How Burnout Is Plaguing Doctors And Harming Patients


Published:

The presidential symposium at this year’s Annual Meeting of the Child Neurology Society of America in early October in Kansas City raised many eyebrows. The first presentation of this symposium focused on burnout rates among neurologists around the country.

Many of my colleagues felt that this was an inappropriate choice, especially with so many trainees and young child neurologists in the audience. Typically, the presidential symposium at a conference of such eminence addresses an issue of scientific importance. But some other colleagues felt that this discussion was essential and that the elephant in the room cannot be ignored anymore.

As I sat through it, I felt that the presentation was outright depressing, with speakers belting out dismal data about the state of mind of neurologists around the country. The most striking statistic was that about 60 percent of neurologists in the U.S. were experiencing burnout symptoms, including emotional exhaustion or lack of a sense of accomplishment. They also showed signs of depersonalization, which is an impaired perception of self and others that can lead to lack of empathy, including for patients.

I have been taking care of patients for more than two decades since graduating from medical school in 1994. I had not even heard of physician burnout until about four years ago when a lot of data started getting published. However, it is now a subject of discussion among physicians on wards, in clinic and at conferences, as we all realize that it is a menace.

The Core That Provides Care

Unsurprisingly, the rot extends beyond the field of neurology. Several reports recently have highlighted that physician burnout rates across many major specialties in the U.S. have reached epidemic proportions. For example, a survey earlier this year suggested that the physician burnout rate exceeded 50 percent for the fields of emergency medicine, obstetrics and gynecology, family medicine, internal medicine, critical care, anesthesiology, pediatrics, neurology, urology, cardiology, rheumatology and infectious disease.

This is bad for doctors, and it’s bad for patients. Physician burnout is a public health hazard, because it is a danger to patient safety and leads to poorer care.

The presidential symposium got me thinking about my own professional life. Was I positive about my career? What made me continue to pursue the practice of neurology? And, did anyone at work inspire me to remain engaged?

As I reflected on these questions about what helps me avoid burnout, an obvious answer came immediately: I knew that I continually looked up to two senior physicians in my division who trained me to be a child neurologist about a decade ago and now happen to be my colleagues.

But then I realized that there were some others who served as my inspiration at a subconscious level.

One of them is a medical social worker who joined us just a few months back. Imposing in stature, with a crop of curly high-top hairdo that makes him appear even taller, he is at ease when interacting with kids and parents alike. The focus of his work is to provide support to families that are overwhelmed with the care of children with chronic neurological illnesses. I can rely on him to come up with solutions to any of my patients’ problems, whether it is finding mental health support or getting insurance coverage. And he manages to handle an extremely demanding schedule without ever appearing to be hurried. While many of us dread electronic medical record keeping, his notes wondrously manage to not only incorporate precise wordings but also have the most aesthetically pleasing fonts.

The other co-worker who inspires me guards the front desk of our office. He ushers in patients and their families. This may not sound like an important job to laypersons. But he gives a new meaning to the art of making a first impression, the art of putting sick patients and their families at ease. And he does so day in day out with warmth that few can ever manage to radiate.

The four individuals mentioned above have little in common, except that they directly interact with and take good care of patients and their families.

The Superstructure

At the same time, I, like most doctors across America, have scores of colleagues who never interact with a patient or directly contribute to the actual care. These include billers, coders, financial counselors, accountants, managers, directors, strategists and so on. They play an increasingly critical role in the complex multi-payer health care setup as it operates today.

Unfortunately, the nurses, the therapists, the physicians, the pharmacists, the social workers – the folks who interact with patients and directly contribute to the provision of care – are arguably becoming smaller in their significance within the health care system of America.

The entire industry’s focus seems to have shifted to administration and the business side of medicine. There are data to support this: We spend way more on administrative costs than any other country around the world to deliver care, particularly in the hospital setting. This shift in focus is likely the central cause of burnout.

Can the setup be overhauled or the course be reversed?

My grandfather once risked his life and crossed a flooded river on a horseback to steer a woman in the midst of a complicated labor to safety. He treated the poor free of charge, and he took money from the rich to build a hospital in an area of India where medical care was in short supply. He had nothing much to worry about then, except his conscience.

In 21st-century America, we can’t hope to recreate such a utopian scenario. But we can certainly restructure the health care setup enough to help us restore some of the passion. In my opinion, adopting a single-payer health care system will help cut administrative layers. A majority of physicians in the U.S. support moving to a single-payer model, according to a recent survey.

I offer an additional or an alternative solution, one that will require innovative strategies to implement: Any person engaged in the health care industry in an administrative capacity ought to spend at least 20 percent of time and effort in interacting directly with patients. This will put the patients back in the focus and bring passion back into the field of medicine.

Jay Desai is a child neurologist, and a member of the faculty at Keck School of Medicine of USC.

This article was republished from The Conversation.

