INSIDE WVSMA
Message from the President
Getting to the Root of Burnout
Suzanne Gharib , MD
While thinking about a topic for this article , I was reading about the proposed Medicare cuts to the physician fee schedule . As I pondered the news , I was led down the pathway of burnout and its root causes . Granted , I am no expert on burnout and there is certainly a lot of discussion around this topic . That said , I ’ ve never believed the rhetoric that burnout is about work-life balance , etc . It seems more complex at its core . Physicians are exiting the workforce at an alarming pace and many of those are leaving mid-career . The days when physicians worked well into their 60s and 70s are rapidly becoming a thing of the past and its past time that we , as a medical community , take a good , hard look as to why .
In my experience , most people embark on a career in medicine for a few main reasons . They are born caregivers , love science , and / or are looking for secure work . All of these are good , valid reasons to seek a career in medicine . Sadly , however , this career has been under fire for the last several decades and the war continues to escalate . The system we currently are operating under has robbed us and continues to rob us of all the enjoyment of our profession .
Firstly , we have been robbed of the joy of caregiving . The patient-physician relationship , which is built on trust , respect , and genuine desire to heal , has been eroded and continues to be corrupted with every new change made . We start out in medical school with a hopeful outlook and goals to improve the health of our individual patients and society at large . That hope is quickly replaced by computer screens that sit between us and our patients and force us to spend more time on mind numbing data entry than we do communicating . The interaction described by Sir William Osler where we listen to patients and , through a good history and exam , formulate a plan of care has been replaced with brief , perfunctory histories followed by a mass of expensive and oftentimes unnecessary testing in an attempt to practice defensive medicine . Insurers dictate day-to-day treatment , denying appropriate treatments and testing to save money . They also force us to waste our time and energy in peer-to-peer appeals where we never speak to a peer but have to make a case for those with limited knowledge of our patients to be able to provide adequate care . We
do all this without a word of thanks . In fact , we are often made the enemy with patients directing their anger at us for prescriptions that won ’ t be filled or procedures that will not be done .
Secondly , our love of science has been corrupted . This has been highlighted in excruciating detail by the developments of the last several years . I distinctly remember telling some colleagues when the COVID-19 pandemic started not to get too comfortable in the role of healthcare heroes that was being brought up on the news and social media . It was almost a foregone conclusion that the tide would turn and physicians would become the villains in the play . Instead of being able to lead and have good scientific debate about a novel virus , we find ourselves as pawns for those on all sides of the political spectrum who politicized a global pandemic . Not only were we sidelined in what is perhaps the most consequential medical event of our lifetime but public trust in physicians has continued to spiral in a horrific fashion .
Lastly , our ability to make a living is being targeted . Apparently , physicians are not subject to inflation like the rest of the population . Physicians can afford to have salaries that stagnate over a decade . Physicians can afford rising costs of medical school , often starting their professional lives with a debt burden that rivals a house mortgage in more upscale neighborhoods . Hopefully , the sarcasm shines through in these statements and stirs up some righteous anger .
In conclusion , I write this with genuine frustration and a touch of bitterness at the state of our profession and deep sadness as to what we are leaving for future generations of physicians . That said , I think the onus is on us who are practicing medicine in this current reality to fight . We need to fight with our votes . We need to fight with our pocketbooks . We need to fight with our phone calls and emails . Never should we allow a proposed pay decrease to go unchallenged . We need to work harder to take back our profession in meaningful ways .
Best regards ,
Suzanne Gharib , MD
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