Back when I was in college in the 90s, there were three “high-powered” careers available: medicine, law, or finance. Since I attended a selective high school, most of my classmates chose these competitive and highly compensated jobs. My friends were mainly drawn to law (remember the TV show “LA Law”?) or investment banking.
But a few of us pursued what we thought was a higher calling and went into medicine. We liked science and loved the idea of helping people. We volunteered in hospitals and organized free community health weekends to support disadvantaged populations.
Credit: Charles Ng
Credit: Charles Ng
Those who ultimately made it into medical school excelled beyond science. In college, I created a startup selling inexpensive first-person video games, founded a club to help homeless people access free clinics and was the top-ranked econ student (random, I know). Many of my peers accomplished more than I did, with some being concert pianists, published authors and varsity sports stars. They notched these achievements while scoring straight As in physics and organic chemistry.
What was our motivation? We wanted to be there for the children bravely fighting cancer while cradling fuzzy stuffed animals and cold IV tubes. We stood shoulder to shoulder with fearless grandmothers in walkers battling heart failure so they could spend more time with their families.
We sacrificed our young adulthood for medical school and residency. While our law and finance friends were partying and traveling the world, we worked overnight helping laboring women or grandfathers with chest pain. While our peers were making a fortune, we ate dinner alone at 1 a.m. under the cold glow of the hospital cafeteria’s vending machine.
Once we finished residency, we were finally real doctors. We were ready to jump in and make a difference. As newly minted physicians, we were chomping at the bit to cure disease, deliver babies, and comfort the suffering. We were ready to take charge and change the world.
But that’s not what happened.
Instead of the captains of the ship of health, we became cogs in a wheel. Reality crushed our enthusiasm.
We discovered we had all these bosses that we never expected, superiors without our medical training or experience caring for patients.
We found that the insurance industry is our boss. They decide which patients can have which procedures and when. Non-clinical administration is our boss. They choose office hours, staffing, and policy. They determine our team, as we have no control over hiring and firing. Private equity is now our boss. They dictate which centers open and close, budgets, and direction.
We’re still responsible for patient outcomes. If something doesn’t go well, we’ll undoubtedly be blamed. Yet, we have no organizational power.
Doctors, we quickly discovered, suffer from responsibility without authority or distributed leadership. The administrative decision-makers are largely shielded from the impact of their decisions as patients suffer and doctors are left holding the bag.
It’s no wonder that physicians are quitting medicine in droves. We are burnt out because we no longer feel like we’re making a meaningful impact.
It isn’t the overnight shifts, long days or hard work. We’re used to that. The fundamental problem driving doctors out of clinical practice is the sense of powerlessness. Why sacrifice seeing our kids grow up only to go to work and be overruled by a faceless bureaucrat?
Over more than 1 in 2 doctors are burning out. Female doctors burn out 60% more than their male counterparts, and the consequences are dire. Concerningly, doctors lost to burnout disproportionately harm underserved minority communities.
Thankfully, there may be some promising signs on the horizon. As a society, we are more comfortable openly discussing burnout. Artificial intelligence can reduce doctors’ email burden and assist with annoying, repetitive tasks. Physician freelancing (locum tenens) helps doctors recharge their batteries and brings them where they’re most needed.
Simplifying the credentialing and licensing processes makes it easier for doctors to work in sites that match their temperament and skill sets. Finally, telehealth can make medicine more equitable by empowering women doctors and Black and Hispanic patients.
As our population ages, we’ll require greater access to high-quality healthcare. Unfortunately, burnout is causing emotionally exhausted doctors to leave medicine just when we need them the most. Our demand for competent, compassionate, and motivated physicians will only increase.
It’s in everyone’s interest to keep doctors engaged. After all, who will be left to care for us when all the physicians quit?
Dr. Gregory Charlop is an anesthesiologist in private practice in Atlanta. He’s an expert on physician burnout and the author of “The Physician Wellness Project.”
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