To prevent burnout, physicians need less resilience, not more

With the latest data calculating physician burnout at greater than 50 percent, American medicine is at a tipping point.  How to fix this crisis?  Why, make physicians more resilient, of course!

Except physician resiliency is exactly what got us into this problem.

Let me explain.  Doctors are notorious people pleasers.  We spend years of our life at study, sacrificing the fun and freedom of youth, deferring childbearing, and delaying income.  We abuse our bodies, ignoring pain and physical necessities to hunch over operating tables and round endlessly on hospital floors.  And after spending our entire work shift immersed in the emotional trauma of human suffering, we show up the next day to do it all over again.

The bottom line is that doctors just don’t get through medical school and residency without an extreme degree of resiliency.  But there is a payoff for all that resiliency.  We get to take care of our patients.

It might sound funny, but doctors really and truly want to take care of patients.  In fact, most of us want to take care of our patients so much that we have turned our back on anything that doesn’t directly relate to patient care, trusting others to manage the day-to-day realities of running a practice.  And as we immersed ourselves deeper into our clinical duties, we relinquished financial management to the MBAs and government agencies, and politics to the politicians and lobbyists.

So when those practice managers have asked us to just do a little extra, maybe click a few more boxes, or be a bit more flexible with a new electronic medical record, perhaps adapt our systems and practices to improve reimbursement, we’ve just nod our heads and roll with the program.  We’re resilient like that.

But before we knew it, doctors were working for practice managers, not for patients.  All of a sudden, we have found ourselves spending more time on paperwork and computers than face-to-face with patients.  And that’s where our resilience is ending — for good reason.

It’s time to end our resilience to the demands of third parties.  It’s time to say “no” to intrusions that add zero value to our workflow.  We must no longer roll over when asked to do more for less pay, fewer resources, less time.

And if our practice managers can’t be resilient to these demands, then doctors will have to unbury ourselves from our clinical responsibilities and take a more active role in creating our own future outside of the current broken system.  We just can’t afford to be resilient anymore.

Rebekah Bernard is a family physician and the author of How to Be a Rock Star Doctor:  The Complete Guide to Taking Back Control of Your Life and Your Profession.  She can be reached at her self-titled site, Rebekah Bernard, MD.

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