For those of us who practice medicine, there is a deep desire to care for people. To end pain and suffering. It is the one true passion that unifies everyone in healthcare. It comes from our hard-wired human instinct to help one another, and has been woven into our code of medical ethics since Hippocrates. The optimal medical system should promote these noble instincts. The current medical system, however, forces doctors to disengage them. It creates the problem known as Physician burnout.
Physician burnout
Physician burnout is a condition experienced by overworked and overstressed physicians. There are three main symptoms of burnout: disengagement from patients and the practice of medicine, emotional exhaustion, and reduced professional performance. Physician burnout is common and has recently received considerable attention; both in the media and in professional medical societies. Although measuring burnout is difficult, most surveys estimate that 50% of doctor's are currently experiencing burnout. Unfortunately, burnout is increasing over time. Physicians are now twice as likely to commit suicide as compared with the general population. Burnout affects physicians across all specialties, but it is particularly affects primary care.
It is important to understand that Physician burnout is really the symptom of a failing system, not the fault of the individual physician. Its potential causes have been traced to several issues in the system. These include:
Increased clerical work (Electronic medical records)
Dealing with insurance
Degradation of face-to-face time with patients
Decreased income
Increased patient load (to offset income decline)
Increased medico-legal threat
Decreased autonomy, excessive oversight
Increased complexity and technology in medicine
Most experts agree that the top candidate is increased clerical work. Ironically, the invention of the electronic medical record was supposed to make the practice of medicine more seamless and efficient. It seems to have backfired. Every one hour of direct patient care generates two hours of chart work. After working a 12-14 hour day, physicians spend an additional 2-3 hours at home, working late into the evening in what we would call “pajama time". According to Michael Schneck, MD, Professor of Neurology and Neurosurgery at Loyola University,
“We take people who are highly trained, highly educated individuals selected because of their motivations in terms of humanism and their ability to learn copious amounts of material, and we turn them into highly educated factory workers.”
Concierge Medicine and caring
Physician burnout is not a problem in my practice. All the above causes of burnout are absent. In fact, I enjoy practicing medicine today more than I did when I first graduated. My practice is small. I see 2-4 patients per day. The paperwork is very manageable, and I deal very little with insurance or medico-legal issues. I have no boss except for my patients; and my only concern is keeping them healthy.
I have no boss except for my patients; and my only concern is keeping them healthy.
However, the absence of Physician burnout is only the beginning of caring. A small practice gives me the opportunity to go much further. It give me the opportunity to get close to my patients. Every patient becomes important. Every patient becomes unique. No problem is too big and no problem is too small. I take the role of primary care doctor as it was originally intended. A doctor that develops a caring relationship with you. Taking charge and becoming accountable for your health. Getting involved with all facets of your health and guiding you through hardship and wellbeing. Health is a journey we experience together.