NEJM: Excellent Essay on Physician Burnout

[drusso]

NEJM - Error

"Out of the Straitjacket"

"My work lost meaning; I was just going through the motions. I thought everything I tried to accomplish was a failure. I had trouble relating to patients and felt the urge to avoid encounters altogether. I cared less and less about anything I was doing."

Something for Pain Physicians to keep in mind.

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[SSdoc33]

NEJM - Error

"Out of the Straitjacket"

"My work lost meaning; I was just going through the motions. I thought everything I tried to accomplish was a failure. I had trouble relating to patients and felt the urge to avoid encounters altogether. I cared less and less about anything I was doing."

Something for Pain Physicians to keep in mind.

this sounds more like a tale of underlying depression than a problem with his job.

i sort of feel that most cases of physician burnout are "self-inflicted". we see a ton of patients, many times, simply because we want to make more money. that carrot is too big of a motivator for us to slow down a bit and enjoy life and work. no amount of "mindfulness" deep breathing is going to change our love for the almighty dollar.....

 

[drusso]

this sounds more like a tale of underlying depression than a problem with his job.

i sort of feel that most cases of physician burnout are "self-inflicted". we see a ton of patients, many times, simply because we want to make more money. that carrot is too big of a motivator for us to slow down a bit and enjoy life and work. no amount of "mindfulness" deep breathing is going to change our love for the almighty dollar.....

"Blame the victim." I think that people who make it through 4 years of rigorous undergrad, 4 years of medical school, and 4-8 years of residency and fellowship have proven themselves to be incredibly resilient human beings accomplishing an intellectual and emotional feat less than 0.01% of people can ever aspire to complete.

Burnout is a problem caused by overbearing admins, assembly-line style medicine, loss of professional autonomy, and over-regulation.

 

[SSdoc33]

"Blame the victim." I think that people who make it through 4 years of rigorous undergrad, 4 years of medical school, and 4-8 years of residency and fellowship have proven themselves to be incredibly resilient human beings accomplishing an intellectual and emotional feat less than 0.01% of people can ever aspire to complete.

Burnout is a problem caused by overbearing admins, assembly-line style medicine, loss of professional autonomy, and over-regulation.

depression, however, which is more the problem here, is multifactorial. to blame his suicidality and severe major depressive disorder on "burnout" or taking it even further and blaming overbearing admins is nearly laughable

 

[drrosenrosen]

While there is definitely overlap between burnout and depression, it can be surprisingly compartmentalized. Burnout is more like you're "depressed" while at work, and not when you go home. I felt pretty burnt out on my practice here when I was working with a disruptive partner. Now that I'm by myself, even though I'm working harder, I feel more energized and engaged with the work I'm doing. I feel ownership (not in the financial sense) of my clinic and its policies, staff, and practices. The sluggish feeling of being burnt out - not wanting to see patients being one the key ones - never came home with me, but it made being at work pretty hard for a time.

 

[Ducttape]

"Blame the victim." I think that people who make it through 4 years of rigorous undergrad, 4 years of medical school, and 4-8 years of residency and fellowship have proven themselves to be incredibly resilient human beings accomplishing an intellectual and emotional feat less than 0.01% of people can ever aspire to complete.

Burnout is a problem caused by overbearing admins, assembly-line style medicine, loss of professional autonomy, and over-regulation.

this line is the only line in the 3 page article that discusses hospital employment:

I also find daily frustration in the workload, the amount of time spent in the hospital, the shrinking control we have over our work environments, and the economic drivers in health care.

not even in the ballpark. try again...

 

[willabeast]

After reading the article it seems the most likely Dx is Persistent Depressive Disorder. i doubt money has anything to do with his Dx or his symptoms or his choice of a profession. If anything, his income kept him from being even more symptomatic. Of course i hope he is "cured", but i am reminded of another high achiever who had ECT .Ernest Hemingway.Ernest subsequently blew his brains out - allegedly because the ECT messed with his memory.
NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals

 

[Blitz2006]

this sounds more like a tale of underlying depression than a problem with his job.

i sort of feel that most cases of physician burnout are "self-inflicted". we see a ton of patients, many times, simply because we want to make more money. that carrot is too big of a motivator for us to slow down a bit and enjoy life and work. no amount of "mindfulness" deep breathing is going to change our love for the almighty dollar.....

100% correct. No one is forcing you to work 6 days/week, 70 patients a day, 100 procedures a week, etc.

Its culture and mindset. Our medical colleagues in the NHS/England all earn a base pay of 80K pounds/year, and they are (financially) content. If you want to work 100 hours/week to buy a Ferrari than that is your own prerogative, and burnout shouldn't be a surpise..

 

[bedrock]

100% correct. No one is forcing you to work 6 days/week, 70 patients a day, 100 procedures a week, etc.

Its culture and mindset. Our medical colleagues in the NHS/England all earn a base pay of 80K pounds/year, and they are (financially) content. If you want to work 100 hours/week to buy a Ferrari than that is your own prerogative, and burnout shouldn't be a surpise..

And residencies are even longer in Britain.

I didn’t get into medicine just for the money but after a dozen or more years of schooling you should make more than someone who just got a bachelors/masters degree.

I don’t think I would have become a physician in Britain.

Do you know if their medical school training is realatively inexpensive? Should be seeing as they makes as much as a pharmacist in the US.

 

[Blitz2006]

Well. Here are some counterpoints:

1. You start medical school at age 18

2. You start earning a resident salary at age 23

3. Residents overall in the UK earn more than Residents in the U.S. Using an exchange rate of 1.7 (pre brexit average), the PGY4 equivalent salary is around 65 to 70k. And resident salaries are exactly the same throughout the country.

4. You work 48 hours a week max. This includes neurosurgery residents. Therefore, you have more time to moonlight (average pay is 70 bucks/hour for moonlighting).

5. Much less litigation

6. Medical school until 5 years ago was 3000 pounds (5K USD) a year. So that's 25K for M.D from Oxford or Cambridge potentially (#2 and #3 in the world). However it is now 9 000 pounds a year. But still cheap compared to U.S. and medical school tuition are all the same across all 33 medical schools.


So it's not all bad in the UK. I'm not saying it's better, there are obviously a lot of cons (Lower pay for attendings, longer training, much higher taxes).

But when you have 4 kids, free healthcare and dirt cheap education doesn't look too shabby.

And residencies are even longer in Britain.

I didn’t get into medicine just for the money but after a dozen or more years of schooling you should make more than someone who just got a bachelors/masters degree.

I don’t think I would have become a physician in Britain.

Do you know if their medical school training is realatively inexpensive? Should be seeing as they makes as much as a pharmacist in the US.

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