Physician Burnout

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I came across this article and found it to be pretty interesting:

http://archinte.jamanetwork.com/Mobile/article.aspx?articleid=1351351#ioi120042f1

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Here is the part I found to be the most important:

"Collectively, the findings of this national study indicate that (1) the prevalence of burnout among US physicians is at an alarming level, (2) physicians in specialties at the front line of care access (emergency medicine, general internal medicine, and family medicine) are at greatest risk, (3) physicians work longer hours and have greater struggles with work-life integration than other US workers, and (4) after adjusting for hours worked per week, higher levels of education and professional degrees seem to reduce the risk for burnout in fields outside of medicine, whereas a degree in medicine (MD or DO) increases the risk. These results suggest that the experience of burnout among physicians does not simply mirror larger societal trends.

Burnout can have serious personal repercussions for physicians, including problematic alcohol use, broken relationships, and suicidal ideation.10,11,28 When considered with the mounting evidence that physician burnout adversely affects quality of care,4,6,29- 35 these findings suggest a highly prevalent and systemic problem threatening the foundation of the US medical care system. The fact that almost 1 in 2 US physicians has symptoms of burnout implies that the origins of this problem are rooted in the environment and care delivery system rather than in the personal characteristics of a few susceptible individuals. Policy makers and health care organizations must address the problem of physician burnout for the sake of physicians and their patients.4,36

Unfortunately, little evidence exists about how to address this problem. Although extensive literature suggests that contributors include excessive workload, loss of autonomy, inefficiency due to excessive administrative burdens, a decline in the sense of meaning that physicians derive from work, and difficulty integrating personal and professional life,9 few interventions have been tested. Most of the available literature focuses on individual interventions centered on stress reduction training37 rather than organizational interventions38,39 designed to address the system factors that result in high burnout rates. Efforts to promote self-awareness and meaning seem promising40- 43 but may not appeal to all physicians and have typically required investment of personal time that is already in short supply for physicians. Efforts to date have been further limited by short-term follow-up periods, small sample sizes, or nonrandomized study designs. Limited funding for such studies has severely undermined the quality of research in this area."
 
Very interesting study, it'd be interesting to see a survey that asked physicians why they chose to become a physician in the first place and their reason why their perspective "changed"...
 
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I think part of a problem that I happened to observe even on SDN is that some doctors believe that being a physician is a "calling" and not simply a job. Therefore it is okay to expect things from doctors we don't normally expect from anybody else. Can they work more than others? Sure. It's a calling, they must sacrifice. In a meantime the burnout is way above national average even in the most lifestyle friendly specialties. Let's not forget that doctors are humans to and there is good reason why 40 hours a week is conserved full-time even though there are 168 hours in a week.

And there is a phrase thrown around here that pisses me off even more. "If you don't like it - don't be a doctor". How stupid.
 
I think part of a problem that I happened to observe even on SDN is that some doctors believe that being a physician is a "calling" and not simply a job. Therefore it is okay to expect things from doctors we don't normally expect from anybody else. Can they work more than others? Sure. It's a calling, they must sacrifice. In a meantime the burnout is way above national average even in the most lifestyle friendly specialties. Let's not forget that doctors are humans to and there is good reason why 40 hours a week is conserved full-time even though there are 168 hours in a week.

And there is a phrase thrown around here that pisses me off even more. "If you don't like it - don't be a doctor". How stupid.

I have to agree.

If someone struggles with the burnout, he or she gets criticized by fellow physicians and administrators. There is no standard, widely accepted cutoff on what is reasonable workload and what is not. However, clinics struggle financially due to low reimbursements and physicians inevitably have to see more patients to cover the cost.


Back to the article, I am not surprised to see derm and rad onc doing well in both ranks. Their reimbursement rates seem to be relatively better than others. They could do more lucrative procedures while keeping the number of patients stable.

But what about general peds, preventive med, environmental med, and occupational med? Anyone has insight on why these areas have great satisfaction and the least burnout?
 
I have to agree.

