PHYSICIAN BURNOUT

It’s a real thing, and the changing façade of healthcare in the US is bringing doctors to their own brink before they hit middle age.

 

What do I mean?

 

Well, many of us in my generation went into medicine for the simple reason that we could help people, and in turn feel good about ourselves. All the while having job security in a very uncertain world.

 

Please note that I say “to have job security,” NOT “to be rich. “

 

Gone are the days of doctors leisurely golfing a couple of days a week and driving to work in their luxury cars. After all, when I entered medical school many of my peers were starting high paying jobs in the world of finance. I accrued more debt in tuition each year than they were making. But the goal was a long term one; we medical students told ourselves we’d put in our time (and money) so that we would have fruitful careers in the long run.

 

So if we didn’t go into medicine for the money or the easy lifestyle, we should be happy right? You’d think so, except that in order to sustain income these days, doctors are faced with LOTS of red tape and paper work. So called “Quality Measures” imposed by Medicare are a perfect example of this. Physicians need to check off so many boxes on electronic health records. If they fall short, they lose incentives or get penalized monetarily.

 

The more specialized you are the worse this scenario: for example, it takes me more time to fill out paperwork and dictate information related to a procedure than it takes me to do the procedure itself!

 

How is this better medicine?

 

Then you have the issue of medical liability. Ambulance chasers as well as reputable malpractice lawyers will gladly take a patient’s case, regardless of grounds. The number of malpractice cases has skyrocketed over the past few decades. According to one study by the American Medical Association, 6 out of 10 physicians 55 and older have been sued. 60 percent!

 

Meanwhile, studies show that more time spent with patients where a doctor communicates with them and shows empathy lessens their chances suing. Yet we have less time with each patient! And so medical liability insurance becomes another thorn in our sides.

 

How is this better medicine?

 

Reimbursements doctors get from insurance companies (commercial and governmental) for in office visits have gone down almost across the board. The number of patients a doc needs to see in a day to cover their costs has steadily increased since I left residency. So if we can’t add hours to the day (we wish!) then the main solution is to increase patients seen on the daily schedule. Which we know means less face time with each patient.

 

How is this better medicine?

 

So less time with each patient, more clerical issues to deal with just to get plummeting reimbursements, and higher costs to operate the business of being a physician make for a perfect storm.

 

No wonder so many physicians are leaving practice! No wonder so many doctors when asked if they would want their children to go into medicine say “NO WAY.”

 

The latest estimate predicts a physician shortage in the US of over 91,000 by the year 2020. Meanwhile the patient population in need of medical care is growing. This is mostly due to our booming elderly population, as well as expansion of covered people under new plans. The supply of doctors is falling woefully short of the demand of patients.

 

How sad indeed – bright minds and compassionate souls being dissuaded from the practice of medicine. No wonder we are so burnt out as a profession. Hippocrates is probably turning in his grave.