The Burnout Trap

Every two years when I have to renew my state medical license, I get some standard questions, including whether I drink too much, use dirty needles, suffer from depression or anxiety, visit unlicensed brothels, run with scissors, or have any other condition or behavior that may impair my ability to safely treat patients.

Recent studies claim physician burnout to be at extraordinarily high levels, costing billions in lost services every year.  A lot of idiotic solutions to physician have been proffered, most of which involve adding even more time, delay, and stress in the form of “forced fun” to already hectic days.  A new “burnout-prevention” industry has sprung up, peddled by those who have not, or no longer see patients because it’s too hard.  We can bat around the term “burnout” or the more elegant term “moral injury,” but in any case we are discussing the loss of control, and the lack of enjoyment or feeling of reward in a job that for many of us is simply not fun, and barely preferable to unemployment.  While the solution of the DPC movement and its participants have my unqualified admiration, it is sadly not a realistic alternative for many due to age and economic obligations. 

Now the World Health Organization (WHO) is describing burnout as a medical diagnosis, including it “in the 11th Revision of the International Classification of Diseases as an ‘occupational phenomenon.'”  “WHO also announced that it would be releasing evidence-based guidelines concerning mental well-being in the workplace.”

Expect the usual suspects such as the AMA and AAFP to rush out with even more new guidelines, toolkits, helpful articles from helpful experts, and a systemic rush to help physicians without proposing a single, substantive fix.  CMS will jump on, show concern, and probably issue mandatory surveys for hospital staffs, penalizing said facilities if they show evidence of too much burnout without instituting CMS-approved burnout improvement strategies.  State medical board members will nod somberly, mandate anti-burnout CME’s, and inwardly thank their lucky stars they no longer have to see patients. 

All of this is a huge trap.  Any physician that voluntarily admits a psychiatric diagnosis to any third party is an idiot asking for a lifetime of trouble.  That is not to say that they should not seek help, but doctors should not share such info with their employer, the government, or even their own insurance carriers, as it will definitely be used against them.  This also applies to new diagnoses of “burnout.”  If recent reports are accurate, the majority of us suffer it.  And we had all better lie on any official survey, swear everything is just fine, and keep our mouths shut.

Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at AuthenticMedicine.com . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption.