Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Therapy and self-help strategies aren’t the answer to solving physician burnout

Matthew Hahn, MD
Physician
February 27, 2018
Share
Tweet
Share

There is growing recognition that the broken American health care system is taking a toll, not just on patients and their families, but on health care professionals as well. Nearly half of all physicians in various surveys now report that they are burned out. Inevitably, the experts are lining up to further study the issue and to teach doctors better coping skills.

In terms of the need for further study, I am but a simple country doctor, but I think the issues are pretty clear. If you punch someone in the face, they’re going to get a black eye. And if you try to practice good medicine in our terrible health care system, you’re going to get very frustrated, often to the point of burnout.

Burnout is a simple case of physicians’ lofty expectations meeting up with the disappointing reality of the American health care system.

In medical school, we are given the impression that medicine is a sacred pursuit. It is traditional at many medical schools to begin a student’s experience with a white coat ceremony, where we are given our pure-as-snow new uniforms and invoke an oath to do no harm and to give every patient the best care possible. It is a powerful, emotional experience. We talk about medicine as a calling rather than a profession. We then receive intense, prolonged years of training, at great expense, but leave medical school armed to help people, who are often in dire straits, with a well-honed history and physical exam, and an amazing array of modern tests and treatments.

But then, once in practice, reality quickly takes hold. We are driven to maximize revenue in the setting of a payment system so complicated that it often takes Herculean effort just to get paid. At the same time we are badgered to minimize spending on patient care, but have no control over, or even knowledge of, the costs of care. There are barriers to the best patient care at every turn: patients unable to afford the care they need, inscrutable insurance coverage, tests and treatments priced far beyond almost anyone’s ability to pay for them, and now, lengthy insurance prior authorization processes for even basic tests and treatments. As if all that wasn’t enough, we are also forced by government mandate to use unusable EMR computer systems to report unattainable quality metrics. We are incessantly belittled that our care lacks value in a system designed to destroy value. And despite everything, if anything should happen to go wrong, we can still be sued.

Under these circumstances, burnout is inevitable. We are truly damned if we do, and damned if we don’t. We carry on our shoulders the responsibility for patients’ lives — to do no harm in a harmful health care system.

What can physicians suffering from the effects of burnout do to mitigate the situation? Experts suggest things like getting more sleep, learning to meditate, exercising regularly, learning to say no, learning to value the small things in life, recognizing that things could be worse, and learning better time management skills, just to name a few.

These are wonderful suggestions that will be incredibly effective as long as while we are doing them, we also fix the broken health care system that is the source of the burnout in the first place!

If we really want to reduce burnout among physicians, we will:

  • Simplify the American medical coding, billing, and payment system.
  • Remove the myriad barriers to patient care, enabling doctors to make decisions based on what they (and their patients) feel is in the patient’s best interests.
    • Finally enact legislation that brings affordable, comprehensive care to all.
    • Eliminate prior authorizations for all but truly exceptional tests and treatments.
    • Eliminate payment bundling strategies that encourage us to skimp on necessary care.
  • Create some semblance of functional health care markets.
    • Require transparent pricing so that decisions can be made based on cost when feasible.
    • Limit the size and/or monopolistic power and practices of the largest health care entities, including insurance companies, pharmaceutical companies, and health systems.
  • Create a functional, usable EMR that delivers on the great promise of health IT, and then give it, at low or no cost, to all who want it.
  • Eliminate value-based payment programs like MACRA until we have a functional health care system and health IT tools that make value attainable.
    • Avoid payment penalties that would discourage doctors from taking care of the sickest, poorest patients.
    • Avoid payment strategies, like bundling, that encourage physicians to skimp on necessary care.
  • Once and for all, create a reasonable malpractice system that protects patients, but also encourages improvements in care.

There should be no surprise that American physicians are burned out. And therapy and self-help strategies aren’t the answer. The answer is fixing the broken American health care system.

Matthew Hahn is a family physician who blogs at his self-titled site, Matthew Hahn, MD.  He is the author of Distracted: How Regulations Are Destroying the Practice of Medicine and Preventing True Health-Care Reform.

Image credit: Shutterstock.com

Prev

A roller coaster of emotions at my community clinics

February 27, 2018 Kevin 1
…
Next

"Shards of Glass" from Medicine the Musical

February 27, 2018 Kevin 0
…

ADVERTISEMENT

Tagged as: Psychiatry, Public Health & Policy

Post navigation

< Previous Post
A roller coaster of emotions at my community clinics
Next Post >
"Shards of Glass" from Medicine the Musical

ADVERTISEMENT

More by Matthew Hahn, MD

  • This doctor got COVID. Here’s what it taught him.

    Matthew Hahn, MD
  • These leaders will not fix health care

    Matthew Hahn, MD
  • The demonization of socialized medicine

    Matthew Hahn, MD

Related Posts

  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • A physician’s addiction to social media

    Amanda Xi, MD
  • Physician burnout is as much a legal problem as it is a medical one

    Sharona Hoffman, JD
  • Despite physician burnout, medical schools are still hard to get into. Why is that?

    Suneel Dhand, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • The black physician’s burden

    Naomi Tweyo Nkinsi

More in Physician

  • How tragedy shaped a medical career

    Ronald L. Lindsay, MD
  • A doctor’s guide to preparing for your death

    Joseph Pepe, MD
  • How policy and stigma block addiction treatment

    Mariana Ndrio, MD
  • Why don’t women in medicine support each other?

    Jessie Mahoney, MD
  • IMGs are the future of U.S. primary care

    Adam Brandon Bondoc, MD
  • The high cost of gender inequity in medicine

    Kolleen Dougherty, MD
  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Therapy and self-help strategies aren’t the answer to solving physician burnout
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...