Our ability to question our own existence. To ponder on the origins and endings of life. The complexity of our emotions, long evolved from the bare minimum of instinctual impulses bursting from the fire that is the drive to survive. These are what make us human.
But have you ever stopped to ponder the relaxed state of our hands? Noticing the way our fingers seem to comfortably curl towards our palms? Serving as a tangible, lingering token of our not-too-long-ago ancestors who roamed unpaved roads using all four limbs, almost as if to whisper to you, remember, you’re still only an animal.
So as humans, who can arguably be defined as glorified animals, don’t we often forget that we too have many limitations? In fact, do we not commonly use the expression “I’m only human” precisely to explain our shortcomings?
Whether we like it or not, our culture has an inclination for us as individuals to be defined by our careers. In truth, questions such as what do you do, where do you study, or what do you want to be when you grow up often serve as the entire basis of conversations during our initial interactions. And while careers are certainly a fulfilling and necessary activity for both personal gratification and to meet essential demands of goods and services, at what point do careers become our entire lives?
This brings me to the issue of physician burnout. Physician burnout has long been a concern, but not one that appears to be getting better. Physician burnout is often defined by three main characteristics:
- Depersonalization: Where physicians begin to view patients in an increasingly impersonal way
- Emotional Exhaustion: When physicians feel overwhelmed or overextended to the degree that it affects their mental health and well-being.
- Lack of Sense of Accomplishment: Loss of fulfillment and pride in their work.
Even though careers as physicians are becoming increasingly more specialized (we don’t have Family Medicine doctors delivering babies or, in a less extreme example, even simply doing as many pap smears anymore), it does not seem to lighten the work load on physicians. Medscape conducted a study just this year in 2015 and found that there has been a 16% increase in the incidence of physician burnout in just 2 years, and roughly half of the 20,000 physicians surveyed indicated they were experiencing burnout. These conclusions were also supported by a study conducted on a national level by Dr. Shanafelt, who found similar increases and rates of burnout, particularly in the fields of primary care and emergency medicine. Even more frightening, is that working physicians are not the only ones feeling overwhelmed and unenthusiastic about their career choice. In fact, significantly high rates of burnout are found in medical students and even premedical students. And while it is no secret that medical school or the stresses of getting into medical school are not meant to be easy, it is certainly alarming that depersonalization from the work, emotional exhaustion, or lack of fulfillment is felt by those who haven’t even begun yet.
Burnout is not only an issue for those experiencing this on a personal level, but also on a national level. Dissatisfaction with any career can affect the level of productivity, so it is no surprise that in the case of physicians, it clearly affects the quality of patient care. Combine this with reimbursements increasingly being cut almost across the board in correlation with changes in healthcare policies, then it is also no surprise that more doctors are choosing to leave the field, creating the burden of high costs in the recruitment of new physicians.
There have been attempts at increasing regulations to prevent overworked doctors (setting a limit on the number of hours a physician works for example), but this only increases the demand for doctors. But while many medical schools are increasing the number of students they accept to accommodate for this demand, residency programs are not (much to the dismay of this exhausted medical student) and so we are back at square one.
Doctors are one of many noble careers that are as close to comic book superheroes as we can get. For one thing, they save lives. Many are willing to stay available around the clock for days at a time, putting many aspects of their life on hold, just in case there is someone in need. And they do all of it using “powers” only they have been trained to use. But the bottom line is doctors aren’t superheroes. In fact, they’re only human. And something needs to change.