Healing patients shouldn’t be killing doctors

Healing others shouldn’t be killing you. This warning in a physician recruitment ad pulled me in, while an image of a choking stethoscope triggered flashbacks of my years in medicine. Many physicians feel like they’re choking. Squeezed in from every angle. Stretched to the max. Spent.

And they feel this way right as they open the door to greet their next patient.

I know of a prominent office that lost three superb physicians in seven months, and counting. They all left for the same reasons. They had little control over their days, no joy in their work, and felt they couldn’t provide excellent care with the obstacles they faced. These stories have become the norm, making us wonder if there’s hope for our profession. I believe there is, but only if physicians become courageous champions of change. Dr. Y’s story illustrates this well.

It all started with a simple conversation with a new neighbor. I quickly learned Dr. Y was a physician starting a new job and feeling the weight of a new EMR, a new health care team to lead, another new boss, and family stressors. He felt exhausted and stretched to a point he’d not felt previously. So I shared my story.

I recounted my journey as a well-trained, confident physician trying to “do it all” while raising a family and remaining active in my community. Dr. Y kept nodding. We bonded through our common experience of feeling like the reality of the physician life would lead us down an unhealthy path if something didn’t change — soon!

Months later, I found out this conversation was the beginning of a transformation. Dr. Y stepped off the treadmill that had become his life to spend time discerning what he truly wanted, as a person and as a physician — a wise investment. He was grateful, and here’s what sparked his “Aha!” moment.

When we met, I shared the statistics on physician burnout and the article on the quadruple aim. The triple aim urges physicians and health systems to focus on improving the health of individuals and communities while mindful of the “bottom line” of an increasingly costly health care delivery system. Hmm … what about the health care professional? Who takes care of us so we can care for others?

Noticeably absent from the triple aim goals are the needs of physicians and the health care team. Did you notice? Dr. Y noticed too.

A 2014 article highlights a liberating fact: When physicians pursue the triple aim while not fully supported, their ability to reach these goals diminishes. Furthermore, attempting to reach these goals under those circumstances drives burnout, which limits the physician’s ability to help patients while increasing defensive medicine, hurting the “bottom line.” Predictably, this cascade of unmet needs decreases patient satisfaction and physician engagement. Everyone loses.

Unsupported physicians chasing after the triple aim are like hamsters in a wheel — going around and around — never getting anywhere while running themselves to the ground. Sound familiar?

But fret not, colleagues, for there’s hope in this growing awareness. As the article suggests, we must prioritize a fourth aim: Caring for and supporting physicians and their teams, so they’re equipped to achieve the triple aim. Studies show the most important contributor to physician burnout is the inability to do our job well, which the system makes increasingly difficult. The Quadruple Aim places the needs of health care professionals back in the equation.

Let’s all exhale and shout out our reaction together: Thank you!

When physician wellness and support are prioritized, the triple aim goals become feasible. And greater autonomy, optimism, and a renewed sense of purpose return to physicians, with the coveted side effect of joy.

As I shared all this with Dr. Y, something clicked, and at once he felt relieved and empowered. A fresh awareness of his many obstacles and unmet needs helped him remember that he was, in fact, an excellent physician in a tough environment. In this paradigm shift, he found energy, hope, and the will to act.

Dr. Y was one more self-reliant physician pursuing the triple aim while his needs at work and in life sat in the back burner. This lonely pursuit is a formula for burnout, and worse. He’d hoped he could remain an effective leader while unsupported and running on empty. As physicians, we’re good, but we’re not that good! Nobody can do that.

So what can we do? We can begin by remembering we are human. We must prioritize our wellness. We must fight for the work support needed to care for people with compassion and excellence — from efficient EMRs with real-time IT support to adequate time with each patient. And we must advocate for our wellbeing and equipping as strongly as we advocate for our patients.

In a sense, we do need to heal ourselves, though not without help. Part of our healing will come as we encourage, equip, and empower each other, reclaiming our place as healthy, equipped, and engaged leaders of the health care team.

Helping others shouldn’t be killing us. If that’s how you feel, consider one change that will bring you greater health, effectiveness, and/or joy as a person and as a physician. Tell someone about your decision and go do it.

Once that’s done, do the next thing, then the next one … and watch your life improve. As you empower and care for yourself, I hope you’ll have more good days, finding new ways to live the life you want. Seek help if needed, whether from a colleague, IT experts, your CEO, or a career or physician coach like me. Remember why you became a physician, and begin to make the changes that will ensure you can have that life … one change at a time.

Amaryllis Sánchez Wohlever is a family physician and can be reached at her self-titled site, Amaryllis Sánchez Wohlever, MD.  She is the author of Walking with Jesus in Healthcare.

Image credit: Shutterstock.com

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