Physicians: Want to overcome burnout? Start studying business.


I have no business background: zero, zilch, nada. Growing up, I was the kid who bought the lemonade, not the one who set up shop on the busy street corner. My parents bought the cookie dough, coupon book and every other school fundraiser from the kid next door instead of their own child. Job interviews? Never had them. All the jobs I’ve ever had I got because I knew the boss, usually my own father. I’ve had one job I went out and got on my own, though I’d like to erase it from memory. Scrubbing toilets at 3 a.m. during the months leading up to medical school is hardly a resume builder. While my wife and friends studied accounting and business in college, I spent my time studying Spanish translation and taking medical school prerequisite courses. I didn’t need that business stuff; I was going to be a doctor.

My story isn’t all too uncommon among my medical school peers. We’re budding physicians with goals to end human suffering and training to diagnose and treat disease. Business? Leave that to the MBAs and CEOs. Medical schools have taken a similar approach. We scratch the surface on the topics of medical billing and coding with absolutely no mention of how to run a business. You’re going to be a doctor, focus on the medicine.

Before medical school, I contacted a family friend and physician looking for advice. I hoped to receive validation for my thoughts about medicine and “inside information” about how to achieve my goals. My inquiry, however, was met with frustration and pessimism toward the profession, with a plea to “turn around and get out now.” I wrote it off as one poor soul who had become jaded through their own unique experiences. This wasn’t how the majority felt, I told myself.

Over the last five years, I’ve come to know that my friend was not alone. Spend time perusing online physician blogs or in the doctor’s lounge at your local hospital, and you’ll find that many are just as frustrated with the current state of medicine. You’ll come to realize that this frustration is not with the science of medicine but with the business of it. The one thing we’ve ignored for so long has become the major obstacle to the only thing we’ve ever wanted to do.

This frustration plays the central role in a current epidemic: burnout. Physicians and medical students alike are losing the passion they once had for medicine. While some stay within medicine and labor through unhappy careers, others have left the profession altogether. Tragically, some are affected so heavily that they resort to taking their own lives. In the end, physicians and patients suffer.

Research is being done across the country to investigate solutions to the burnout phenomenon with two major camps of thought. The first focuses on the well-being of the physician. Yoga, meditation, nutrition, and stress management have been proposed as self-strengthening solutions. The second focuses more externally, on the administrative burden imposed on physicians. Resolutions from this camp include decreasing physician work hours and stresses associated with cumbersome EMRs. Some of these resolutions have shown reductions in reported burnout, and many are worthwhile interventions. Unfortunately, we have continued to ignore the root cause of the frustration: the lack of physician autonomy in the business of medicine. Taking up yoga or merely reducing the number of work hours to combat burnout is like washing down a statin with a double-bacon cheeseburger: it will do little if any long-term good.

Truly overcoming physician burnout requires a disruption within the structure, not merely attempts to innovate a broken system. This starts with including an emphasis on the one thing that has been absent for so long: business education. Want physicians to lead happy and long careers the way they’ve always envisioned? Teach them how to run a business (and I don’t mean how to manipulate a note to maximize reimbursement). The costs of obtaining a medical education, both financial and emotional, are too steep to allow others to call the shots.

You may be thinking, why listen to a student who admittedly has no business background speak about the importance of business education? Is that any different than being told how to practice medicine from someone with no medical experience? In recent years, I’ve come to know and work with a group of doctors who are challenging the status quo by taking back the reins of business autonomy. This group of pioneering physicians inspires me with their enthusiasm and optimism for the future amidst so much pessimism. Their positive outlook stems from the fact that they practice medicine how they always dreamed, doing so by creatively disrupting the business of medicine. In so doing, they’ve returned the focus of their practice to their patients: the way it should’ve been all along.

Sitting here, staring at my medical school debt is daunting. Like many others, it’s tempting to follow the status quo and chase the stability of guaranteed income. My professional goals, however, won’t allow me to sit on the sidelines and let others call the shots. Learning about business is my way out. My nightstand is now littered with business and finance related books things like “The Icarus Deception,” “Great by Choice,” “Start With Why” and “The White Coat Investor.“

I talk to anyone I can about the business of medicine, much to the chagrin of my wife and unsuspecting dinner guests. Wanting to inspire others to take back their autonomy, I set out and started an organization with two local doctors. We’ve traveled locally throughout the state speaking to medical students, residents and practicing physicians about creative business models of health care delivery and the professional freedom they offer. We aim to empower the future generation of physicians not to settle for the status quo but to take back control of their medical practice. We may be small, but we’re combating burnout with business.

Trevin Cardon is president, Direct Care West.

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