The Disconnect Between Expectations and Reality
Comment From Charles P. Vega, MD (Family Physician)
I like Dr. Centor's algorithmic approach in discovering the causes of burnout. To me, it's fairly simple. When there is a disconnection between physician expectations and the reality of practice, the kindling for burnout is lit.
There is no doubt that the creaking healthcare system we practice in and its convoluted finances are in part to blame for the high rates of physician burnout. But if you study one case of burnout, you have learned about exactly one case of burnout. Each individual has her or his own reasons for dissatisfaction.
I help to teach physicians at the very outset and toward the very end of their careers. First, not everyone is emotionally equipped for a career in medicine. We all know doctors who would be much more effective accountants or morticians. These individuals have a really short fuse when it comes to burnout.
I hear many complaints from physicians who have been providing care to thousands of patients over decades. The degree of bureaucracy and oversight in practice is too much of a cultural change for many of them, and they are leaving in droves. This is a shame; there is a lot of collective wisdom among these physicians, especially regarding how to connect with patients. But there is also a strong sense of bitterness and resentment among many of these doctors.
Cultural change is evident among physicians-in-training, too. These students and residents have a better sense of how a career in medicine fits into and does not overwhelm a complete and healthy lifestyle. However, our medical education system still pushes them too much and inculcates its own values of sacrifice and struggle without reflection as to why we are working so hard in the first place.
Compared with comprehensive health system reform, the way we select and train the next generation of physicians is a relatively easy means to help prevent burnout. Medical schools now feature wellness curriculums, and duty hours limit the degree of exhaustion associated with training. But these efforts are clearly not enough. We need to set realistic expectations for the amount of work ahead and provide outstanding role models to help mentor students as they learn and even beyond graduation day. Over time, these changes will create a healthier, more sustainable, and more effective physician workforce.
Medscape Family Medicine © 2012 WebMD, LLC
Cite this: Robert M. Centor, Robert W. Morrow, Roy M. Poses, et. al. Doc Burnout -- Worse Than Other Workers' - Medscape - Nov 13, 2012.