PMR burnout?

Started by futuredrdo
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futuredrdo said:
any attending/residents have insight as to why the climb is so high for burnout in PMR over the last 3 years?

http://www.medscape.com/viewarticle/855233
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Over the past 15 yrs our field has gone from one where 80% of physicians were in one or two doctor practices to now only having 15% in that sized practice. Add to that, substantially lowered reimbursement (with the decline of EMG payment in 2013), and increasing pressures by hospital/practice administrators has caused this trend. Notice that almost all medical specialties are noting worsened burnout. This trend is endemic in medicine as doctors lose autonomy with no increase in pay. Our country is about to face a crisis because of this trend. In the past, most doctors worked into their late 70s (at least part time). Whereas now, most of my colleagues in all specialties who are in their mid 60's are contemplating retirement. They just don't see the added benefit of being an employed physician.
 
RUOkie said:
Over the past 15 yrs our field has gone from one where 80% of physicians were in one or two doctor practices to now only having 15% in that sized practice. Add to that, substantially lowered reimbursement (with the decline of EMG payment in 2013), and increasing pressures by hospital/practice administrators has caused this trend. Notice that almost all medical specialties are noting worsened burnout. This trend is endemic in medicine as doctors lose autonomy with no increase in pay. Our country is about to face a crisis because of this trend. In the past, most doctors worked into their late 70s (at least part time). Whereas now, most of my colleagues in all specialties who are in their mid 60's are contemplating retirement. They just don't see the added benefit of being an employed physician.
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Can't blame them. The nice thing about PM&R is that if you're MKS-oriented you can set yourself up as a concierge practice. Another great angle is medico-legal-disability consulting work...Who wants to put up with the bullsh*t of working in a large health system their whole life?
 
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The study is a bit of a shock to me--I haven't met a single burnt out physiatrist (I've only met ~40 or so, not including residency interviews where you'd hope they don't display signs of burnout...),. VA physiatrists always are the happiest no matter where I seem to go, but I'm sure there's some self-selection going on (kind of like how geriatricians are the happiest specialty).

Actually I've met physiatrist who seems a bit burnt out, but he's still generally happy.
 
I have meet and talked to many Physiatrist who are burnt out or getting there. They typically are doing inpatient rehab (medically complex patients, call, weekends, low pay, red tape and lack of autonomy) or chronic pain (complex and demanding patients, risk of litigation, reduced reimbursement etc). Most physicians in the MSK world and VA have a low burnout.
 
Something is incredibly ****ed up with medicine in general when physiatrists are being burnt out. Eventually physicians are going to have to rise up.
 
Contributing to burn-out:

Been out of residency 4.5 years. Each year I've seen a pay cut (less $ per RVU) of about 3%. My RVU reimbursement is based upon MGMA data. Account for inflation, and it's even worse.
EMGs/NCS were slashed in 2013.
USGI were reduced in 2014.

So... getting LESS RVUs per procedure, and getting LESS $ per RVU. It's laughable.
 
j4pac said:
Something is incredibly ****ed up with medicine in general when physiatrists are being burnt out. Eventually physicians are going to have to rise up.
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What can we do as rising physicians to generate an effective, collective voice?
 
xjrgpf6 said:
What can we do as rising physicians to generate an effective, collective voice?
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Better leadership...more visible leadership. Leadership ideally with a spine. Folks who don't take what's handed to them...instead takes what is earned. Leadership that would do everything in their power to bring the AMA/AOA to its knees...and remind our insurance and government overlords that medicine existed without their presence and it can once again.

Every physician knows what it will take to gain true medical reform. The problem is that there is a significant amount of learned hopelessness. That along with lack of unity amongst physicians, physicians being too busy to care, and fear of alienating patients has led to what medicine is today.

First things first we need to unify. Next, we to define our enemy. Third, we need to conquer. Oh...it can be done. And it could be done in a week.

Of course all of this will need to be done tactfully while maintaining the confidence of our patients that we are looking out for their well-being. Physiatrists burning out is an ominous sign of things to come for healthcare.
 
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Really depends on where you work, but yeah RVUs are tough and reimbursement has dropped like crazy while student loan payments are ridiculous
 
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