If someone struggles with the burnout, he or she gets criticized by fellow physicians and administrators. There is no standard, widely accepted cutoff on what is reasonable workload and what is not. However, clinics struggle financially due to low reimbursements and physicians inevitably have to see more patients to cover the cost.


Back to the article, I am not surprised to see derm and rad onc doing well in both ranks. Their reimbursement rates seem to be relatively better than others. They could do more lucrative procedures while keeping the number of patients stable.

But what about general peds, preventive med, environmental med, and occupational med? Anyone has insight on why these areas have great satisfaction and the least burnout?
From what I've gathered the type of work you do in those specialties is actually pretty cool.

Being an inspector for OSHA or being a health consultant for a big company sounds pretty cool to me.
 
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But what about general peds, preventive med, environmental med, and occupational med? Anyone has insight on why these areas have great satisfaction and the least burnout?
I imagine that preventive, environmental, and occupational medicine are super relaxed.
 
I have to agree.

If someone struggles with the burnout, he or she gets criticized by fellow physicians and administrators. There is no standard, widely accepted cutoff on what is reasonable workload and what is not. However, clinics struggle financially due to low reimbursements and physicians inevitably have to see more patients to cover the cost.


Back to the article, I am not surprised to see derm and rad onc doing well in both ranks. Their reimbursement rates seem to be relatively better than others. They could do more lucrative procedures while keeping the number of patients stable.

But what about general peds, preventive med, environmental med, and occupational med? Anyone has insight on why these areas have great satisfaction and the least burnout?
From ped docs I've talked to, they knowingly picked a low paying specialty and knew that going in. Pediatricians also seemed to really enjoy the fact that children generally want to get better and so do parents so compliance isn't an issue (not to say it's all roses but this has been a common theme among the docs I talked to).
 
I think pediatric docs actually like their patients. It's not like "it's the patient who's got a problem, not you".
 
I think part of a problem that I happened to observe even on SDN is that some doctors believe that being a physician is a "calling" and not simply a job. Therefore it is okay to expect things from doctors we don't normally expect from anybody else. Can they work more than others? Sure. It's a calling, they must sacrifice. In a meantime the burnout is way above national average even in the most lifestyle friendly specialties. Let's not forget that doctors are humans to and there is good reason why 40 hours a week is conserved full-time even though there are 168 hours in a week.

And there is a phrase thrown around here that pisses me off even more. "If you don't like it - don't be a doctor". How stupid.

Could not agree more with this. It's almost as if you took the words right out of my mouth.
 
This is a very complex issue that is influenced by a multitude of factors. Physicians experience a higher rate of burnout and a disproportionate rate of suicide not only because their jobs are stressful, declining reimbursements, and all the other factors everyone above mentioned. Healthcare professionals also demonstrate lower rates of help-seeking behaviors, which is a known risk factor for those who complete suicide. This is due to fears of appearing incompetent to peers, fears about the implications of such treatment on their license, and the stigma that "helpers aren't supposed to need help." It's unfortunately a perfect storm of factors that contribute to this issue.

The American Foundation for Suicide Prevention has done some interesting studies and outreach regarding physician burnout and suicide. Check it out if you're interested; it's fascinating stuff.
 
I think part of a problem that I happened to observe even on SDN is that some doctors believe that being a physician is a "calling" and not simply a job. Therefore it is okay to expect things from doctors we don't normally expect from anybody else. Can they work more than others? Sure. It's a calling, they must sacrifice. In a meantime the burnout is way above national average even in the most lifestyle friendly specialties. Let's not forget that doctors are humans to and there is good reason why 40 hours a week is conserved full-time even though there are 168 hours in a week.

And there is a phrase thrown around here that pisses me off even more. "If you don't like it - don't be a doctor". How stupid.

There are many, many other professions which demand work weeks much longer than 40 hours, and almost all of them offer considerably lower pay and (arguably) prestige than being a physician. For example, programmers, IT professionals (especially sys admins who, like doctors, are also on call 24/7), lawyers, scientists (even when making $40k/year as a post-doc), and the corporate world in general.

Of particularly interesting note is that academics, despite having terrible compensation for the amount of education and work they put in, boast some of the highest job satisfaction of any career. This is despite academia also being considered "a calling". I don't think it's a stretch to suggest that the reason for the stark contrast in happiness between academics and physicians is due to the fact that one career is so terrible that it only attracts people who have a real passion for it, whereas the other career boasts such high compensation (both financially and socially) that it attracts a very large number of people who only truly care about the tangible benefits. If scientific research also offered guaranteed $200k+ income and near-perfect job security I'm willing to bet that burnout rates would look very similar, if not worse, than what physician burnout looks like.
 
There are many, many other professions which demand work weeks much longer than 40 hours, and almost all of them offer considerably lower pay and (arguably) prestige than being a physician. For example, programmers, IT professionals (especially sys admins who, like doctors, are also on call 24/7), lawyers, scientists (even when making $40k/year as a post-doc), and the corporate world in general.

Of particularly interesting note is that academics, despite having terrible compensation for the amount of education and work they put in, boast some of the highest job satisfaction of any career. This is despite academia also being considered "a calling". I don't think it's a stretch to suggest that the reason for the stark contrast in happiness between academics and physicians is due to the fact that one career is so terrible that it only attracts people who have a real passion for it, whereas the other career boasts such high compensation (both financially and socially) that it attracts a very large number of people who only truly care about the tangible benefits. If scientific research also offered guaranteed $200k+ income and near-perfect job security I'm willing to bet that burnout rates would look very similar, if not worse, than what physician burnout looks like.

I take it that you don't have a phd and don't know anyone that does. Only premeds blather on about passion, prestige and income when those aren't even the main issues.
 
There are many, many other professions which demand work weeks much longer than 40 hours, and almost all of them offer considerably lower pay and (arguably) prestige than being a physician. For example, programmers, IT professionals (especially sys admins who, like doctors, are also on call 24/7), lawyers, scientists (even when making $40k/year as a post-doc), and the corporate world in general.

Of particularly interesting note is that academics, despite having terrible compensation for the amount of education and work they put in, boast some of the highest job satisfaction of any career. This is despite academia also being considered "a calling". I don't think it's a stretch to suggest that the reason for the stark contrast in happiness between academics and physicians is due to the fact that one career is so terrible that it only attracts people who have a real passion for it, whereas the other career boasts such high compensation (both financially and socially) that it attracts a very large number of people who only truly care about the tangible benefits. If scientific research also offered guaranteed $200k+ income and near-perfect job security I'm willing to bet that burnout rates would look very similar, if not worse, than what physician burnout looks like.

I can see academic professors having high job satisfaction. They do have mid 100k income once they make tenure, and just below 100k on track. Once tenured, they do have near-perfect job security. Their work is appreciated continuously in the form of accepted publications and peer collaboration. They work ~50 hrs a week, and the most stress they have is securing grants.

But those are the people that made it. What about the other 90% who gave up on academia because they couldn't get a tenure track, couldn't get tenure, or couldn't get funding? I'm sure their satisfaction is quite low.

Either way, academia is incredibly different than clinical medicine.
 
I think burnout is largely influenced by the inflated expectations many people have going into medicine. If you expect ample money, a great deal of respect, being a part of the social elite, etc, you're probably going to end up feeling sorely disappointed in the end, because when all is said and done, medicine is just another job. It isn't some magical gateway to fortune and respect, it isn't what they paint on television or in the movies, and it sure as hell isn't what some kid thought it would be when he decided to pursue it at 18 years of age. It's a slog of paperwork, bureaucracy, stress, and long hours, in which many of your patients won't even be able to compensate you for your services and the ones that can are often paying you less than you'd like. Your autonomy is stymied by what insurance will pay for, what resources your hospital or group has available, and what is considered the "best practice guidelines" of the day, and you'll find yourself practicing defensively and ordering useless test you don't even believe to be necessary just so some lawyer doesn't take everything you spent decades building and earning through hard work and perseverance. Most specialties will have you on call more than any non-medical professional you graduated undergrad with, on top of the already brutal non-call hours, causing you to miss out on a lot of the "living" part of life, and leading to you having a lot less freedom to spend that hard-earned cash.

