Elderhood by Louise Aronson

Author:Louise Aronson
Language: eng
Format: epub
Publisher: Bloomsbury Publishing

A 2015 study conducted by the American Medical Association and Mayo Clinic found that over half the doctors in America are experiencing burnout.38 The rates have increased yearly in recent years, and are far higher than for the general population, even among people with similar education and work hours.39 They also are, by far, the highest rates recorded among physicians since Freudenberger identified the phenomenon. The study’s authors explain that this epidemic should be of grave concern to all Americans because, in addition to the personal toll on doctors and our rising suicide rates, “burnout appears to impact the quality of care physicians provide, and physician turnover, which [has] profound implications for the quality of the health care delivery system.”40 That’s bad news for patients, and we are all patients or potential patients. It’s also bad news for American health care, which is seeing more and more doctors reducing their work hours, giving up clinical practice, or taking early retirement at a moment when the Department of Health and Human Services predicts a shortage of forty-five thousand to ninety thousand physicians41 by 2025.

As a doctor, if one of my patients has a serious, undesirable side effect to a medication or treatment, I change that medication or treatment. I continue it only if there are no alternatives and the patient and I believe the outcome will be worth the attendant agonies. But those in charge of American health care seem unfazed by our current system’s many destructive side effects, including burnout and its harms to patients and clinicians. Much like our senators and representatives who deprive their constituents of health care coverage while continuing their own extra-special congressional health benefits, they behave as if they believe that people get what they deserve. Words such as resilience and self-care—the trait and skill, respectively, that we are encouraged to developed to combat burnout—suggest the failure is within America’s clinicians, that we have unwisely used up our precious fuel, that we are weak and don’t know how to take care of ourselves. The ubiquity of burnout across specialties and geographic regions suggests our distress is but a symptom alerting the health system to a potentially lethal underlying problem. In the same way a person can have arm pain during a heart attack when a critical artery is blocked, burnout is physician distress signaling that the health care system needs critical care.

Read any of the growing numbers of poignant essays about burnout,42 and you will find most doctors report what I, too, felt, even at my lowest point: that I still wanted to be a doctor, that the work for me has always been more vocation than job, but that the structures and demands of the health care system had begun preventing me from providing the sorts of care and healing I believed my patients needed, and that was something I couldn’t abide.

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