Burned Out Over Burnout by Pat Conrad MD

This last weekend of summer – sigh – reminds us all that it’s important to take a breath, take a break, and focus on our own well being.  Or so that’s the word from the finger-on-the-pulse AAFP.  I stumbled over their section named “Focus on Physician Well-being.”  This included the following submissions:  For This FP, Faith and Family Life Help Stave Off Burnout; FP Achieves Wellness by Bucking Traditional Practice; Yoga, Volunteerism Help Medical Student Battle Burnout; A Year’s Reprieve in New Zealand Gives FP Fresh Perspective; Resident Confronts Burnout by Launching Wellness Program; Embracing Whole-Person Care Key to Beating Burnout, Says FP.

Further down the page are some more attention grabbers:  AAFP Joins National Collaborative to Promote Clinician Well-being; AAFP Joins House Members to Spark Burnout Awareness (c’mon, that reads funny); Speakers Chart Paths from Physician Burnout to Well-being; I Bounced back from Burnout by Setting Boundaries, Priorities; I Filled My Prescription Against Burnout at the Gym; After Hitting the Wall, How Do I Bounce Back?; Try PROBE Tool to Help Stave Off Burnout (not sure probe and tool are attractive in the same sentence); Can Mindfulness Meditation Deliver Us From Burnout?; Give Residents Tools to Turn Tide on Physician Burnout; and a final, absolute gem, Physician Burnout:  The AAFP is Winning Battles For You.

This all could be construed as one hell of a unique marketing campaign to attract would-be FP’s:  Get burned out, volunteer, pray, go to the gym, practice yoga and meditation, embrace yourself, escape to New Zealand!  It’s hard to see why med students aren’t beating down the doors.

Reading about the AAFP joining a national clinician well being collaborative yielded a couple of goodies.  This gabfest is called the Action Collaborative on Clinician Well-being and Resilience.  If you don’t think that name alone is hilarious on the irony alone, then this should help:  “The collaborative, which the AAFP helped launch as one of 36 inaugural sponsors, plans to publish reports, host public meetings and develop support tools for clinicians during 2017 and 2018. The goals are to improve systemic issues that lead to increased clinician burnout and provide resources for clinicians who seek support.”

Still not laughing?  Try this:  “Clif Knight, M.D., AAFP senior vice president for education, spoke at the meeting about the aims of the initiative. He said reducing burnout will require addressing sources of frustration throughout the health care system. The AAFP is preparing to roll out member tools and CME opportunities specifically for family physicians in the coming months.”  Now when have new CME opportunities not made you feel more relaxed, mindful, and self-embracing?

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Doug, if you are accepting new associate memberships to your Medical Axis of Evil, I’d like to nominate this specimen:  “EHRs were sold as being good for patient care, but they are actually used for billing,” said Lois Nora, M.D., J.D., M.B.A., president and CEO of the American Board of Medical Specialties. “How do we reframe it?”  No mob boss from the ABMS can take a back seat to anyone when it comes to causing physician burnout.

The med schoolers will be glad to know that, “More than 100 medical schools are helping their students by offering an elective course called healing arts that include five sessions where participants attend lectures and then break into groups to discuss their values and their reasons for entering medicine.”  That will really help on the USMLE Step 1 (remember kiddies, they won’t allow juice boxes in the exam room).

And if you are already long down the log flume?    “The Brigham and Women’s Hospital Center for Professionalism and Peer Support offers guidance on interactions with medical teams that promote mutual respect, trust and teamwork…”

And that should be an effective substitute for less hassle and better pay.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  8 comments for “Burned Out Over Burnout by Pat Conrad MD

  1. John Chamberlain
    September 3, 2017 at 4:02 pm

    There is a solution for primary care. Do away with insurance, do away with finance-centric EMRs, do away with 7-minute office visits, do away with 35-40 patients a day that get little or no value from your time (or theirs) other than a Rx and a pat on the head, do away with a waiting room full of co-pays, deductibles and other folderol.

    Really communicate with your patients, take the time you need to provide value to them, direct them to ancillary services that offer significant savings to them, in other words, practice medicine the way you want to, not the way that BUCA or CMS wants you to, which is certainly not to make your life or your patients’ life better, it’s to fatten their collective wallets.

    I’m talking about Direct Primary Care.

    Look into it.

    • Doug Farrago
      September 4, 2017 at 5:51 am


  2. Steve O'
    September 3, 2017 at 12:57 pm

    It reminds me how many Vietnam vets burned out after coming back from war. A lot of WWII guys did, too, and that wasn’t talked about much, but the VN vets were really bad. The answer was the same.

    Nobody gave a sh_t if they lived or died.

    How do you reframe that in the proper paradigm to motivate and raise self esteem??

    When you’re in a war that nobody’s running, nobody’s trying to do anything other than not being killed today, for the sake of honors and glory of the nonparticipants Stateside; if you’re lucky to come back breathing, and nobody cares – how do you keep people from expressing negativity?

    For my VV patients, it was alcohol and heroin. They help paradigm reframing. And suicide, of course – the big paradigm shifter.

    For primary care – Nobody gave a sh_t if you live or die, succeed or fail.

    So let’s “learn personal resilience skills, as well as taking a systems-based approach to identifying and combating root causes of physician burnout. Studies have found that self-awareness and mindfulness training can reduce physician burnout and increase both physician well-being and patient-centered qualities.” Anyone who’s taken Bullsh_t 101 can parse the message from that hymn from the AAFP – the Position Paper on Burnout.

    Nobody gave a sh_t if you live or die, succeed or fail.

    VN grunts understood that they were hamburger, and they’ve been mad about it since. What did they do to deserve such contempt. And, by the way, what about us?

    • Pat
      September 3, 2017 at 5:33 pm

      An excellent comparison.

      If I thought the AAFP bright enough – I don’t – I’d wonder at some sinister plan to keep recycling used up FP’s for the greater good. But no, I think they are either covering themselves, or they really believe this idiocy.

  3. Perry
    September 3, 2017 at 8:57 am

    You do NOT want to go into Primary Care.

  4. September 3, 2017 at 8:55 am

    They know where burnout ends, thanks to England and its single payer system: https://www.google.com/amp/s/amp.ft.com/content/16875d1c-8e4e-11e7-9084-d0c17942ba93

  5. Mark O'Brien, D.O. Private solo Family Physician
    September 3, 2017 at 8:18 am

    Doctors are burning out because EMRs are broken. Recent article in Quarts. Now that’s part of the problem. Onerous regulation and BS programs that serve nothing but keep people employed with our health insurance premiums. MACRA, MIPS. PCMH, Meaningful Use, and on and on and on. Administrators are blaming the doctors for noncompliance. Make their salaries that way. That is the root of burnout. All the yoga in the world won’t change that.

    • Mary Carney
      September 3, 2017 at 2:20 pm

      Agree wholeheartedly

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