See also:
Integrative Medicine Steers Healthcare Forward
Patient Advocate Lessons

Edit Module
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags

Daily Astrology

February 21, 2020

An early morning trine between Mars and Uranus arouses enterprising spirits. Some may find themselves on the path to personal liberation. Others assume the role of social reformer or adventurer. Scientific and technological advancements help bridge the…
Edit ModuleShow Tags

Alternative Health Directory

Browse all listings »

Edit ModuleShow Tags
Edit ModuleShow Tags

Calendar

February 2020

Come shine with us! Join us in harmony and in our goal to bring the light of Spiritualism forward to all those who are searching.

Where:
VFW Post 2597
775 Boston Rd, Rt 3A
Billerica, MA
View map »


Sponsor: The Spiritualist Fellowship Church Of New England
Website »

More information

January 19th, February 16th, March 8th by appointment only. Kinetic Chain Release (KCR) to balance body, resolve leg length discrepancies, reduce back, shoulder, knee, hip pain and reduce stress...

Cost: $65 to $145

Where:
Leapin' Lizards
449 Forest Ave
Portland, ME  04101
View map »


Sponsor: Leapin' Lizards
Telephone: 207-221-2363
Website »

More information

Show More...
Show Less...

With Anna DeWitte Mondays—starts 1/27 Our next new class! Join Anna (one of our recent grads) for her mild heat class! The temperature will hover around 80 degrees which helps to loosen...

Cost: $17

Where:
State of Grace Yoga & Wellness Center
104 East Hartford Ave.
Uxbridge, MA  01569
View map »


Sponsor: State of Grace Yoga and Wellness Center
Telephone: 508-278-2818
Website »

More information

Discover Beauty. Discover Goodness. Discover Yourself. Your soul’s gifts are waiting. Breathe. Find stillness. The spark you need to ignite your life is here, within. Max Meditation...

Cost: $15

Where:
Modern Mystery School Boston
132 Charles St
3rd Floor
Auburndale, MA  02466
View map »


Sponsor: Modern Mystery School Boston
Telephone: 617-694-0994
Contact Name: Jordan Bain
Website »

More information

Show More...
Show Less...

Automatic & Channel Writing — Class 1 of 3 Discussion of channel writing and then spending the rest of the class practicing writing. Getting comfortable writing either with paper and...

Cost: At door $20; online reg. $15

Where:
The Healing Power of Flowers — Heaven and Earth
68 Stiles Rd, Unit A
Salem, NH  03079
View map »


Sponsor: The Healing Power of Flowers - Heaven and Earth
Telephone: 603-275-7688
Contact Name: Stacey
Website »

More information

Show More...
Show Less...

In celebration of Pediatric Dentistry Month and recognizing children’s oral health as a foundation for life-long health, join us for a free, fun and informational evening about how holistic...

Cost: Free

Where:
The BioMed Center New England
111 Chestnut Street
Ste 1
Providence, RI  02903
View map »


Sponsor: The BioMed Center New England
Telephone: 833-8BIOMED
Contact Name: Admin Desk
Website »

More information

Free Workshop: What happens to the marital home in divorce? Join us for this timely seminar led by Attorney Beth Aarons, Realtor Sky Minckler, and Mortgage Consultant Craig Tashjian as they...

Cost: Free

Where:
Skylark Law & Mediation, PC
9 Main Street
Southborough, MA  01772
View map »


Sponsor: Vesta: Redefining Divorce
Telephone: 508-744-6014
Contact Name: Deanna Coyle
Website »

More information

Show More...
Show Less...

Are you considering, going through or recovering from divorce? Join us at our FREE Daytime Divorce Boot Camp, and we’ll help you get into shape! In response to requests from people who...

Cost: Free

Where:
Fairway Independent Mortgage Corporation
180 Wells Avenue
Suite 300
Newton, MA  02459
View map »


Sponsor: Vesta: Redefining Divorce
Telephone: 508-744-6014
Contact Name: Deanna Coyle
Website »

More information

Show More...
Show Less...

"Master your breath, let the self be in bliss, contemplate on the sublime within you.” —Krishnamacharya Join us for an evening of deep exploration and transformation using the...

Cost: $40

Where:
Friends Meeting House
5 Longfellow Park
Cambridge, MA  02138
View map »


Sponsor: Allen Howell, M.Ed. LMHC
Website »

More information

Show More...
Show Less...

February 22nd & 23rd Deepen your knowledge and practice of Reiki. Facilitated by Lou Orsan, Reiki Shihan (Master-Teacher) This two-day Level II Training enhances...

Cost: $250

Where:
Northeast Reiki Center
61 Nicholas Road, Suite B2
Framingham, MA  01701
View map »


Sponsor: Northeast Reiki Center
Telephone: 508-808-5696
Contact Name: Lou Orsan
Website »

More information

Get a personal teaching for Brother Granite's new Visionary Shamanism Tarot. This class includes the new Visionary Shamanism Tarot deck as well a 90 minute one on one class with Brother Granite...

Cost: $80

Where:
407 Deans Plaza
407 Rte 44
The Enchanted Forest Taunton
Raynham, MA  02767
View map »


Sponsor: Brother Granite
Telephone: 774-208-6195
Contact Name: Granite
Website »

More information

Show More...
Show Less...
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags