I can tell you why there is a high burnout rate in the medical profession, but to do so, I have to explain why there isn’t one for small private practices.
When I was finishing up medical school, I went to see a general practitioner. Now, this doctor had an unbelievably high level of charisma. To say he was engaged in his patient’s health care would be an understatement. Not only would I receive a birthday card from his practice, but he’d also call me to see how I was doing with my weight loss.
There’s a reason why doctors like him do not exist outside small private practices. It’s the same reason physician burnout is on the rise and why more doctors are turning to binge drinking.
It’s because doctors today have less self-perceived capability. No, such capability does not come from our technical skills, but rather from our patient engagement which has been reduced as we have become slaves to our electronic health records (EHRs). This means the current generation of doctors feel less capable of making a significant change in their patients’ lives due to the fact they have to spend more time online entering health data. A job which could honestly be distributed to another profession like medical assistants.
What makes this feeling worse, is more than two-thirds of my patients have a disease with a substantial lifestyle component. And unlike the doctor I mentioned earlier, I lack the time to properly educate them on this. It’s no surprise that if physicians can spend more quality time with their patients, they will benefit from a therapeutic patient-physician relationship.
Yet there is another element of self-perceived capability at play, and that is the customer-engagement level in the cost of each procedure. Thus, it should be of no surprise when I tell you that 72 percent of consumers are confused by their medical bills and 94 percent of consumers have received medical bills they considered to be “too expensive.”
This makes patients resentful for some of the care they are given, as they struggle to find a means to pay for their hidden health care costs. It is also why I think seeing the face of a patient upon receiving their bill is such a terrible thing to witness.
Deep down, I think most doctors in the U.S. feel the same shame knowing the current health system is exploiting patients, and while we’re not responsible for all the costs, sometimes we still struggle to shake that notion. So many of us drink to forget.
However, what I have recently noticed is far worse. Some patients, like a victim of Stockholm syndrome, are so used to the abuse from our health care system, having been stripped of their choices, they keep coming back.
They often don’t want to hear about how they can help themselves or how their illness has been exacerbated by their lifestyle choices — because they’ve been conditioned to expect the system to take care of them. They’ve become well-trained milk cows.
While physicians have been reduced to overpaid dairy farm labor, they took on hundreds of thousands of dollars in debt, partly for the job security of our profession.
It’s no wonder more of us are dissatisfied with our jobs. Sure, we love the money — but we hate what we’re doing to get it. And with the golden handcuffs we currently have on, nothing is going to change anytime soon.
Nevertheless, if anything were to change, the radical solution would be to restructure how we do medicine. We would need to start restoring the patient’s power as consumers and allow them to shape our system. So hospitals would no longer be bureaucratic crony capitalist farms, but exist only to serve the purpose of the patient.
Kyle Varner is an internal medicine physician who blogs at his self-titled site, Dr Varner, He can be reached on Twitter @Doctor_Varner.
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