Who's really to blame for physician burnout?

The subject of physician burnout has become a major point of contention in our community. Institutions try to help by implementing “mindfulness programs” or bringing in “burnout experts” for a one-time lecture. Physicians complain that the system is flawed and mindfulness is just another way for them to “blame the victim” for being burned out. Meanwhile, there are doctors who are simply trying to survive through each day; they walk around with a straight face, (and some with smiles), acting like all is well, while they secretly are suffering in silence. The shock comes when those doctors suddenly choose to take their own lives.

So who is to blame really?

While the majority of physicians would say the system is to blame, no one considers the possibility that the physician community as a whole has some responsibility.

When a physician inside his or her community does not feel safe even to talk to his colleagues (not his bosses or managers), then we have to look at who we are being as individuals that someone would rather suffer in silence and continue to spiral, rather than admitting to someone that they are in trouble.

Furthermore, we can look at the fact that, in many cases, we are so busy complaining about the system that we often fail to notice anything else … like a colleague who is slowly slipping away. So, while it would be a natural reaction to blame the “flawed medical institution” for a physician’s suicide, it would have more integrity for physicians to look at themselves every once in awhile to see where we can positively impact this issue.

This isn’t just philosophizing; this is personal experience speaking.

As a physician who has walked down the dark path of depression and who has nearly taken my own life, I know what it feels like to NOT know who to call, trust or lean on in an environment of people who are supposed to be your peers. On the day prior to the evening of my “near suicide” encounter, I remember thinking that there was no one — that anyone I talked to would either blow me off or treat me like I had some sort of rare communicable disease (frozen like a deer in headlights or slowly backing away in fear).

But what about the system?

The system is the system. It has its inherent flaws. The many flaws of the medical institutions is a subject that could be discussed ad nauseum. We could talk about the way CEOs are more concerned about the numbers than they are about their doctors (or patients for that matter). We could speak about the transition to value-based medicine, which translates to more patients in less time creating more risk of burnout for physicians and more risk to patients with potential medical errors.

We could commiserate on the long hours, the workload, the incessant paperwork, politics, bureaucracy, and “meaningless use” that often gets in the way of us serving our patients. And we could put the increasingly demanding patients up against the decreasing pay of physicians. There are a number of things that we could complain about the system, but the truth is this: The system is unlikely to change, the patient will continue to be demanding, EMR’s will be tedious and inefficient, and there will always be paperwork and politics.

This is where we can make a difference.

If we are to truly impact our own burnout, then we have to look at what we can do (while we are waiting for the system to miraculously change). We have to look at where we can be responsible in our own lives for getting our needs met, bringing joy back into our lives and even into our careers. This is why mindfulness is a thing, people! It’s not about blaming the victim. It’s about giving up being a victim altogether and taking power back as physicians both on an individual and community level. When we become responsible for our own, then the “oppressor” has less power.

So blame really should have no place in this conversation of burnout.

But if you must assign blame, consider that we are all to blame. The system is flawed, we as physicians are not doing a great job taking care of each other or ourselves. However, As long as we continue to claim victimhood we will continue to suffer.

It will be the physicians who choose to go beyond the complaint and look at so-called “out of the box” solutions like physician retreats, physician life coaching and other personalized options that will return us to ourselves and bring us to a tipping point of so that we can eventually be victorious in this seemingly never-ending physician burnout battle.