will not experience burnout since they will be happy to comply with "directives."
STAMPING OUT PHYSICIAN BURNOUT
Physicians are trained to be autonomous problem solvers; enduring solitary, long hours on-call during internships and residencies. But that tendency to function independently can be a downfall when it comes to dealing well with workplace stress. Case in point: The rate of physician suicide is alarmingly high. According to an article in the Journal of Clinical Oncology, more than 400 physicians committed suicide in 2015. There are initiatives that have been launched to address the increasing stress that physicians - both those in training and in mid-career - find themselves under, but seemingly little headway has been made.
Asha writes: My biggest frustration in obstetrics is my experience with nursing. Nurses in labor and delivery are in control of patient management. They harass female doctors and are very sweet to the male doctors. Gender discrimination and hazing is widespread. This leads to my burnout and stress.
Bill says: Burnout will NEVER go away until MOC does.
Carolina comments: I agree with you. It is a big weight on our shoulders. The ABIM has given their answer already with a letter to all of us and "the change" is no change at all. But the flame is already dying. I have not seen any articles regarding the ABIM answer to the "MOC revolt." As always everything stays the same, no matter how much we complain. And yes. It IS the burnout talking.
Carolina says: "... And when asked if they would do things differently, 56 percent of physicians, a slight majority, said they would choose the same career path as they originally did."
This got lost in your article. ONLY 56 percent would choose the same career. Nearly half of us would not do what we are doing now, in spite of the majority liking being a doctor. Sadly what we do now is not medicine. We are clerks with a doctorate.
Alan writes: Great series of articles on physician stress and burnout. I have written many articles on how to address physician stress and burnout stressing the importance of physician satisfaction and engagement. In my experiences drawing limits and making time for relaxation are the right solutions, but physicians are so compulsive and overwhelmed that can’t make or take the time to do it. With that said, it becomes crucial for the organization in which the physician is associated with to take a pro-active role in trying to help physicians better adjust to the pressures of today’s complex health care environment. The major factors here are to (1) listen to what they have to say (2) show empathy (3) provide customized support (4) offer coaching and counseling, and (5) in some cases provide career guidance. Physicians are a precious resource and we need to do what we can to help them thrive.
Naomi says: I would love to show this to my chairman, but so far my academic institution has been completely unconcerned about, and even hostile towards, my comments that clinic is inefficient, run by the nursing managers and administrators, and understaffed. Even the ombudsman couldn't offer much in the way of optimism. It's so sad. I love practicing medicine, but I spend more time as a secretary than a physician. I may move and uproot my family in an attempt to stay in clinical medicine, because, of course, the non-compete forces me out of my city. I've been a doctor for 18 years, now make a pittance compared to what I used to. What has happened? Where is physician empathy and compassion towards our fellow physicians? This country and medical system needs to galvanize change. We are in deep trouble. Say good bye to talented docs if things don't start getting better soon.
Has your practice of medicine become burdensome? Tell us what you think; join the conversation at bit.ly/burnout-quotes and bit.ly/burnout-eliminate.