Burning Inside Out for Medicine

 
The rates of burnout in healthcare is increasing at alarming rates. Together, we discover the reasons behind burnout, its consequences, and probable solutions.

In 1974, “burnout” was officially recognized between healthcare professionals, especially physicians. Nevertheless, medicine was already known to be a tough discipline many years before that. Dr. William Steward Halsted, the father of modern surgery, obtaining his ideas from Europe, used to train his residents and did not advance them to the next level until he thought they were ready. The term ‘resident’ means that a physician should almost always be present at the hospital performing at their optimal level. Despite his severity as an academic surgeon, he was also well known for being a cocaine addict coupled with lack of time discipline at work.
Burnout is a work-related syndrome that often manifests in domains that deal mostly with people such as the one of healthcare. Dr. Patricia Normand, MD and Director of Wellness and Integrative Health at Rush Medical Center states that “Burnout is different than stress. Stress is a feeling that is activated, you’re hyperactive. [With burnout,] you’re almost immobilized.”
Today, increasing numbers of young physicians worldwide are either looking for alternative side-gigs or leaving medicine early or mid-career for other more ‘convenient’ alternatives. Some collapse because of the pressure, with results as drastic as committing suicide. I still recall that one of our colleagues in France took away his life because he was unable to keep up with the head of the department.
What about me, you ask? Well, let’s just say that some days I feel like taking off my white lab coat and opting for a career in filming.
Many statistics nowadays show that one in every three doctors will suffer burnout[1]. Gender affects how burnout manifests. Males tend to display more levels of physical deterioration in their burnout, while females show more psychological symptoms. Reaching to the roots of burnout is quite complicated as many factors come into play such as increasing workloads, unrelenting demands, constant deadlines in a chaotic bureaucratic work environment, and “becoming sophisticated desk workers”.
We are overworked, drained, and just plain tired. Most of us step into medicine wanting to leave a legacy. The urge to change medicine fades away, and medicine ends up changing us. We end up losing our passion and heart in it as the depersonalization continues. We are constantly told to act professional and show no empathy until we become numb; our memory and attention suffer, and we start making poor decisions that lead to medical errors.  What is interesting to note according to Mayo Clinic is that “Self-perceived medical errors were found to predict subsequent burnout, while burnout was also found to predict subsequent perceived medical errors.” Moreover, a recent study from Stanford University mentioned that “physicians with burnout had more than twice the odds of self-reported medical error.” The ones to suffer the most, as a result, are the patients and their caregivers.
The culture of healthcare is one of resilience and endurance. The notion that healthcare providers, especially physicians and nurses, are superhumans who are expected to suppress their vulnerabilities and toughen up is always there. It often starts from medical school where one plows through intense workload and does not dare to complain. We are known to be brutal on our own kind. As the rate of burnout continues to rise, we are becoming patients ourselves, and in this shift, we are all implicated!
We do not need more inspirational talks about ‘resiliency’ or yoga mats thrown at us demanding we practice more meditation. It’s just a band-aid that can be easily ripped off. Thus, as a result, the scenario of patients internalizing that physicians are empathetic or not good at their job is often repeated. We might be the problem ourselves as susceptible individuals in the first place, or perhaps it is how healthcare is managed nowadays.
Some medical schools started incorporating physician wellness in their curriculums, others have reduced the duration of the teaching. Training programs in several countries are now offering shortcuts for earlier specialization. Despite the lack of literature in combating burnout, I personally believe that we should drastically change the way we practice medicine starting with the young at school. Programs like narrative medicine allow practitioners to be more empathetic and therefore reduces the barriers. Individuals such as Dr. Victoria Sweet advocate for slowing down in medicine and taking time to treat.
With everything being fast-paced nowadays, perhaps it is wise to slow down and change the way we practice medicine before its identity is lost.