Physician Burnout
I truly believe that the public doesn’t understand what physicians do every day. We never had a reason to educate them before. All patients ever see is their doctors come into that small room, listen to their stories, hopefully give them some help, and then leave. Unfortunately, outside of that sterile box is where their physicians are constantly doing more and more work. A new survey mentioned in the American Medical News just came out and showed that eighty-seven percent of 2,069 physicians feel moderately or severely stressed or burned out daily. The top causes were the struggling economy (51.6%), health system reform (46.4%) and Centers for Medicare & Medicaid Services policies (41.2%) As for the breakdown of the stressors in the workplace:
- 39.8% named paperwork and administrative demands
- 33.3% cited long work hours
- 26.2% cited on-call schedules and expectations
Fourteen percent of physicians said stress had caused them to leave a practice. Telling you this is not to gain sympathy for physicians. I get that doctors tend to be on the higher end of income earners in this country. The problem is that doctors are being drawn away from directly doing what they were trained to do; that is to see patients. No one wants to take a hit in their salary, doctors included, but physicians are really feeling the toll of new mandates, hoops, regulations, red tape and non-medical gauntlets which are causing them to lose sight on why they went into this profession. Some people may not care about the increasing stress on physicians. They should. It’s just like in an airplane with those oxygen masks that parents are told to put on themselves first and then put on their children. The reason for this is that if the caretaker struggles trying to help then it is probable that they both will perish. Similarly, in the healthcare system we need to take care of the caretakers appropriately (before they perish) so they in turn may take care of you.
Yep, nurses burn out, just as the docs do. If you want a hint, check out the bait-and-switch that is the “Maggot Hospital” (although they call it “Magnet Hospital” Good nursing staffing (cough-bullshit-cough), support for the floor nurses (cough-ibid-cough), valuing what nurses do (need I repeat myself?) The reason docs ought to care about the above, is that our patients either do or do not get the care they require, depending upon whether the nurse on duty that shift has 4, or 14 patients. True story: I have personal knowledge of a 16 bed big city hospital ER that has been staffed with full knowledge of The Suits, with one (Yep: 1) Rn for Triage, floor care, charge, radio calls, rapid response to the house (interesting dilemma that would present!), and everything else the nurses need to do in a timely manner for minimally acceptable patient care. So, I have to say, the Evil Suits are crippling what effectiveness the system presently has!
In many hospitals the burnout extends to nurses, on call lab and rad tech, who may put in a 20 hour day. All the bureacratic nonsense is just another, and even more cynical way of rationing healthcare.
Paperwork, lawsuit-inspired regulations enacted by non-clinicians, inequalities in access to care, lack of the most basic support staff in my public clinic, and limited time for what I loved most—being present with the patient–led to the decision to save myself & quit altogether. Haven’t even bothered to maintain my license as I couldn’t imagine ever going back. Which is a shame for my underserved area in the under-represented specialty of psychiatry. But I could not continue having ALL the responsibility with less & less authority.
I was an FP working full-time in an ER until 3 years ago.
Regulations and computers more than doubled the amount of time it took to treat a patient. True, computers allowed me access to records more easily than a fat paper chart, but most of the stuff I had to wade through on the computers was pure BS, and it was almost impossible to figure out why the patient went to the doctor each time, because it was buried among questions about suicide, feeling safe at home, smoking cessation, etc. that had to be asked every time. Anyway, I got totally fed up with the laundry lists in the ER, the forms to fill out and the inability to get any follow-up, and the crazy hours, so I just quit.
I now do disability exams. M-F, 8-4.
One patient at a time.
If any clinical-type questions are asked, I’m not allowed to establish a D/P relationship, so I tell them to ask their doctor. The only treatment I’m allowed to do is if they are unstable or mention a red flag, I pick up the phone, call an ambulance, and get them the heck out of my office. And I get to go home earlier.
I mentored a HS student for a year. He got to see most (not all) of what I do. Part of the school requirement was for him to write a quarterly report to submit to the coordinator, and I was required to sign off on it. On one of his early reports he wrote that he was surprised to see how much goes on in the background; how much work is involved that is not direct patient care. (I’m not sure if I told him that much was also not billable). I wonder if the public would think we were so rich if we actually calculated how much we make per hour. I tried to do that once, but it can be hard because my work and my personal life have becomed so intertrined. Need a stopwatch…