I read the recent article on KevinMD: “I’m sorry: Why I lost my love for medicine” with great sadness. My heart goes out to the author; many of their concerns echoed deeply within me. I am sorry that we, as physicians, haven’t effectively succeeded in solving the myriad of problems facing health care today. And the author is right: Health care as a system, in the United States, is broken and infuriating. Burnout of physicians, nurses, and other front-line providers is intensely serious and frustrating since our “managers” do little to impart meaningful change. However, I worry that we introduce a pervasive cynicism in all the buzz of talking about physician burnout. We are consistently reminded that no one cares about what we do or the sacrifices we’ve made to do it. Once these thoughts take hold, it impacts our happiness, job satisfaction, and ability to be care providers. We forget that we went into health care to help people, not please administrators.
Some time ago, I was heading to my office at the end of the day, when a code blue was called. I ran over and found a young (for the hospital) patient with no pulse, no airway, and no IVs. It was an intense code. We did compressions on and off for an hour. We placed IOs, IVs, and central lines. We intubated them and shocked them over a dozen times. Every patch of stability was lost over and over again, and I didn’t think they would make it. Luckily, I was wrong and got the patient to the ICU. I went home. My kids were getting set for bed; my wife was frustrated at how late I was, I was hungry and exhausted and still had to prepare for my next day in the hospital. And just like most of my colleagues who are both physicians and parents, we take our mom and dad roles just as seriously as our physician ones. So, of course, the day was completely and totally exhausting. No administrator cared that I was there (they wouldn’t have been there to see it, anyway!). I didn’t get “call money” for staying late, and even in showing up, I exposed myself to high risk of a malpractice suit – when stakes are high, the consequences can be severe whether I do my job perfectly or not. None of my colleagues knew I was there, and honestly, I could’ve gone home and let a resident show up instead.
But – and this is important to remember – I signed up for this. I actively decided long ago to sacrifice my time for my patients. I signed up hoping that someday I could be the person that ran into a room and knew what to do and how to direct the team that saves someone’s life. It isn’t just “a job,” it’s a privilege and a chosen profession. Sometimes, thinking on and on about how burnout makes us falsely believe that our job is only “compliance,” billing, charting, and making administrators happy. We’ve forgotten to focus on the most important aspects of our work.
I stopped by my patient’s room the next day, expecting that she would be comatose and sick. But she wasn’t. She smiled at me and said, “So, you’re the one?” She grasped my hands and said thanks. I cried and said I was honored and thankful that she was OK. I got a letter from her family weeks later, thanking me for giving them more time together. The letter sits at my desk, front, and center. As someone who tends to run towards the dumpster fires, I would be lying to pretend it always goes like this. In honesty, normally, it doesn’t. But when it does, it is important to hold on to it: That day, I showed up to work and saved someone’s life.
Several years ago, I was burnt out and caught in the never-ending newsfeed about the negative aspects of managed health care. I would read article after article about how bad things are for doctors. The despair I felt impacted my ability to show up smiling, keep reading and learning, and provide compassionate care. But it wasn’t being a physician that burnt me out – it was focusing on all the non-doctoring parts of my job.
Of course, these problems warrant our attention and voices. We need to care about them. But, if you find yourself stuck in a cycle of burnout, go back, read your personal statement and remind yourself of the core reasons why you became a doctor. Then, try to go through the memories of the people you’ve helped, the connections you’ve made, and the special experiences you’ve had. Maybe it’s doing a cool procedure. Maybe it’s connecting with a depressed teenager in clinic. Maybe it’s managing a complex trauma, running a code, or saving a premature baby. It is crucial to remember that what we all do is very, very special. If we only focus only on the disheartening aspects of our job, it is easy to become lost, frustrated, and angry. But, if we hold onto the truly special moments where we’ve helped someone, however infrequent, we can discover that our careers as physicians have deep meaning and purpose. Being a doctor sometimes isn’t a job – it is an identity.
It is a tragedy that so many of us struggle with. In the darkest times, however, it is absolutely crucial to focus on what really matters. To lock-on to the most impactful and important parts of what we do. To remember what we all wanted when we wrote those personal statements: to help people in some incredible way. Not many jobs offer that opportunity — hassles, or not. If we can shift our emphasis to those moments, we may be able to show up and provide phenomenal, compassionate care while also tackling the problems of health care — all without becoming lost.
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