Physicians are often seen as pillars of strength, guiding patients through their most vulnerable moments. However, behind the white coats and the stethoscopes lies a troubling reality: an alarming rise in physician burnout.
In the U.S., data from the American Medical Association and the Mayo Clinic found that physician burnout has reached 54 percent, compared to the 45 percent reported in a similar study conducted in 2011; this translates to an estimated 1 million doctors in the U.S. now suffering from burnout.
Physician burnout is characterized by an overwhelming feeling of fatigue, emotional exhaustion, depersonalization, and a decreased sense of accomplishment. If we continue with the current trends due to the actual state of health care, then we should assume that at some point in our lives, we will become the patients who will have to deal with a doctor struggling with burnout. This is when my story starts.
As a general pediatrician, I know that a good history and physical examination will allow you to elaborate a proper assessment and plan. We learn this during medical school, and it is drilled into our brains during residency. At 41 years of age, I felt a pelvic mass that I knew was abnormal. I knew that it was not supposed to be there. My first struggle was to find an appointment with my PCP soon enough so that I could get the proper testing done. Possibly the first sign of how damaged our current health system is, one in which not even doctors know that their schedule is booked far ahead, and even if they know, they might not have the authority to change that. Then, my best next option, since I wanted to get a CT scan done, was to go to the Emergency Room.
I do have the utmost respect for every health care provider. I only identify as a physician if they ask what I do for a living. That day, though, I wore my hot pink scrubs because I came to the ER after work. I do not exaggerate that the ER doctor performed the worst exam. I even went through her notes afterward, and the history lacked the main reason why I was in the ER in the first place; the examination does not even mention anything about a mass because she did not even check on me. I have dealt with dismissive doctors, but this one was negligent. It took 3 hours for someone else to come to my room and tell me that the radiology tech was delayed and that it would take even longer for me to get the CT scan. My response was, I am going home.
Two weeks and a half later, I saw my PCP, got blood work the same day, and had a CT scan STAT – preliminary diagnosis of ovarian mass. I met a GYN oncologist two days later. I had to undergo a total hysterectomy with bilateral salpingo-oophorectomy along with right inguinal lymph nodes. Stage 1 endometrioid adenocarcinoma was the final diagnosis. This journey made me think about the thousands of patients who do not have an outcome like mine.
The consequences of physician burnout extend far beyond the individual practitioner. Studies have shown a disturbing correlation between burnout and medical errors. When doctors are physically and mentally exhausted, their cognitive abilities become compromised, leading to lapses in judgment, decreased attention to detail, and a higher likelihood of making mistakes. Physicians with symptoms of burnout or low personal accomplishment were likelier to report patient safety incidents. With increasing levels of depersonalization, the other core dimension of burnout, internal medicine residents were shown to have an increasing probability of reporting at least one suboptimal patient care practice.
In my case, I advocated for myself and kept looking for an answer to my problem. But what would happen to our patients with different opportunities whose doors do not open as quickly? To do what is suitable for ourselves and our patients, we all must fight to continue demystifying the effects of burnout. To mitigate the impact of burnout on patient care, health care organizations must implement strategies to reduce administrative burdens, improve work-life balance, provide adequate support systems, and focus on a culture that prioritizes physician well-being. Additionally, interventions such as mindfulness training, peer support programs, and mental health resources can help doctors cope with the demands of their profession.
I was able to be disease-free after one extensive surgery, but for many, that is not the case.
Ariam Mathusek is a pediatrician.
