NYT Article on Doctor Burnout Misses the Role of Patient Partnering

An interesting article in the Times on physician burnout collects the data the damage done to patients and does an excellent jo pointing out the need for institutional change rather than wedding out those who suffer burnout.

“The solution is not to weed out the ones who don’t care, but to support the large number of physicians who are deeply invested and have the capacity to provide excellent care, but lose that capacity over time,” Dr. Schonfeld said. “Physicians enter medical school deeply committed to the field, they come with the desire to be empathic and compassionate, if we just create a system that nurtures what they come with then we will have less burnout and higher quality care.”

It should not be the doctor’s responsibility to feel that “if I’m just more mindful, if I just exercise more or do it better or more consistently, all will be well, and I shouldn’t be feeling burned out or exhausted,” Dr. McClafferty said.

The fact that nearly half of physicians and over 50 percent of trainees experience burnout at some point “shows that it is not predominantly an individual deficit, but an organizational and system problem,” Dr. Schonfeld said

“If you’re my physician,” Dr. McClafferty said, “I want you to be in good shape mentally, physically and emotionally, so you can be really successful at helping me.”

All dead on, and very important. But, I would urge that building institutional structures that encourage patients to want to “take care” of our doctors could have a huge important.  Most of us are deeply grateful to our doctors — indeed to all the medical staff — and the best way to show that is to even just try to take care of our doctors.  I remember one of my doctors, when I gave her a copy of  new paper, said “I will put it on my self with the other gifts from patients.”  She was, I think, telling me how much she valued the gesture.  She did also promise to read the paper, saying that she liked to know what was going on in other fields.

I also try to engage my providers about things like the emotional difficulties of going from a massive crisis to a routine interaction.  I doubt it helps on the concrete level, but I hope it at least gives them permission to have emotions.

Above all, I suspect, conveying the sense of partnership, that we as patients take shared responsibility for decisions — both those that turn out well and those that turn out badly — helps reduce burnout.

Anyway, my overall point it is that is not just on the doctor and the institution, it is on all of us.

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