Searching for Meaning

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David Bornstein did a real nice job in his NYT editorial entitled Medicine’s Search for Meaning.   He partly captures what it is like to walk in our shoes.  This is not a pity party for doctors.   It is a limited look at some of the stuff that tears us up inside.  He explains nicely the damage we have to absorb to get to the pinnacle of our careers only to see it fall apart due to burnout.   He then goes on to discuss a course called A Healer’s Art which really seems pretty intriguing.  Here is how it described:

The Healer’s Art is predicated on the idea that medicine is an ancient lineage that draws its strength from its core values: compassion, service, reverence for life and harmlessness. When students and doctors connect to these values in a community, they derive meaning and strength, and can “immunize” themselves against the assaults of the medical curriculum and even the health care system itself.

So, why isn’t this kind of thing more accepted?   I mean the description above could be described as Authentic Medicine.  The answer lies in loss of autonomy.    The problem is that physicians have none.   Many of us wish we go back to the time where we could connect with patients more.   That is so far behind us now that is laughable.  So no matter how much a course like this may make the doctors think they are “immunized against the health care system” they will be reminded of it the first day they are back in the clinic.   They will be reminded of it every time they rush through a patient visit who has 5 issues to be discussed in a ten minute appointment.  They will be reminded of it every time an administrator puts a new and useless mandate in place.  The will be reminded of it every time they get bogged down in a bloated EMR chart.   And on and on.  Pretty soon all the good will of the course is forgotten as the stress of the job comes right back.  You see, the easiest part of the job and the most fun part of the job is actually seeing and treating the patients. Unfortunately, it is the unbelievable amount of bureaucratic drag that tears it down to a point where everybody wants to quit.

Do you think I am wrong?  Bornstein goes on to say the following:

However, if hospital administrators are going to allow doctors to cut back on “productive” activities so they can take time to focus on self-care, he adds, “We’ll need to provide hard evidence for people making financial decisions that this is a good investment.”

Hospital administrators allow?  Hospital administrators allow!!!   He makes this statement so matter of fact but he ignores the obvious, that is the problem.  Hospital administrators have to allow us to heal ourselves?   That, my friends, as I have said on this blog so many times before, is what is really wrong with heathcare.   Loss of autonomy = Loss of meaning.

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  4 comments for “Searching for Meaning

  1. Pat
    October 2, 2013 at 12:23 am

    “Too long a sacrifice
    Can make a stone of the heart.
    O when may it suffice?” – W.B. Yeats

    It seems Mr. Bornstein would have physicians find strength and solace in collective ways. On the contrary, working in medicine has taught me the value of the individual, and that neither the patient nor the physician should be regarded as more valuable than the other. To do so makes a commodity of the lesser party. That doing one’s best for the patient is a proper interest of the physician does not change the fact that it IS the latter’s interest, goal, and desire. Medicine has taught me that when I subordinate my ethically pursued interests – my self – to another, that my best characteristics will then be used to enslave and corrupt me. For some of us, the job of seeing and treating patients ceased to be enjoyable long ago. Those same patients, through their agents – lawyers, politicians and establishment doctors, Big Insurance – have brought about the loss of autonomy that Doug so rightly names. All the campfire singing in the world will not bring back trust between physician and patient, or restore the autonomy of either.

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    • T
      October 2, 2013 at 11:40 am

      Then why don’t you do what other doctors have done? What the The Surgery Center in Oklahoma has done?

      And what’s that? WALK AWAY AND OPEN YOUR OWN SHOP – CASH ONLY!!!! NO INSURANCE!!

      A bunch of you need to get together and REBEL, against the rules. Go Galt.

      But you doctors are too chicken sh*t to do it, aren’t you?

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      • Pat
        October 2, 2013 at 1:07 pm

        T, you raise an excellent question. I think as more and more of this garbage is weighted upon us, you will see much more of that. Already a soft “Galt” is happening, with physicians limiting their scope of practice or retiring early, not to be replaced. Your criticism is also valid insofar as many of us daily balance the risk/gain and judge it not to be so dire – yet – as to risk financial ruin. The primary care docs will be best suited to go independent, until state laws catch up and prevent them from doing so (which will happen, as both Doug and I have written). The specialists/surgeons will have a tougher time but some will be able to ; good luck radiation oncologists. And admittedly, a number of us don’t have any other marketable skill and are just numb to this as anything other than a paycheck.

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  2. Allyagottadois
    October 1, 2013 at 7:34 am

    All you have to do is………………………..
    LOVE my career. HATE my job

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