Residents are Getting Burned Out

According to a study published in the Sept. 18 issue of the Journal of the American Medical Association symptoms of burnout and career choice regret are prevalent among U.S. resident physicians. The researchers found that 45.2 percent of 3,574 resident physicians reported symptoms of burnout. Overall, 14.1 percent of resident physicians reported career choice regret.

Residency is supposed to be hard.  This is what distinguishes us from those who are “not” doctors. Suck it up.

Al Jolson famously said in the Jazz Singer “Wait a minute, wait a minute I tell yer, you ain’t heard nothin’ yet” which marked the arrival of what from that moment on became known as the talkies, it instantly killing off the silent cinema.  Well, the same goes here.  As far as burnout goes, “you ain’t seen nothin’ yet”, because once you graduate you instantly killed off any semblance of normal life.  Such is the life of a doctor and comes with the territory.

Cheers.

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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] 

  6 comments for “Residents are Getting Burned Out

  1. James
    October 6, 2018 at 1:09 pm

    I just finished family medicine residency this year and have started my own DPC practice. Yes, residency is going to be hard because there is a lot to learn (my personal record is 61 hours awake, don’t believe the hype that duty hours have changed anything). But my fellow residents and I didn’t complain because of long hours and hard work treating patients, we complained for the same reason that is most of the basis for this newsletter. Imagine doing the same medically rigerous residency you did in the old days, and on top of that all the documentation, metrics, quality measures, etc that are making seasoned physicians burn out. And residents are burdened with even more tracking and bullshit paperwork than practicing doctors. I burned out, I regreted my career choice, and if it weren’t for DPC I would have left medicine. I am surprised that physicians, who are experts at empathy, can in one sentence complain about how all the joy and meaning has been sucked out of medicine, and in the next sentence condemn millennial residents for not being satisfied with their job. We are talking about the same problem, we just also work longer hours for less money. If you really want to change the system for the better, you should be supporting residents like me that turned down generous salary, benefits, and loan repayment from hospital systems to go out in my own and tell insurance companies to fuck off. I assure you that CMS and big healthcare are grooming tomorrow’s physicians, so that they don’t question new bullshit rules. You telling them they are wimps for having the same frustration and lack of meaning that you write about is just pushing them further to the dark side. Don’t be part of the problem, be part of the solution. As you say, be the change, in this matter as well. We need the next generation with us. Be well Doug.
    PS, I’m with you on basically everything else, love the letter and the DPC revolution

    • Doug Farrago
      October 6, 2018 at 11:07 pm

      Appreciate the feedback. My point really was to state that the worst may be yet to come. I am not condemning anyone. Residency is part of the gauntlet you just have to go through but there may be worst to come unless you take control of your life. It is great you went into DPC. You chose the right path.

  2. Kurt
    October 3, 2018 at 6:26 pm

    57 hours awake was my record in the bad old days. Doug is wrong. The specialty folks I’ve talked to, many are happy with their choices. Paid well, some don’t get much call time or if they do they’re not yanked in at all hours (Plastic surgeon: “Put saline soaked fluffs on the wound and put ’em on the schedule in the morning.) Or if they get called in they get paid well for doing it.
    Many an older specialist in the surgical fields in large groups don’t have to take call after age 60.
    Cardiologists too. There is a problem in cardiology because “aghast” the female cardiologists don’t want to do call or work weekends because lo’ and beholden they fell in love, got married and last I looked, children can result from such a situation. They wanna have a life! Imagine that!
    I know a female dean of a medical school who refused weekend call for 6 years in the medical group she started out in (before going into “administration”) and refused to work Wednesday night because it was “date night”. I was surprised the group put up with that for 6 years before telling her to leave. Then became an employed physician in academics. Primary care used to be ok as I told people what to do for good health and if they did it, they generally did ok. If they didn’t, I tried to pull them out of the hole. Now were being held accountable for the patients sins and it sucks big time.

  3. Martha O'Reilly
    September 29, 2018 at 8:48 pm

    Suck it up is what got us here. Suck it up is shitty advice. Suck it up prevents change. Suck it up blames the resdent and exonerates the system. Suck it up sucks

  4. Charles Merson, MD
    September 29, 2018 at 11:47 am

    Internship/Residency was grinding when I did 36 hour stints in Internal Medicine. I can only imagine what it would have been like with all the additional documentation and electronic filing that has to be done now. Are they trying to diminish the number of MD’s and DO’s out there for the alternatively cheaper nurse practitioner and PA? I came up with a phrase that pretty much sums it up:
    “Any idiot can produce a new piece of paperwork, it takes real genius to eliminate them.”

    • Steve O'
      September 29, 2018 at 4:27 pm

      Somehow we have come under thrall of primitive superstition that residency conveys magick powers; but the computer has recorded these arcane secrets, and can even recite them better than humans do.
      Text and numbers are the bricks and mortar of magick medicine; and what better idol is there than the Medical Computer to transmogrify them into cures?
      Healthcare is racing forward, according to our imagination. In Reality, it is getting worse and more expensive. But superstition dies slowly.

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