There is a lot to love about medicine. But there is also a lot that makes it one of the most demanding, difficult, and stressful careers out there. To reiterate and summarize: burnout is probably largely a result of the great disconnect between inflated perceptions of the good in medicine and minimizing the downsides of being a physician, which leads to a huge case of dissatisfaction in the end.
 
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I met an ophthalmologist who was getting ready to retire early at 55. His patient population was very wealthy, and he made a lot money. However, he wasn't satisfied with the work. He summed up one of the reasons for me in a story:

One of the co-founders of a national news website came in to see him, and refused to pay the co-pay. $25 to a multimillionaire is pennies. The patient just felt like doctors undeservedly make too much money, and refused to pay on principle. The ophthalmologist told me that medicine is one of the only businesses where customers expect a perfect product for free. The same people that happily pay a plumber $100/hr to fix their pipes balk at paying a physician to fix their health.
 
It's a slog of paperwork, bureaucracy, stress, and long hours, in which many of your patients won't even be able to compensate you for your services and the ones that can are often paying you less than you'd like. Your autonomy is stymied by what insurance will pay for, what resources your hospital or group has available, and what is considered the "best practice guidelines" of the day, and you'll find yourself practicing defensively and ordering useless test you don't even believe to be necessary just so some lawyer doesn't take everything you spent decades building and earning through hard work and perseverance. Most specialties will have you on call more than any non-medical professional you graduated undergrad with, on top of the already brutal non-call hours, causing you to miss out on a lot of the "living" part of life, and leading to you having a lot less freedom to spend that hard-earned cash.

On a more productive note, can we discuss some individual-level ways to reduce probability of burnout for those going into medicine? Things such as for example, not talking criticism (from residents, attendings, even patients at times) personally, or making sure you don't over-defer your real life and instead keep protected time for non-medical activities throughout your training? Sorry, I don't have a lot of ideas myself, but I'm interested in strategies for having a happier existence in medicine, given the many challenges.
 
There are many, many other professions which demand work weeks much longer than 40 hours, and almost all of them offer considerably lower pay and (arguably) prestige than being a physician. For example, programmers, IT professionals (especially sys admins who, like doctors, are also on call 24/7), lawyers, scientists (even when making $40k/year as a post-doc), and the corporate world in general.

Of particularly interesting note is that academics, despite having terrible compensation for the amount of education and work they put in, boast some of the highest job satisfaction of any career. This is despite academia also being considered "a calling". I don't think it's a stretch to suggest that the reason for the stark contrast in happiness between academics and physicians is due to the fact that one career is so terrible that it only attracts people who have a real passion for it, whereas the other career boasts such high compensation (both financially and socially) that it attracts a very large number of people who only truly care about the tangible benefits. If scientific research also offered guaranteed $200k+ income and near-perfect job security I'm willing to bet that burnout rates would look very similar, if not worse, than what physician burnout looks like.
There are certainly jobs that work more hours on average but comparing to national average doctors work a lot more. I am not sure about academics though. I've heard they have it just as bad if not worse than doctors. Maybe I am wrong?

Regardless, my point is that it is ridiculous to expect a 40-year-old with a completely different set of priorities comparing to when he was 20 years ago to consistently sacrifice his life and family for a job, regardless of what that job actually is and how much he loves it.
 
On a more productive note, can we discuss some individual-level ways to reduce probability of burnout for those going into medicine? Things such as for example, not talking criticism (from residents, attendings, even patients at times) personally, or making sure you don't over-defer your real life and instead keep protected time for non-medical activities throughout your training? Sorry, I don't have a lot of ideas myself, but I'm interested in strategies for having a happier existence in medicine, given the many challenges.
The ways you can prevent burnout are largely individual to person and each specialty. You can't apply most of the the stress reduction strategies you would use in FM to surgery, for instance, as the stressors and challenges are completely different in the two fields. Turning off the Type A personality switch and relaxing would probably help a lot of people, as would managing their time better, but very much of the time, these are core aspects of people's personalities that are quite difficult to change.

