Time was baffling. It seemed like just yesterday, I sat in a posh auditorium in Chicago as an enthusiastic young adult during my first day of medical school orientation at Northwestern in 1995. Eighteen years later I was a 43-year-old burned-out physician, practicing in Boise, Idaho, doing Google searches on the most effective way to end my life. During my time of maximum burnout, I observed that I was becoming the type of physician that I never wanted to be: impatient and sarcastic, occasionally dismissive of my patients. I made caustic jokes about some patients in the lunchroom. I was not happy.
As I learned about the problem of physician burnout, I came to recognize I was not alone. While researching the topic for a book, I realized physician burnout is not some psychological abnormality to be embarrassed to speak about in public — quite the contrary. For example, survey results in the past five years show 87 percent of American physicians experience burnout symptoms. On the extreme spectrum, according to the American Foundation for Suicide Prevention, female physicians have a successful suicide rate of 250 to 400 percent higher than their counterparts in the general population.
Something very alarming is going on in the American healthcare system today. Increasing time constraints, burgeoning bureaucracy, increased patient expectations, and technological advances have made the challenging, stressful profession of medicine even more so. In fact, given the current demands, I have realized burnout is an almost inevitable response. Something needs to be done about it.
Burnout impacts not only physicians and their family but also their patients. Patients suffer because a disabled doctor can’t deliver the best care. Sure he can go through the motions, can prescribe the appropriate meds, but that’s all he does. And patients intuitively sense his lack of commitment. A magical placebo effect occurs between an engaged doctor and a sick patient. “Hands on” was how the profession referred to this phenomenon. The physical touch of a committed physician was thought to promote healing, to give the patient confidence in his care. Maybe this practice strikes us as a little hokey today, but the general principle still holds true.
Patients need to believe in their doctor. An empathetic touch can make all the difference and also be the key to medical success. Danielle Ofri exemplifies this point in her book, What Doctor’s Feel, when she notes that the rate of severe diabetic complications in patients of doctors who rate high on a standard empathy scale is a remarkable 40 percent better than those cared for by physicians with low empathy scores. Ofri observes that this difference is comparable “to the benefits seen with the most intensive medical therapy.” The tragedy of burnout is that it effaces genuine empathy, spirituality and commitment. Nietzsche put it best: “Physician, heal thyself: then wilt thou also heal thy patient.”
At some point in almost every physician’s career, there has been a powerful desire to help others. When suffering burnout, many of us become so disillusioned by our failure to achieve these aspirations that our passion is replaced by a strong contempt for the profession we chose and once loved. My goal is to reignite that flame for others, as I have been able to do for myself, and give physicians a chance to rediscover a sense of joy, pleasure and fulfillment from this noble profession.
Dr. Tom Murphy recently published a book: “Physician Burnout: A Guide to Recognition and Recovery.” His website is also dedicated to the issue: tommurphymd.com.