I Can’t Believe It’s Not Burnout?

Big news from the ivory towers over a JAMA editorial.  There are some heated battles going between researchers and academics on whether to call the term “physician burnout” or “physician depression”.  Here is a taste:

  • “The term burnout has taken on meaning far beyond what is understood about it as an actual diagnosis or even a syndrome. The medical profession has taken a self-reported complaint of unhappiness and dissatisfaction and turned it into a call for action on what is claimed to be a national epidemic,” the editorial says.
  • “What is more important to note is the high level of depression as a criterion-based diagnosis, with a more clear understanding of pathophysiology and consequences including student, resident, and physician suicide. This would be a more worthy area of focus. It is possible that the use of the term ‘burnout’ has increased as a sort of more acceptable substitute for a diagnosis that still carries considerable stigma, namely depression,” he said.
  • “Effective responses have already been crafted. Two good systematic reviews and meta-analyses demonstrate effectiveness of interventions.  Nevertheless, we have much room to improve. Physicians and those they serve will benefit from continued research on the causes of burnout and associated development of more effective individual and organizational level interventions,” Trockel says.

The names of the people pontificating about this subject are irrelevant.  Why?  Because the one commonality between them all is that they DO NOT PRACTICE MEDICINE FULL TIME OR AT ALL!

Who cares what we call it?  We need to go after the cause and these same idiots that are quoted for these types of articles are the same idiots that caused it by agreeing to bogus metrics, insurance-based EMRs, quality measures and and on and on.  They created the mess and then pretend they didn’t.  They get the AMA and the AAFP and and the ACP and so on to agree to their recommendations and when those fail they come back later with brilliant solutions that fail again.

The system is broken because of these people and the organizations that support them.  I don’t know all the answers but one of them is to have physicians work with patients directly. We need to get the third parties out of the way, let the free market work and then let’s see who gets burned out.

And I have proof this works.

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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] 

  5 comments for “I Can’t Believe It’s Not Burnout?

  1. James Tinsley
    October 13, 2018 at 9:12 pm

    Why don’t they recommend we call PTSD depression? Enough of us at the the Hampton VA complained of burnout they made it a topic at a doctors meeting. They recommend we rub a golf ball under my foot and take more time for myself. Thanks Captain Obvious. I spend 11-12 hours a day at work. 1-2 hours with the kids then 7-8 hours of sleep. So I’m supposed to take for myself from my kids or my sleep. all after they admitted that the physician suicide rate is higher than the veteran suicide rate.

  2. DrPhil
    October 12, 2018 at 12:13 am

    Actually they are incorrect – it should be physician adjustment disorder (DSM V) depression is defined as endogenous where it is present even if a stressor is removed.

    Reminds me of the old adage – the whippings will continue until morale improves!

  3. George Voigtlander
    October 7, 2018 at 9:38 am

    The pundits fail to understand that “burned out” or whatever term you use, affects not just physicians but also their patients. Industrial medicine is a system that hurts patients and physicians. The emphasis on profit as the main measure of success of a system is a disaster for patients and physicians. CMS doesn’t know how to measure quality. They keep doing things that not only don’t improve care of patients but actually detract from it.
    Physicians, like attornies, provide time and knowledge, counting checked boxes is not quality improvement.
    Remember, dissent IS patriotic!

    • James Tinsley
      October 13, 2018 at 8:29 pm

      It’s a disaster for our families too.

  4. October 7, 2018 at 8:44 am

    Amen, Doug, Amen!

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