One thing that contributes to burnout in medicine is the inefficient and cumbersome nature of the systems in which we practice. This is particularly true for compassionate, trauma-informed clinicians who must watch their patients suffer under a system that clearly has built-in historical and current harms. In 2008, when I started my nonprofit organization, the disparities had already cost this country millions of dollars and untold numbers of lives. We now have more exquisite data about those losses and the enormous cost to our health care system. Not only would universal health care help to address this issue of health disparities, but by eliminating the need to constantly credential, negotiate, and pay for the plethora of different insurance plans and their requirements, it would also mobilize thousands of administrative personnel into other professions, perhaps actual medicine where we know a detrimental shortage exists.
In 2015, I wrote a letter to CDC requesting that they recognize racism as a Public Health crisis and was given a cursory, borderline dismissive response at first, then empathy, and then indignation. As municipalities and organizations admit it across the United States, the former head of CDC, Rochelle Walensky, recognized it as a “serious public health issue” due to the disproportionate and grave toll in communities of color. The mere fact that she understated this crisis and only as she left office is significant, and some would argue an example of institutional racism, and we have heard nothing of this from her replacement. For those at highest risk, most people of color know that these systems are functioning as designed, to exclude them. Whether due to this racism, high-paid lobbyists, fear of long wait times (already an issue), or poor quality services, every president that has tried to create universal health care has been defeated. As clinicians, we are uniquely positioned to strategize and add that to the fight, especially post-pandemic when our work is being recognized.
If we as clinicians unite the way U.K. clinicians have, we can demand more responsive and nimble systems that service practitioners and patients instead of insurance companies and their execs, who strategize to deny services, meds, and healing interventions. The burnout is enormous because the bureaucracy is keeping us from the one thing that fights it – helping patients. I recently took a county clinic job to directly serve the patients who need me the most as a clinician of color, and it took four different staff three months to onboard me with credentialing though I’ve worked in the same clinic for nearly 16 years and previously worked at the county medical center. Meanwhile, patients at the clinic are needing to be booked out months due to understaffing. It also contributes greatly to the health disparities estimated to cost $451 billion per year, which would mostly cover that cost and contribute to health justice. There is much more to discuss, brainstorm, and collaborate to fix.
Leslie Gregory is a physician assistant.
