The nurse grabs me. "You have to check my patient now! She is screaming and bearing down." Without letting go of my hand, she leads me into the labor room. I don’t even consider saying no, I know not to question this nurse. She has been a labor and delivery nurse nearly as long as I have been alive -- she knows much more than I about everything. The room is dark, but ...

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The ICU nurse positioned the mirror in front of my face. “You look more like yourself now, Dr. Berk,” she said. She was right! The nurse, whose name was Meghan, had just shampooed, dried and brushed my hair. Clean and coiffed for the first time in over a week, I appeared normal — except, that is, for the tubes sticking out of my left nostril and my mouth. It was 2009, and my ...

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They say to be a good doctor, you have to leave everything behind when you enter the exam room. You walk in with a clean slate — shiny and sterile, crisp, clean and decontaminated. I wonder if that’s why we wear a white coat? To symbolize the unscathed, untouched and pristine figure who walks into the room and solves all the problems. The one who just woke up from a ...

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As has been much discussed in the last few years, our health care system is in crisis. We spend $3 trillion a year on Medicare. MRIs bill out at $5,000. My recent bilateral mastectomy totaled $33,000 with $800 of that actually going to my surgeon. I left my role as an employed physician in the traditional insurance-based fee-for-service structure because I spent 80 or more hours a week typing, collecting data, ...

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It has been a struggle to get out of my own way. I’m sure many of you have the same feeling. My health and well-being have suffered mightily from the stress of taking care of others in my work as a physician. I have not taken care of myself. Period. My career does not make me unique in this situation, as the patients I treat every day suffer from similar ...

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Physician burnout is increasing at an alarming rate. According to a January 2017 AMA Wire report, physician burnout rate has increased from 2013 to 2017 across every specialty in medicine. Greater than 50 percent of primary care providers are burned out. Therefore, every patient at the entry point of medical care is, more likely than not, going to be treated by a burned out physician. The question is why are ...

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Physician burnout is the depression of the medical world. We are aware of its presence and the detriment it can cause, but yet, we don’t really like to talk about it. The problem is, just like depression, if we don’t talk about it or seek to address it, it persists and leads to a number of unwanted outcomes including decreased productivity, decreased patient satisfaction, and increase in medical errors. And ...

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The words were like bitter candies that I had been sucking on, hoping to come to a sweet center. I had walked the hallways of the hospital holding them in the silky pocket of my cheek for weeks. Finally, afraid I would choke, I spit them out into the middle of the dinner table. “I think I’m depressed.” I stared down at the tablecloth, moisture collecting on the base of my water ...

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Recently, I was asked to give a talk on resilience and its role in reducing physician burnout.  I was excited by the opportunity, but asked if I could focus more on cultural change and institutional solutions for burnout.  When they said no, I declined.  Why? Well, it’s not that I don’t see the value in resilience.  A lot of physicians that I really respect write and speak about resilience.  I think ...

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Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on ...

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