The solution to burnout will be as individual as the person seeking it though, as some people might burn out due to the lack of respect or compensation compared to what they imagined, while others might experience burnout due to the stress and fast pace of their particular specialty. Look at EM, for instance. EM docs work less hours than most physicians, take no call, and generally work 12 hour shifts. Yet they have by far and away the highest rate of burnout of any physician field (and, last I read, of any field in the country). Many of the the very fixes that many would say should "fix" medicine, and make burnout less likely, have already happened in EM (increased compensation, no call, manageable shift lengths, less hours per week, vacation time without worrying about the health of your patients), and yet burnout is the highest there of any specialty.

Looking into alternative practice models (locum tenens, job sharing, shift work, etc) or less stressful specialties (PM&R, derm, etc) are possible things to help those seeking to avoid burnout in the future. But there are no universal fixes or band-aids in burnout land.
 
IMO the problem with EM is that they have all of the responsibilities of social workers without any tools to do the job.
 
I take it that you don't have a phd and don't know anyone that does. Only premeds blather on about passion, prestige and income when those aren't even the main issues.
Yeah, aside from bosses, coworkers, and friends I don't know any PhDs. Also, if you had exercised reading comprehension you would have understood that I was saying that medicine has exceptionally low job satisfaction because pay, prestige, and job security attract a lot of people who wouldn't even think of doing medicine otherwise and who are thus quickly disillusioned when they realize those things don't make up for doing a job you hate 80+ hours a week.
 
I admittedly didn't read the full article, but what is considered "burnout" in this study? I seem to remember reading a study a few years back on physician burnout where the study basically asked physicians if they experienced any of a number of symptoms (some of them were relatively minor). If they responded "yes" to any of the symptoms, they were considered to be burnt out.
 
I think burnout is largely influenced by the inflated expectations many people have going into medicine. If you expect ample money, a great deal of respect, being a part of the social elite, etc, you're probably going to end up feeling sorely disappointed in the end, because when all is said and done, medicine is just another job. It isn't some magical gateway to fortune and respect, it isn't what they paint on television or in the movies, and it sure as hell isn't what some kid thought it would be when he decided to pursue it at 18 years of age. It's a slog of paperwork, bureaucracy, stress, and long hours, in which many of your patients won't even be able to compensate you for your services and the ones that can are often paying you less than you'd like. Your autonomy is stymied by what insurance will pay for, what resources your hospital or group has available, and what is considered the "best practice guidelines" of the day, and you'll find yourself practicing defensively and ordering useless test you don't even believe to be necessary just so some lawyer doesn't take everything you spent decades building and earning through hard work and perseverance. Most specialties will have you on call more than any non-medical professional you graduated undergrad with, on top of the already brutal non-call hours, causing you to miss out on a lot of the "living" part of life, and leading to you having a lot less freedom to spend that hard-earned cash.

There is a lot to love about medicine. But there is also a lot that makes it one of the most demanding, difficult, and stressful careers out there. To reiterate and summarize: burnout is probably largely a result of the great disconnect between inflated perceptions of the good in medicine and minimizing the downsides of being a physician, which leads to a huge case of dissatisfaction in the end.
I met an ophthalmologist who was getting ready to retire early at 55. His patient population was very wealthy, and he made a lot money. However, he wasn't satisfied with the work. He summed up one of the reasons for me in a story:

One of the co-founders of a national news website came in to see him, and refused to pay the co-pay. $25 to a multimillionaire is pennies. The patient just felt like doctors undeservedly make too much money, and refused to pay on principle. The ophthalmologist told me that medicine is one of the only businesses where customers expect a perfect product for free. The same people that happily pay a plumber $100/hr to fix their pipes balk at paying a physician to fix their health.


