If you’re in the healthcare community, you’re probably tired of hearing the word burnout. It gets discussed, but we don’t really solve the core issues that cause it. And that isn’t solving anything.
We Should Be Concerned About Keeping Our Health Care Workers from Fleeing
Take health care aids. We couldn’t keep health care aids before the pandemic. They’re not highly compensated and they aren’t very supported. They could go to a retail job and make the same salary. Why would anyone with that choice go to work everyday in an environment that puts their life at risk? I think you’re going to see a lot of people leaving and it’s going to become even harder to fill their open spots.
I do a lot of physician leadership work, mentoring others and acting as a peer advisor. The questions I get usually revolve around physicians looking for a way out of the clinical environment. “Should I get an MBA?” Now, my response is usually, “Well, what do you want next?” And the response usually comes down to “I want to get one of those easy administrative jobs.”
I always tell people that ask me this question the same thing: If you don’t really want an administrative role, don’t go into it and don’t get that MBA. If you’re only getting the MBA because you think it’s going to make your chances of getting that job easier, it doesn’t. You can just as easily get one of those jobs without an MBA without having to disappear for three years.
But hearing this question so often really speaks to how many people are trying to leave clinical medicine because of how oppressive it is. Most doctors really love working with patients. It’s everything else surrounding that work that beats them down into a state of despair. Most doctors walk around with a mild degree of anhedonia. They’re numb and I believe it’s a form of sub-clinical depression.
The Realities of Clinical Life
What I’ve experienced and countless doctors I know, is a state of being not fully depressed, but we’re just about there. Almost every doctor I know is walking around like this. They feel trapped, they can’t do anything else, they have tons of loans and there’s so many pressures.
It pushes them into a state where they almost cannot experience emotion at all in regard to other people, both good and bad. The experience of working in the medical field can push you into this state.
The Lip Service of Burnout
Burnout is starting to get a lot of press especially within the medical community. It’s becoming a cottage industry. It’s the cool thing. Some doctors are even positioning themselves as “burnout coaches.”
But the way I see it, it’s their own clever way of getting out of the clinical environment. You can call yourself the Burnout Doctor if you’re still practicing and you’re not burnt out. But can you really call yourself an expert in helping doctors avoid burnout if you yourself escaped the environment they’re struggling to live in?
Burnout Isn’t About the Individual
I think the answer is not what people talk about. I think so many times the answer gets positioned as akin to a defect of the individual. You’re burned out because you’re not resilient. And you need to go to some coaching or training to work on your resilience.
When I hear administrators saying this I want to say f- you. I went through years of college harder than you ever could imagine. Went through med school which is something you couldn’t dream of doing. I ate things during residency that would make a billy goat puke. Running in the middle of the night with no sleep, working 48 hours. I think I and the thousands of doctors out there who have had the same experience are a pretty resilient bunch.
The problem is that no matter how resilient you are, you are beyond the cutoff of your capacity and you can’t build the capacity up.
The Problem is the Environment
It is a crushing environment. Training someone to better deal with a malignant environment doesn’t help, you need to remove the malignant environment. And that is not happening.
We’ll here administrators say, “Here’s a better way to deal with the EMR.” No, the EMR sucks. There is no better way of dealing with the EMR. I’m not going to be happy dealing with the EMR.The EMR is horrible.Unless you fix the EMR I’m not going to be better.
The conversation about burnout too often comes to a non-solution that’s focused on trying to make the problem go away, rather than how do we better deal with it.