One of the most overlooked sources of physician burnout is the toll that medicine takes on our social and emotional batteries. Of course we all know that overbooked clinic schedules are difficult to manage medically. We must prechart, obtain a history, do an exam, come up with an accurate diagnosis, create a proper treatment plan, and then document all of it within 10–15 minutes. We then lather, rinse, and repeat this process with each patient, anywhere from 25 to 50 times in just a single day. This alone is mentally draining and a significant source of burnout. However, this also means that we are actively speaking to 25 to 50 different patients and their families each and every day as well, which becomes socially and emotionally taxing too.
Our jobs go far beyond just diagnosing and treating. We are expected to give medical care while simultaneously making sure our patients feel good about that medical care being given. This includes calming patients down, being their shoulder to cry on, serving as their cheerleader, making small talk, and generally tailoring the conversation of each visit to the patients interests, concerns, and needs, all while staying enthusiastic and engaged with them. With Press Ganey and other patient reviews becoming more commonplace, these emotional and social demands have only risen. Add in the growth of medical misinformation and mistrust, and these demands can become almost impossible to satisfy. Even between these visits I am speaking to nurses, answering portal messages, coordinating with front-end staff, and taking calls. Thus, creating a nonstop work day of actively speaking, socializing, and thinking with other people.
Of course, I love talking to and bonding with my patients. Patient interaction is a big part of why I chose medicine. However, I didn’t realize how draining it would be to interact with so many people in just a single day. I don’t want to become a robot just diagnosing and treating then rushing out the door with minimal interaction. I want my patients to feel good about their visit with me and to build a relationship with them. Yet in doing so, I’m left running on fumes by the end of the day. I feel incredibly guilty when I come home feeling like a zombie with no social or emotional reserve left to listen or talk to my own family after listening and talking to over 30 other families at work.
It’s tough for most people outside of medicine to truly understand how draining a busy day of clinic actually is. I once heard a clinician describe it to their corporate friend as having to not just attend but actively lead 25 to 50 back-to-back meetings each day, not knowing exactly what or how many issues will be discussed at each meeting beforehand but still having to address all those issues properly in real time, and then writing up a detailed summary of everything within the limited meeting timeframe. All of this while making sure the attendees of each meeting feel good about what you did, with each meeting having different attendees with differing personalities and preferences. And if you mess up any meeting, you may get negative reviews, lose your employment, or face a crippling lawsuit. Of course, the other people in the meeting will often run late, go on tangents, or require you to run overtime too. This would be insane and unacceptable in any corporate work place, but we accept this in healthcare.
I do believe the only solutions are to set strict boundaries with patients or work less hours, seeing fewer patients with longer visit times. We must push for better reimbursements and staffing so overbooked schedules with so many short visits are not the norm. If we don’t, we may drain ourselves to the point of no return with nothing left for our families or our patients.
How do you recharge after spending an entire day caring for others? Share in the comments.
