I’ve come across several articles recently highlighting the Dr. Lorna Breen Healthcare Provider Protection Act. The primary stated intent of this is “to improve mental health among health care workers. It is named in honor of an emergency physician who died by suicide during the height of the COVID pandemic.
Although my very first thought was, “oh, thank God … they are finally listening,” that was quickly replaced with a sick feeling in my gut. Why? Because I realized that, like almost every other “resource” available to promote mental well-being in health care workers, the word resilience would inevitably show up. I looked at the official wording of the law and yep, it’s there. “Identify strategies to promote resiliency.” Sucker punch to the gut.
I can obviously only speak from the physician’s perspective, but I feel the anger welling up inside me every time I see this word. If you want to find a group of resilient people. you don’t need to look much further than a gaggle of doctors. We spend seemingly endless years studying, four years in one of the most academically grueling settings and then we do residencies which involve anywhere from 3 to 7 years switching rotations every 30 days, constantly adapting to new surroundings and expectations. We are simultaneously learning and making decisions (though with oversight during residency) that can single-handedly change the trajectories of our patients’ lives. We do this at the expense of our personal lives. Many of us delay dating, marriage and/or childbearing due to the demands that come with medical training. But we do this because we have been called to this profession. We sacrifice many things to be able to walk alongside patients as they navigate serious illnesses and the complicated health care system. We spend days continuing to fight for our patients with the storm cloud of insurance companies, regulations, ever-increasing administrative burdens hanging over our heads. Resilience? I’d say we have that in spades.
I recently spent some time doing practice questions for my hospice/palliative medicine board exam. I distinctly recall one question. The question stem presented a situation with a female physician who was suddenly becoming short with patients, angry with staff, and generally very cynical and jaded. I instantly recognized this physician. It was me. This was how I spent my last year in primary care, the most difficult year of my life thus far. I was enraged to find out that the correct answer was “Approach her with your concerns and suggest that she take advantage of resiliency training.” When I realized that this was the correct answer, the tears immediately began to flow. Tears of both sadness and anger. This is an absolute slap in the face for all physicians who are just barely getting by, digging deep for every ounce of empathy and compassion they can muster in the midst of severe mental angst from dealing with a ridiculous health care system. The same system which puts inhumane demands on its physicians and then has the nerve to suggest yoga, meditation or a pizza party to improve morale.
I truly hope that this new law does make it easier for physicians to access mental health services without the repercussions of having to report this every time we renew our licenses. But, here’s a thought. Perhaps Congress could also spend its time trying to actually address the root cause of the problem. Stop forcing physicians to see patients in 10 minutes. Stop incentivizing invasive procedures and testing and put more emphasis on giving physicians the time they need to properly address concerns. Force the insurance companies to stop practicing medicine. Allow us to actually put the patient first. Stop trying to fix the physician when the problem is the system.
I have finally found a niche in medicine where I am allowed to spend time with my patients and to provide the care that I deem necessary. I am forever grateful for the convoluted journey that has led me to this place. I am so lucky, and beyond grateful, to work for a health care system that does very much value its clinicians. We have forward-thinking leadership who have gone far beyond the insulting suggestions of lunch-time yoga and meditation. But, I can promise you this. I will never stop speaking out for those who aren’t this lucky.
Lauren Roth is a family physician.
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