Clinician burnout is a thing–to the point that the National Academy of Medicine has released a report on the topic. (NAM Report) Let’s face it, there is no reason why practicing medicine in today’s environment would be fun. Medical students come out of medical school loaded with debt; sometimes in the hundreds of thousands of dollars. They are increasingly employees with little control over their work environment. They face immense regulatory burdens, including the constant threat of fraud and abuse investigations. Their clinical decisions are subject to the judgment of others, often not even clinically trained. They work with extensive information technology that makes their jobs harder, not easier. They are often pressured to see a large number of patients very quickly. And their patients often give them grief if they aren’t treated in a certain manner. Finally, they are now expected to also solve all of our social ills. Regardless of the relatively high pay, sounds like a fun job, right? The report notes all the studies indicating increased incidence of burnout symptoms from doctors in particular, estimates ranging from 35% to over 50%. The report has a lot of information on physician perception of their work environments, the consequences of burnout and some recommendations for improvement. Without going into detail, most of the information is pretty obvious. And the primary recommendations to improve things are to create a more positive work environment. duh. How do you do that? Maybe start by stop trying to create so many programs to make the health system better. Stop all the quality improvement, information technology, evidence-based medicine stuff and simplify how we monitor performance. It is very important that we attract the best people we can to the practice of medicine. We want them to like their jobs. If they do, they will be more likely to do a good job keeping patients healthy and treating their illnesses effectively. It is a hard job, and we keep making it harder. This report fails to highlight the role that government has played in making doctor’s work lives miserable. We need less government action, not more.
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MedPAC 2019 Report to Congress
June 18, 2019
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