So both of these imply that both the public and students have inflated perceptions of the good in medicine with other unfavorable sides minimized. The way to address the burnout is, therefore, to educate the public and students about the negative side? (But isn't this surprising since many pre-meds do EM shadowing and still have inflated views? Is it because they paid attention to things that they like, or confirmation bias?) If we do that, for example, EM residency spots will probably not be filled as easily as before (as this article implies: http://www.studentdoctor.net/2014/0...a-sizzling-hot-specialty-burn-you-to-a-crisp/) and those EM doctors who decided to pursue EM anyway could still go through some burnout eventually (since the system hasn't changed; EM doctors still can't choose whom to work with or whom to treat, exhausting shift work, etc.).
 
I admittedly didn't read the full article, but what is considered "burnout" in this study? I seem to remember reading a study a few years back on physician burnout where the study basically asked physicians if they experienced any of a number of symptoms (some of them were relatively minor). If they responded "yes" to any of the symptoms, they were considered to be burnt out.

Along with a few other survey questions, they used Maslach Burnout Inventory.
 
@Mad Jack Are you currently a med student? Your tag says premed, but you seem versed in the more intiment facets of doctor's lifestyles.

Anyway, my mama was a special education teacher for 23 years, and she was forced to retire due to burn out. That is happening more often in primary/secondary education, because government policies are burying the teachers in extra paperwork and forcing them to fill the rolls of councilors, social workers and surrogate parents on top of their primary occupations. The young lady who replaced my mom had a nervous breakdown by Christmas and the school has to replace 4 other teachers who bailed for similar reasons. Like medicine, teaching is often seen as being a pursuit of passion that ought to be done out of the goodness of the heart without expectation of recompense. She was forced to attend special Olympics events on weekends with no addition pay. The expectations are unrealistic yet administrators and "consumers" seem to believe that they can handle all that work with no trouble; that they are, in fact, more than happy to do it because their job is their life. From seeing what my family member dealt with, I can definitely appreciate what people in a doctor's position may be put though in their professional lives. The expectations put on such professionals should be altered. With less pressure originating from people outside the profession, burnout levels should fall, as far as they relate to that particular stressor.
 
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So both of these imply that both the public and students have inflated perceptions of the good in medicine with other unfavorable sides minimized. The way to address the burnout is, therefore, to educate the public and students about the negative side? (But isn't this surprising since many pre-meds do EM shadowing and still have inflated views? Is it because they paid attention to things that they like, or confirmation bias?) If we do that, for example, EM residency spots will probably not be filled as easily as before (as this article implies: http://www.studentdoctor.net/2014/0...a-sizzling-hot-specialty-burn-you-to-a-crisp/) and those EM doctors who decided to pursue EM anyway could still go through some burnout eventually (since the system hasn't changed; EM doctors still can't choose whom to work with or whom to treat, exhausting shift work, etc.).
Better information would probably provide less burnout. But EM is a great example of a field that might just never get a whole lot better. What else can they do? You can't just not work nights and holidays. You can't start turning away the patients you don't like. The only feasible ways to increase EM satisfaction would probably be increasing the level of communication and trust that they have when consulting other physicians, and increasing staffing levels so that they have a lower case load. The former is feasible but requires a large culture change, the latter is doable but would likely result in decreased salaries. Tort reform could help them sleep better at night, I suppose.

@Mad Jack Are you currently a med student? Your tag says premed, but you seem versed in the more intiment facets of doctor's lifestyles.

