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The silenced physician voice

Nandini Venkateswaran, MD
Physician
January 6, 2024
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Medicine, for many of us, has been a calling. Since I was a child, I knew I would be a doctor, and I did everything in my power to make that dream come to fruition. Nearly 13 years of education, hundreds of thousands of dollars in debt, years of lost income and retirement savings, countless hours away from family and loved ones, and a disregard for personal passions and hobbies were needed to ultimately reach this zenith. Here I sit today, a board-certified physician and surgeon, with the job I always wanted.

But was it all worth it?

Many would argue that at times, yes. But sadly, more often than not, physicians like myself express genuine regret in having pursued this arduous path.

More than half of physicians (53 percent) report burnout, with female doctors reporting significantly higher rates of burnout than their male colleagues. It pains my heart to hear that 13 percent of physicians have felt suicidal as a result of this.

However, one contributor to burnout that is not spoken about enough is patient mistreatment of providers. In speaking with many colleagues, many of us in health care have felt we are victims of patient bullying and verbal/emotional abuse. We endure unnecessary commentary from patients about our appearance, race, ethnicity, years of experience, among other things. Workplaces mandate public posting of all patient comments and reviews that physicians have to read and process. Other times, physicians are forced to read letters of complaint written by patients sent to patient relations and patient advocacy departments, attacking physician quality of care with threats of litigation. The statistics regarding litigation in medicine are staggering — the American Medical Association found that in 2022, nearly 1/3 (31.2 percent) of U.S. physicians reported being previously sued. In addition, they found that the longer a physician is in practice, the higher their exposure to risk, and that nearly half of physicians (46.8 percent) over 54 years of age have been sued. The reality that we as physicians will more likely than not get sued looms above us. We cannot do anything but accept it as reality and feel helpless. These outlets have amplified the power of the patient voice, and the negative, disparaging voices sadly drown out the thankful, positive ones.

So I ask all of you, where has the physician voice gone in this landscape of health care? Patients have an abundance of outlets to relay their thoughts and concerns with abandon, but why do we as physicians remain silenced? How do we protect ourselves and retain our love for medicine in a world that is so quick to point fingers and denigrate us while all we are trying to do is take the best care of our patients? How do we formally voice our concerns over patient abuse and disrespect to defend ourselves? How do we hold patients accountable for their behavior just as we are held accountable for the values of the Hippocratic oath we took when we first put on our white coats?

No physician walks into a patient room or an operating room desiring to incite harm. They apply hours of training and expertise in striving to provide the highest quality of care to their patients with an inherent desire to take care of others. Yet our patients forget that we too are human. Patient expectations and entitlement have become unreasonable. We are no longer viewed as physicians but as a service industry that is at the beck and call of our customers.

I urge you all to sit back and think about how we as physicians can advocate for ourselves. Where can we find resources to advocate for ourselves? How can we reinvigorate the patient-physician relationship without fearing retaliation and litigation during every patient encounter?

I worry that if we lose our voices, we will very soon lose valuable clinical talent as many of us will choose to leave clinical medicine for other ventures. Burnout is an epidemic that we will not escape if this continues. And sadly, the ones who will suffer are the patients who bullied us from the start.

Nandini Venkateswaran is a physician.

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