The Joint Commission is Now on the Fix Physician Burnout Bandwagon
I received the above email and couldn’t believe it. The Joint Commission states that clinician distress is a problem and can affect patient care. No SH$T! And this is coming from an organization that CAUSES clinician distress. Imagine being so clueless, and without self-reflection, to not know this? They even have nice links on how to make you more resilient and improve your well being:
For more information on healthcare worker well-being, please access The Joint Commission’s Quick Safety, Issue 50: Developing resilience to combat nurse burnout and the National Academy of Medicine’s Resource Compendium for Healthcare Worker Well-Being.
Here was my response to the email:
“I don’t know of ONE physician who likes the Joint Commission. You are part of the cause of our burnout so don’t pretend to care. I believe I can speak for every doctor when I say GO F%CK YOURSELF!!”
I have not heard back from them.
The only other remedy for burnout and I understand it’s not possible for everyone is to retire. I hung on until age 64 and life is as good as it can be under the circumstances now.
My lovely spouse died of Radon induced lung cancer 3 years ago and I have guardianship of a 27 year old mentally handicapped son. My wife incidentally never smoked in her life and I had to get the house abated. Levels are extremely low now.
I was too tired of doing hospital work, take call and do office work. Weekend call could be terrible and we docs didn’t get call pay either. An office only practice might have been more workable but wasn’t available. So I retired. Primary care sucks.
No one wants to be sloppy with prescriptions, but I can’t generate any anxiety over inappropriate antibiotic prescriptions.
70% – SEVENTY PERCENT of all antibiotics in the USA are given to livestock.
https://www.cidrap.umn.edu/news-perspective/2016/12/fda-antibiotic-use-food-animals-continues-rise
If you want to see multi-drug resistant bacteria, try the meat counter at your supermarket.
One of the JC’s standards for accreditation is the use of patient satisfaction surveys. Surely that has nothing to do with inappropriate antibiotic prescribing?
Be clear.
Be polite.
But-be assertive, vocal and direct.
Do not wait for them to come to their senses.
Be unpleasant. Use the mass of your numbers to effect change.
Learn American Black history. Not one advance took place without nonviolent struggle against oppression.
That is not “race theory,” whatever that might mean.
All Americans should learn how to fight oppression, for repression is universal. We should honor all those who showed how to fight it, and make it our pledge to continue and be vigilant against wrong.
The Joint Commission showing concern over burnout will be as effective as a U.S. celebrity wearing a Ukrainian flag pin in stopping the Russian invasion.
Myths reassure people that what they believe in, is comfortably true. That the world is simple and comprehensible, in spite of what painful reality they experience daily. When something central to human culture fails, we struggle to harden up the myth to avoid talking about the obvious decline.
The myth is the collapse of care is simple to understand, of an easily characterized and obvious cause, and can be intelligently repaired. Of course, especially in healthcare, not one of these claims is true. The American myth is that failures of every sort are due to easy, cheap and simple deviations from right thinking and right practice.
We are encouraged to inflict these premises upon patients. They have heart disease and diabetes because they are fat and do not exercise. They are fat and do not exercise because they are of a lesser strain than we, the sensible, smart and noble. They are Morlocks, and we are the Eloi.
We have allowed our approach to psychology to shift towards the dark side in practice. One side of psychology struggles to liberate the human from one’s own internal frustrations and limitations, that we can grow. The dark side is the goal of understanding people in a more primitive and occult manner, understanding the things that they do not realize as individuals about themselves, in order to manipulate them by tactics and rules to be of profitable service to interested entities. The first is analogous to Martin Buber’s Ich und Du, the relatedness of people to others like one’s self the second, to Ich und Es, related to people-as-things.
Now, the prevailing goals of “the healthcare industry” are the effective manipulation of the herd, to render them ever more profitable. It is driving towards a large-animal veterinary model. Long ago the physicians and nurses began to realize that, in fact, they are part of the herd, not the owners.
The myth that must be sold to the sapient herd is that their misery is due to their stupidity. Rather than being intrinsically valued, we are valued to the degree that we are saleable. This is the lie that we must embrace to remain docile.
Being “burned out” is our fault. We are defective animals that do not understand how to live in our environment. The Harvard Business Review reminds us, unlike most of the puff pieces on burnout, that “resolving burnout often requires changes at the job, team, or organizational level.” The only argument I have with this statement is that resolving burnout always requires changes at the job, team and organizational level.
They, of course, go on to remind us that exhaustion, cynicism, and inefficacy are the cursed triskelia of burnout. I should say that these three form a timeline. Inefficiency breeds exhaustion. Cynicism is merely the honest insight that one’s environment is damaging and nobody will change it.
It is perhaps cynical but certainly true to restate Laurance J. Peter’s observation that “whatever is unsustainable will stop.” Few people but physicians understand the principles that there are uninterruptible processes that lead inevitably to complete failure. People want one more myth for hope, even if there is no hope.
Modern 21st Century American Medicine is unsustainable. Such entities as the Joint Commission, the ABIM and such are the equivalent of the USO Christmas Shows in Vietnam, a distraction from the inevitable. They are a bureaucratic entertainment similar to the Burt the Turtle cartoons of the ’50’s teaching children how to survive a nuclear attack. Sadly, Burt the Turtle was just propaganda to sooth the existential dread of children about nuclear war. The fool-show walkthrough of the Joint Commission is simply an opportunity for sporadic goal-directed scavenger hunt games every year or so, to pretend that what they do will matter.
Reality, sadly, is painful. If something is unexpected and dismaying, very frequently it is Reality. We prefer to avoid such discomfort.
Just as the fiction of Medicare was sold as a wonderful program that could handle all of retirees’ health worries. The actual purpose of this medical version of Bert the Turtle was to sell the appearance of comprehensive, high quality, affordable care, not actually provide it.
Dear Doug: I am known as being rather outspoken and even confrontational when provoked but even I would have hesitated to put in writing your response although I certainly was thinking the same when reading their baloney! So thank you for calling them out!