This past month I had the opportunity to present at a medical conference; my research topic was burnout and depression in osteopathic family medicine residents. A variety of attending physicians and residents stopped by my poster, excited to see this topic being brought to light. With the recent rise in physician dissatisfaction and suicide, there has been increased attention to finally start addressing this issue.
I was super excited about giving an intellectually stimulating presentation on a topic I am very passionate about and having a meaningful conversation with my judge. I smiled and shook the hand of the elderly physician who walked up to me with a click board. He fumbled while trying to find his grading sheet seeming discombobulated. After giving him a helping hand, I was ready to start the conversation. To my surprise, one of the first comments out of my judge’s mouth was “You look cyanotic.” I glanced down at my hands thinking that maybe I was cold, however confused I looked back up at him. “Your nail polish,” he remarked.
Now, being that the conference was in Puerto Rico, I had decided to get a manicure and pedicure after successfully completing my fourth year of medical school and getting accepted into my number one residency choice. As it is a tropical place, I decided to get a teal color — something light and fitting. As a female in medicine, I am used to hearing remarks in regards to how I dress, my haircut, my nails and all things superficial from both patients and other colleagues.
However to have this brought up as the first thing my judge noticed about me was appalling; he didn’t ask about my accomplishments or the fact that I had successfully conducted and published the research study I was presenting on. No, he instead chose to focus on my appearance and outwardly vocalize his disapproval.
Well, being the kind of person I am, I brushed this off and continued enthusiastically giving my presentation. The judge quickly showed his lack of knowledge and interest in the topic. He constantly interrupted before I had a chance to explain and provide further information; it was as if he was trying to speed me up, though I was well within the time frame given me.
The best part was yet to come. The elderly physician proceeded to ask, “Do you think there is an age difference in regards to burnout?” I responded, “In the two studies that we conducted we didn’t find a significant difference in age. However if I was to postulate based on previous studies, I would say that burnout rates are higher among older physicians as they have been exposed to much more.” At this, he scoffed, “I think it’s the opposite. Burnout is higher in younger docs, do you know why?”
As I tried to quickly ponder over the hours of research, I read to come up with an intellectual reason for this statement I was at a loss. So I proceeded to ask the judge as to why he thought this was the case. “Well you see,” he began, “You new generation of doctors are a bunch of wimps. When you guys get hit in the head with a beam you sit down and cry; but when my generation got hit, we’d get up and keep going. Burnout and depression were never any issues in my generation of doctors.”
At hearing this, I was absolutely shocked; I didn’t know how to respond. I had a bunch of facts I wanted to shoot out at him, but by the look on his face, he didn’t want to hear them. I missed a teaching opportunity out of fear of being perceived as disrespectful or condescending. So now, after taking some time to digest what this judge said I wanted to present some basic facts:
- The term “burnout” was first introduced in the 1970’s by psychologist Herbert Freudenberger, who noted that this syndrome was most commonly seen in “helping” professions, such as doctors and nurses.
- Since that time, burnout has been studied in all stages of the medical training trajectory: from student to resident to attending physician.
- There is high occurrence of burnout among medical students and physicians, with rates ranging from 25 percent to 75 percent.
- During residency training, burnout is the most prevalent resident impairment, more so than either depression or substance abuse.
- Burnout has been linked with poor health, sleep issues, depression, hypertension, anxiety, alcoholism, and myocardial infarction.
- Medical errors have also been linked with burnout in a cause and effect relationship: For each 1-point increase in depersonalization, there is an 11 percent increased likelihood of reporting a major medical error.
- Burnout and physician dissatisfaction are related to increased rates of job turnover, absenteeism, decreased job performance and reduced job commitment.
- Over half of current physicians state that if given the opportunity to choose again, they would not choose medicine as a career.
- Suicide rates are steadily increasing, with male physician rates being 70 percent higher and female physician rates being 250 to 400 percent higher when compared to their nonphysician gender counterparts.
- Further, patients of unhappy physicians are less likely to follow prescribed treatment plans.
So no, burnout was not created by a new generation of wimps. No, it is not OK to keep ignoring something that is killing almost an entire class of medical students a year. Yes, burnout did and does exist in your generation of doctors, the only difference is no one was willing to talk about it; just because something is swept under the rug doesn’t mean it doesn’t exist.
And to you, dear judge, I sincerely hope you never actually get hit in the head with a beam, but if heaven forbid you do I hope the physician taking care of you isn’t so emotionally exhausted and depersonalized that she/he isn’t able to properly take care of you.
Jessica Lapinski is a family medicine resident.
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