How physician burnout hurts patients


On Saturday morning at the breakfast table surrounded by my husband and kids, I suddenly felt chest pain, palpitations, and was about to collapse. Being an internist, I knew it: arrhythmia. Paramedics at arrival confirmed it. I was running ventricular tachycardia.

Out of the chaos surrounding me at that moment, my physician’s brain assessed the situation: “VT. Serious arrhythmia.”

After that, I lost it. I became a scared-to-death patient who has a serious heart condition and is feeling like dying right now. The years of training, practice, and medical knowledge are not helping at all when doctor becomes a patient.

At arrival in ED, I was in and out of VT, terrified and suffering from all of the symptoms. Having worked in the ED before, I was familiar with workflow and structure, but things look completely different when you are a scared patient.

You have a different perception of ED. You are analyzing the tone of the voice, body language, the speed of action. I see the holes in curtains, and the irrational thought jumped in my head: “Is it really a good hospital?”

Then comes an agony of waiting for the ED doctor to come. I pray for the one who listens and has a solid medical knowledge. I am a physician — I know the next steps, but are we going to be on the same page?

He comes, tired, overworked, and exhausted. He briefly asked me a few questions. He is convinced that minimal changes in electrolytes are the reason for my VT. He is refusing to do anything until electrolytes are corrected.

Everything inside of me was screaming: “This kind of small electrolyte changes could not have caused a VT in previously fit and healthy patients. Look for the reason. Call cardiology. Please give me medications to terminate the VT.”

Now, we are in disagreement. I did the wrong things. I interfered with my care. I hear a cold voice: “You are the patient. I know what we are doing.

“No, you do not,” but I deflated with the new run of the VT feeling I am dying again.

Electrolytes correction did not help. Finally, cardiology was called but arrived only four hours later. All of this time, I was on and off VT, scared, seeing the horror in the eyes of my husband, crying, thinking about my kids.

I thought about why my experience as a patient was so terrifying? How come the doctor and nurses are so distant from the patient? Why this health care system is so slow and lack of compassion?

I think I know the answer. It is all about burnout. I see each symptom of it in my care team members: exhaustion, cynicism, and doubt. They lost the ability to care, emphasize, and connect with the patient. The busy, unpleasant environment of the health care system broke the best quality of our profession — humanism, compassion, and sacrifice. When did it happened, and if there is a way back? I do not know. But being the patient, I know that doctor’s burnout is affecting patients who are most vulnerable and in need of our help.

Natalia Usoltseva is an internal medicine physician.

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