This burned out physician was happier as a resident

I log onto KevinMD every day to get my much-needed dose of physician commiseration. At least once a day, one of us writes an article about burnout. It typically leaves me feeling quite validated. I particularly enjoy reading the comments section, as many of you make me laugh with your physician reality-based humor.

I am more burned out than I ever hoped to be. I work in primary care, have a family and my spouse is a surgeon. My spouse and I are equally burned out, despite our differing specialties. I have “PCP burnout” qualified by: patient-centered care, clicks, forms, feeling like a doormat, patient satisfaction ruling my life, too much volume and documenting while too much time spent talking about things I don’t care about. I find myself annoyed with my patients and extremely doubtful of their intentions. I cannot be honest with them and I feel guilty about how jaded I’ve become. My spouse’s “surgeon burnout” is qualified by: insurance companies ruling his life, prior authorizations, documentation, litigation threats, ridiculous call schedules and inefficiencies that make his job a struggle. Oh, and we don’t get paid nearly enough to offset the time investment and combined $750,000 of out-of-state loans it took for us to get here. I don’t know who is making the big bucks out there but it’s not us.

So what happened?

We wanted to help and heal people. We were so eager in medical school, looking for that light at the end of the tunnel. The light where you get to be the attending, you get to determine what type of physician you want to be and you have respect. The infamous tunnel that ends and lets you have your life back post-residency.

Fifteen years later, I confess that I was more satisfied as a resident. I’m tired in a different way now. I don’t recognize the callous and cold person I’ve become. If patients get upset because they’ve been waiting too long in the waiting room, I tune them out and hope they find another physician. If they call too many times in one day, I get frustrated because I haven’t had a chance to pee that day — let alone return a phone call about a lab they don’t understand on their patient portal. Most days, I fake enthusiasm and pray that I don’t make a mistake. Chief complaints bother me: fatigue, abdominal pain, and headache. They want convenient and quick but quality care (hah!), and I want to pull my hair out.

Based on the comments and articles I read on this site, it seems most of us feel this way. We are all trying to find the fastest way to go part-time or retire. Those who have cut back, retired or gone into the elusive DPC tell us tales of the greener grass. We all speak the same language yet no two cases of burnout are the same.

So now what?

Our careers have been stolen from us, and we’re frustrated. We don’t have the time to tackle burnout properly because we just don’t have time for anything productive. Most of us don’t even have time to read or polish our medical knowledge so the actual quality of care we are giving is slipping. If you’ve been a patient in the last ten years, you know what I mean. It keeps getting worse instead of better. We all also know that wellness is a farce. Any solution an organization has to burnout won’t fix anything quickly enough because the problem is complex and global. The only way to provide proper patient care is to remove administration from our examination rooms.

Therefore, I urge you all to consider the key to burnout to be centered on one concept: just say no. The next time a bogus form is added to your list, remind them that it is not evidenced based and say no. The next time you are taken advantage of, say no. The next time a new policy is implemented and you know you won’t have an extra 20 seconds a day to devote to it, say no. The next time the email comes out that makes you want to scream, just reply back politely and say no. Start resisting and support each other. The next time a fellow physician is feeling down about a patient complaint, litigation or a slap on the hand, back them up. Fight for them. Many physicians are non-confrontational, but it’s time to step out of that zone and stand united.

You are undoubtedly going to be met with a lot of backlash. You will be accused (bullied?) that you’re “unprofessional” and “not a team player” and you will feel small for questioning things. You will be told that you don’t have the patient’s best interest at heart or that you won’t get paid by the insurance company or you won’t be a quality providing physician. You will be told about other doctors who endorse the policy you are questioning. You will be condescended to about changes in our industry, reminded the patients want easy and convenient care, teledocs will steal all your patients and that reimbursement is decreasing. You will have people come to your office and talk you into exhausting circles.

But our kindness and professionalism have been taken advantage of and we need to come together now. If we start refusing things that do not benefit the patients, then we may have a fighting chance. We need to treat them the exact same way they have treated us. They made decisions without us and we should make them without them now. Keep doing your job while fighting for your patients and each other. Stand your ground and stand it together. Until now, nothing else has worked. Nobody worthwhile has fought on our behalf and we aren’t left with any other options.

The author is an anonymous physician.

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