Anyway, my mama was a special education teacher for 23 years, and she was forced to retire due to burn out. That is happening more often in primary/secondary education, because government policies are burying the teachers in extra paperwork and forcing them to fill the rolls of councilors, social workers and surrogate parents on top of their primary occupations. The young lady who replaced my mom had a nervous breakdown by Christmas and the school has to replace 4 other teachers who bailed for similar reasons. Like medicine, teaching is often seen as being a pursuit of passion that ought to be done out of the goodness of the heart without expectation of recompense. She was forced to attend special Olympics events on weekends with no addition pay. The expectations are unrealistic yet administrators and "consumers" seem to believe that they can handle all that work with no trouble; that they are, in fact, more than happy to do it because their job is their life. From seeing what my family member dealt with, I can definitely appreciate what people in a doctor's position may be put though in their professional lives. The expectations put on such professionals should be altered. With less pressure originating from people outside the profession, burnout levels should fall, as far as they relate to that particular stressor.
I've worked in healthcare for quite a few years, and have a lot of physician friends in EM and IM that are very forthcoming about what they like and do not like about their careers. Having asked a few hundred residents how they feel about medicine now that they're past intern year, you start to get a good feel for the problems that you're going to face. "What do/don't you like about your specialty and would you choose it again" and "what are the things you wish you'd known about your specialty prior to choosing it, and would they have changed your mind" are two questions that can really net you some great info from residents. Let's just say everything I've learned has more than tempered my expectations, and that I expect medicine to neither be glorious nor magically fulfilling, but a worthwhile pursuit nonetheless.
 
I met an ophthalmologist who was getting ready to retire early at 55. His patient population was very wealthy, and he made a lot money. However, he wasn't satisfied with the work. He summed up one of the reasons for me in a story:

One of the co-founders of a national news website came in to see him, and refused to pay the co-pay. $25 to a multimillionaire is pennies. The patient just felt like doctors undeservedly make too much money, and refused to pay on principle. The ophthalmologist told me that medicine is one of the only businesses where customers expect a perfect product for free. The same people that happily pay a plumber $100/hr to fix their pipes balk at paying a physician to fix their health.
People be cranky and scared when dey sick..
 
Better information would probably provide less burnout. But EM is a great example of a field that might just never get a whole lot better. What else can they do? You can't just not work nights and holidays. You can't start turning away the patients you don't like. The only feasible ways to increase EM satisfaction would probably be increasing the level of communication and trust that they have when consulting other physicians, and increasing staffing levels so that they have a lower case load. The former is feasible but requires a large culture change, the latter is doable but would likely result in decreased salaries. Tort reform could help them sleep better at night, I suppose.


I see your point there.

I just skimmed through what occupational, preventive, and environmental med doctors do, and although their salaries vary depending on where they work and what they actually do, their salary is somewhat comparable to the salary of FM. I wonder whether EM burnout will decrease or at least become manageable if EM doctors have a choice to decrease the work load as well as their salaries. Maybe senior attendings might prefer to lower their workloads and salaries?
 
There are many, many other professions which demand work weeks much longer than 40 hours, and almost all of them offer considerably lower pay and (arguably) prestige than being a physician. For example, programmers, IT professionals (especially sys admins who, like doctors, are also on call 24/7), lawyers, scientists (even when making $40k/year as a post-doc), and the corporate world in general.

Of particularly interesting note is that academics, despite having terrible compensation for the amount of education and work they put in, boast some of the highest job satisfaction of any career. This is despite academia also being considered "a calling". I don't think it's a stretch to suggest that the reason for the stark contrast in happiness between academics and physicians is due to the fact that one career is so terrible that it only attracts people who have a real passion for it, whereas the other career boasts such high compensation (both financially and socially) that it attracts a very large number of people who only truly care about the tangible benefits. If scientific research also offered guaranteed $200k+ income and near-perfect job security I'm willing to bet that burnout rates would look very similar, if not worse, than what physician burnout looks like.

As far as I know, none of those professions have training periods of a MINIMUM 11 years, they don't usually rack up $200k in loans on average, and they don't get sued for everything they have when they make a mistake. There's nothing to be surprised about here. If you look at the pros/cons of each profession and the toll they take on a person's life you'll find a lot more cons than pros for wanting to be a physician.

Question is, do one of the pros cancel out a few cons for you personally?
 
From ped docs I've talked to, they knowingly picked a low paying specialty and knew that going in. Pediatricians also seemed to really enjoy the fact that children generally want to get better and so do parents so compliance isn't an issue (not to say it's all roses but this has been a common theme among the docs I talked to).


Peds isn't always low paying but you have to work pretty hard to get the big bucks.
 
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