WPost article on Academic EM burnout

[slystalone]

Thought this was interesting - especially when they talk about how the program ends up paying for itself:

http://www.washingtonpost.com/news/...room-doctors-from-burnout/?tid=pm_local_pop_b

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[Zebra Hunter]

Its nice that they are trying to do something, but I seriously doubt it will have any effect on burnout. As it is, we probably have the greatest control over our hours worked of any specialty in medicine, and those out of residency usually don't work much more than 40hrs/wk. This does nothing to alleviate stress from drug seekers, abusive patients, and difficult consultants. Also, all those services offered could be set up by anyone in a large city.

 

[Birdstrike]

Whether this will work or not, I don't know. Either way, I do think it is a step in the right direction to acknowledge the problem and experiment with solutions, rather than tell recruits it is a myth. The "16 shift month" is not a perk, it's a survival adaptation necessitated by the fact that for every 3 EM shifts worked, one "day off" is spent recovering, painfully enough to be equivalent to a day worked.


Birdstrike's Theorem of EM Recovery - For every three EM shifts worked, add one painful "off" day for recovering, that is equivalent to a day worked.

15 EM shifts per month = 20 shifts per month practicing any other specialty

18 EM shifts per month = 24 shifts per month practicing any other specialty


Birdstrike's Law of EM Work Stress- Every hour worked in EM, is equivalently stressful as 1.5 hours worked doing anything else.

40 hr per week in EM = 60 hr per wk practicing any other specialty.


These are the undeniable truths of Emergency Medicine, that allow the specialty with the least hours worked hours per month, to still, year after year consistently place in the top 1 or 2 spots in reported physician burnout surveys.

Emergency Medicine = The toughest speciality in Medicine.

 

[Vandalia]

Acknowledging that you have a problem is the first step.

(The profession, that is.)

 

[deleted109597]

Of course, the other question is "why do you have to work 6 overnights in a row?" Oh, right, child support for the failed marriage and living in the highest cost of living area known to man. Carry on.

 

[WilcoWorld]

Of course, the other question is "why do you have to work 6 overnights in a row?" Oh, right, child support for the failed marriage and living in the highest cost of living area known to man. Carry on.

That's not true! He could live in Tokyo.

 

[AlmostAnMD]

I remember seeing the house the president of Honda lives in. One of the few actual houses in tokyo on a regular yard.

The only thing I could think was, "wow, looks like my parents house." (we are not multi millionaires)

 

[bashwell]

The Bay Area is pretty similar to Tokyo in a lot of ways. (I base my facts on movies like Big Hero 6)

I've been to both the Bay Area and Tokyo and know both well, and both are expensive. But last I checked median housing prices in Sydney, Australia are roughly as high as the Bay Area. Around $1 million. I'd guess cities like London and Paris are expensive too.

 

[CSingh]

Here's a counterpoint to this article, which is sure to infuriate some:

http://apennedpoint.com/privilege-and-entitlement-in-work-life-balance/

 

[goodoldalky]

It will be interesting to see if this has any impact. Certainly these types of interventions are needed to decrease the number of able-bodied physicians leaving practice, which is contributing to a serious access-of-care issue. However, I'm not sure these specific interventions really address the problem. I think there are systemic issues in medicine that are inherent and have a tendency to cause burnout as a natural response (volume of work, malpractice stressors, administrative mandates/oversight, expensive/malignant/long training, non-patient care burdens - insurance, documentation, EHR downtimes, endless MOC/merit-badge-medicine, lack of control in some settings over your practice environment and sometimes the actual practice of medicine, etc). To really fix this problem you'd have to address those issues that vary from specialty to specialty. Or you can follow in the footsteps of Birdstrike, who experiences an all-time low level of burnout these days.

 

[deleted109597]

Here's a counterpoint to this article, which is sure to infuriate some:
http://apennedpoint.com/privilege-and-entitlement-in-work-life-balance/

Nah, it doesn't infuriate me. I and many of us didn't grow up white collar with soft hands. I still mow my own yard.
However hard it is for me to dig a row of fenceposts, and how much it makes me ache, it's still easier than what I do at the hospital. Sure, not physically harder, but emotionally, mentally, absolutely it's easier. Nobody is arguing we aren't paid well. Some complain about loans, which is reasonable. But the point isn't that they aren't paid enough. It's that they work hard, long hours, and are held responsible for things out of their control. They're given ever decreasing margins to do what they actually want to do, which is care for patients, and not meaningfully use worthless EMRs.
So no, it doesn't make me mad.

 

[Birdstrike]

Here's a counterpoint to this article, which is sure to infuriate some:

http://apennedpoint.com/privilege-and-entitlement-in-work-life-balance/

Her counterpoint doesn't infuriate me. She does miss the point a little, but generally I agree we're a fortunate bunch in general (all doctors) and most of all, I agree that our burnout and other job satisfaction are at least partially self-imposed in many cases. We shoot for sun and complain that it's too hot.

 

[Angry Birds]

Here's a counterpoint to this article, which is sure to infuriate some:

http://apennedpoint.com/privilege-and-entitlement-in-work-life-balance/

I've always had the viewpoints expressed in the article, because I've seen my father toil in his trade, without ever being "entitled" about it, as we tend to get.

 

[Perrin]

The way I see it, albeit brutally honest, is that physicians are one of the most concentrated source of income for the hospital, manpower-wise. It's in their best interest to keep them healthy with little perks as long as they don't cost too much. If a physician gets burnt out, it can lead to mistakes, malpractice, or a toxic work environment. Some of those can be costly to the hospital. If a waiter, landscaper, or clerk gets burnt out, less likely of a mistake costing millions to their employer, but I'm sure there are rare instances of it.

 

[Old_Mil]

If you want to burn out an intelligent, hard working individual put them in a position where they have 100% of the responsibility for what goes on around them and 0% of the authority to change any aspect of it. It is almost a joke that MOC has a practice improvement component because nobody wants to hear how a physician thinks things could be made better.

 

[WilcoWorld]

If you want to burn out an intelligent, hard working individual put them in a position where they have 100% of the responsibility for what goes on around them and 0% of the authority to change any aspect of it. It is almost a joke that MOC has a practice improvement component because nobody wants to hear how a physician thinks things could be made better.

I agree with the first part of your post, but I'm not sure I understand the latter. Can you please elaborate on the statement "It is almost a joke that MOC has a practice improvement component because nobody wants to hear how a physician thinks things could be made better."

 

[DeadCactus]

Here's a counterpoint to this article, which is sure to infuriate some:

http://apennedpoint.com/privilege-and-entitlement-in-work-life-balance/

The only thing that infuriates me about it is that yet again we have cross-specialty and cross-generational quibbling among physicians instead of any sort of unity. It's particularly annoying coming from a specialty that sold its own future to mid-level providers...

 

[Birdstrike]

a specialty that sold its own future to mid-level providers...

I don't think this will happen. Salaries for EM are increasing as the number of mid levels is increasing. I understand the concern, but it's not actually happening.

 

[DeadCactus]

Talking about anesthesia, the prototype for giving physician scope of practice to midlevels...

 

[Birdstrike]

Talking about anesthesia, the prototype for giving physician scope of practice to midlevels...

It's apples to oranges, but if you do want to compare, their salaries still consistently rank above EM and consistently in the top 1/3 of specialties. So the sky may not have fallen as hard as they'd have you believe. Also, their protests have not kept CRNAs out of ORs. But I get it. Some people do see PAs and NPs as a threat to their careers. Personally I think it's a little overblown. But hey. I'm just one guy on the Internet.