DISCLAIMER: The following blog addresses some very real issues regarding providing medical care in this day and age in the U.S. Despite my struggles to reconcile my own feelings about practicing primary care, I still do and always will love medicine. I cannot emphasize it enough. I trained to become a knowledgable, compassionate, and competent doctor, and my love for that will never change. It’s all the other bull***t that keeps getting in the way and messing things up.
It only makes sense that my first real post would address the huge dead elephant in the room. At the age of 37, I took a big breath and completely walked away from my career in clinical medicine. Obviously, I didn’t just wake up one day and decide to quit being a practicing doctor. This was a heart-wrenching resignation that was made over many years and many countless attempts to fall back in love with being a practicing physician. I also think it’s important to mention that I am not one of those folks who came out of the womb knowing I absolutely had to be a doctor. There have always been other interests and talents in my life that have pulled at me in other directions, and I have never worried that the sun would somehow fail to rise in the morning if I decided to do something else. I have shifted my horses in midstream, become my own boss, and am doing a combination of medical consulting and foreign language interpreting, and quite honestly cannot remember a time when I have been happier in my work (more on that later….)
Still, what was it exactly that lead me to basically (and with much relief) walk away from what appeared to be a thriving clinical career and throw all my colleagues into an apoplectic fit? The answers do not only belong to me, but to a startling number of my fellow physicians who are struggling daily with the urge to simply give up.
According to a 2011 JAMA article by Dyrbye and Shanafelt, an estimated 30 to 40% of physicians are experiencing burnout. It’s not just a few disgruntled docs who have been at it too long and need to spend more time finding their inner zen. Burnout among our nation’s physicians is nothing short of an epidemic right now, and one we cannot afford given that we have some of the poorest medical outcomes among industrialized nations. Yes, we all love to think that America is the mecca of medical care, but compared with other economically-industrialized countries, our statistics are some of the least desirable in areas like infant mortality and life expectancy (OCED health data 2011).
So what’s at the heart of this tsunami of doctor burnout? There are lots of articles and research efforts being devoted to this very question. Right now there is an interesting article posted on kevinmd.com regarding gender differences in physician burnout. For me, I did a lot of introspective thinking in the six months I took off after my resignation. I don’t claim that every other physician experiences these issues the same way I did. But for me, they were very real and ultimately forced me to walk away from clinical practice in order to salvage my love for it.
After much thought and soul-searching, here are the things that drove me to leave clinical medicine (in no apparent order):
- Managed Care Impositions
- Administration Without Vision (aka “Looking for Icebergs Instead of Bailing Water”)
- Grossly Negligent Support Staff
- Passive Parents
- A Voiceless Faculty
- A Startling Self-Realization
My blog posts over time will address each of these, and will probably require a decent amount of red wine to get everything put down honestly and accurately. I hope for some of my colleagues, this may serve as some comfort knowing you are not the only one feeling this way. And for others not in the field, I hope you will find this helpful in taking away a little empathy for what your doctors deal with in their work day. Cheers….