In a recent interview with MedpageToday, Surgeon General Vivek Murthy, MD, MBA addresses physician burnout. While what he said about physician burnout being on the rise is true, he failed to discuss the true causes. And he offers no tangible solutions other than stating the fact that burnt out doctors do not always make good doctors. The Surgeon General Indeed missed the mark about physician burn out.
While he discusses emotional well-being, no one can argue that this is novel goal. No one can just wish themselves balanced. While work-life balance is an issue with doctors, it always has been and always will be. Doctors are not necessarily burning out because of this. We are not going to become unstressed by talk therapy or “seeking serenity”. Most doctors enjoy their work; it is just all the outside forces Dr. Murthy failed to discuss what is the true cause of physician burnout.
Why are doctors burning out?
– Doctors start their careers in debt for the most part. This debt for many is in the hundreds of thousands. Doctors are not all rich and financially stable as the stereotype that prevails.
– The government is in charge of our exam rooms. They are pumping out new mandates and regulations all the time devising ways to force us to comply and cut our reimbursements. Imagine you work at a job where an outside party comes and changes the rules of how you perform your job every few months. This would be stressful for anyone.
– Overhead costs are rising, inflation keeps climbing, yet doctors salaries have not changed much in over a decade. And often we are doing more work for this.
– Third parties intrude on medical decision-making. Doctors often feel medical care is out of their control and they can only watch as their patients are denied the proper medical care. That is not why anyone of us went to medical school.
– Executives are running the show. They decide how many patients many doctors see, even how many times a day we must wash our hands. If we speak up to make our work-place better, we are labeled disruptive and who wants that. This dominance has turned many doctors passive and forced them just to endure whatever is thrown at them.
– Malpractice tensions are huge. Any patient can sue any doctor at any time for any reason. A doctor’s career can be destroyed by one lawsuit. When we treat patients, we don’t only need to give them the best medical care, we often must cover our bases in order not to be sued.
Doctors who burn out often have no remedy or support. They are left to face the fires on their own. Many simply give up under the strain of it all. There are several studies that show doctors are retiring at earlier ages than in past years. Burn out is a key reason.
While Dr. Murthy finds emotional well-being through yoga and healthy eating, for the rest of us doing the downward dog pose doesn’t fix the stress of fighting an EHR that doesn’t do what it is supposed to or an insurance company that refuses to cover a medication a patient needs. Eating 5 servings of veggies a day is not going to ward off liability threats or unhappy patients. An apple a day never did keep the doctor away and it sure won’t protect us from run away government mandates. Dr. Murthy is in a unique position to address the problem of physician burn out. But, he failed to offer any substantial remedy or any true discussion. His healthy lifestyle may work well for him, but for the rest of us, we need a healthcare system that serves patients and not executives and politicians.
Copyright secured by Digiprove © 2016 Linda Girgis, MD, FAAFP
I appreciate your article and your effort to list out causes of burn out that were missed in the referenced article. Many of the causes you listed are the same as those faced in veterinary medicine; some are different. We have a lot of compassion fatigue as well as burnout. That said, I did not have the same Dr-Murthy-doesn’t-get-it impression. I suspect the author of the article chose not to focus on causality, but from other things I’ve read I think Murthy “gets it” about burnout and other challenges he is facing. I’m glad he offered some hope.
Here is an excerpt from the referenced article:
—–“But there’s a growing body of science that tells us there are things we can do to develop our emotional well-being proactively, and that in turn can have a positive impact on our health.”
Murthy noting that promoting well-being doesn’t require reinventing the wheel as there are already programs focused on emotional well-being that have significant outcomes for health and education, but people just don’t know about them.
“Sharing success stories is going to be an important part of expanding our prevention efforts,” he said. —–
I offer one of the most important tools I’ve used to help me with burnout and compassion fatigue is lovingkindness meditation. This is part of my success story, that this meditation technique has bolstered my self-compassion along with my empathy and compassion for others. The result is that I am better able to stand up for myself and calmly inform clients and staff what I can do, what I will not do, and why; all the while truly having compassion and empathy for their situation. This way I can help others without compromising my wellbeing and integrity. While not a panacea, it is one solution and one success story.
Thank you for your insightful article. Let’s hope that more discussion of burnout and compassion fatigue will reduce stigma.
Great to be bringing awareness to this!
Having personally “been there” I have a blog with my experience and some suggestions.
Jamessmithweb.wordpress.com
Feel free to contribute to it!
Jim
The government is only in the exam rooms because like always not every physician is or was honest. I remember the days of medcaid/medicare fraud. Drs right and left were being indited for various reasons. Unfortunately we all suffer.
The answer is to return physician to leadership. Become empowered. Seizing control is not only ethical, it is necessary to protect patient interests.
Please engage.
http://www.Physician-CEO.com
I was once a pediatrician, and by many accounts, a pretty good one.
And now I teach public high school.
http://doyle-scienceteach.blogspot.com/2012/08/why-i-left-medicine-to-teach.html
Don’t forget Medical Board complaints which can often be worse than a lawsuit as you are guilty until proven innocent so that the boards can meet their “discipline quota”. So much for jury of peers.
Dr. Linda
Great and timely topic
Next year there is a CME conference at St. George’s University Grenada. This would be a great presentation. Contact Dr. Bruce Bonanno.
Stan Sujka, MD, class of 1982
Thanks! How do I contact him?
I think Dr. Girgis did give a solution. One that would save billions of dollars.
Get the government out of the exam room.
You sound like every other physician that’s blaming the system instead of trying to understand it. Costs are a huge concern and physics need to get over the fact that this will effect their clinical decision making. You simply listed a bunch of problems without offering solutions as well.
Kavin Shah. Perhaps you sound like every other computer/tech person/business person/politician/policy maker who has taken no time to put yourself in the place of the physician. We the physicians agree that costs are out of control. We pay the insurance premiums for ourselves, families and our staff. The problem is that in order to save money you need to target the areas where money is being spent and lost: pharmacueticals/hospitals/surgery centers/and DME. Technology dfoes not replace the skill and years of training of a physician. The current proposedf changes puts in places regulations that will prevent a doc from practicing good medicine. Given that we take our Hippocratic oath seriously and we are devoted to our patients, many of us have no choice but to leave medicine. What will end of happening is a true class system where the wealthy will pay for their healthcare from private physicians. The good Docs that practice medicine bc it is their calling will leave. What is happening in medicine today such as mandtaed EHR, MACRA, etc will bring about the downfall of American medicine.