Give it to me straight, Doc! How bad is it?

 

There are a few reasons why Medicine has now found itself at a crossroads. Loss of Autonomy, EMRs and workplace stress all contribute to where we are.

 

But, where is Medicine, statistically?. Nearly half of its’ practitioners are burning out and one out of seven are suicidal.[1] Seventy percent of doctors would not recommend healthcare as a profession.[2] Large studies over the last ten years have shown burnout rates to be 45% in 2011, 54% in 2014 and falling to 44% in 2017.[3],[4]A 2018 survey showed that 67% of Urologists are either burned out or becoming burned out. Twenty-five percent are making active plans to leave Urology in the next two years.[5] I hate to be, as a Urologist, the number one specialty for rates of burnout for 2019 and 2020 at 54%![6]

 

Burnout increases medical errors and malpractice risk.[7]

 

Perceived medical errors by physicians can be quantitated to a 4% increased risk for every night of call duty.[8],[9]

 

Two-Thirds of studies looking at burnout saw increasing medical errors with burned out physicians[10], with the rate of medical errors triple that of non-burned out physicians.[11] An ICU study showed an increased mortality rate for patients cared for by burned out physicians. Not only is burnout dangerous for physicians, it can be deadly for patients.

 

As Docs, we like to be data driven, but I am not sure even the most statistically rigorous analysis can quantify how badly someone hates being on call, spending that time AT WORK and AWAY FROM family, friends, loved ones. That number probably does not exist. The frustration, the loss of patience, declining satisfaction and loss of compassion also are hard to measure.

 

Have you had your ‘moment’? You know, that moment where you just might chuck it all, as the downsides are out weighing the upsides. I did and worked very hard at getting back to the joy, satisfaction and fun of medicine.

 

It is not easy, quick or a one-time cure. It is a process that you can learn. It will take time, effort, habit change and a vision for your future.

 

Statistically, recovery is guaranteed if you try! Let’s do it together!

 

Jeff Moody, MD

 

 

[1] Medscape National Physician Burnout, Depression & Suicide Report 2019.

[2] The Future of Healthcare: A national survey of physicians – 2018. The Doctors Company.

[3] CHANGES IN BURNOUT AND SATISFACTION WITH WORK-LIFE BALANCE IN PHYSICIANS AND THE GENERAL US WORKING POPULATION BETWEEN 2011 AND 2014. SHANAFELT, TAIT D. ET AL. MAYO CLINIC PROCEEDINGS, VOLUME 90, ISSUE 12, 1600 – 1613

[4] Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017. Tait D. Shanafelt, et al. Mayo Clinic Proceedings. In Press. 2019. DOI: https://doi.org/10.1016/j.mayocp.2018.10.023

[5] Urology Times, December 2018. Pp. 1, 22.

[6] Medscape National Physician Burnout, Depression & Suicide Report 2019, Slide 3.

[7] Personal Consequences of Malpractice Lawsuits on American Surgeons, Balch CM et al. J Am Coll Surg 2011; 213:657–667.

[8] Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PLoS One. 2016; 11(7): e0159015. Published online 2016 Jul 8.

[9] Burnout and Medical Errors Among American Surgeons. Shanafelt, Tait D. MD*; Balch, Charles M. MD†‡; Bechamps, Gerald MD†§; Russell, Tom MD†; Dyrbye, Lotte MD*; Satele, Daniel BA*; Collicott, Paul MD†; Novotny, Paul J. MS*; Sloan, Jeff PhD*; Freischlag, Julie MD†‡. Annals of Surgery: June 2010 – Volume 251 – Issue 6 – p 995-1000.

[10] Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PLoS One. 2016; 11(7): e0159015. Published online 2016 Jul 8.

[11] Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors, Shanafelt, T, et al. Mao Clin Proc. November 2018, Volume 93, Issue 11, Pages 1571–1580