Doctors are people, too

Having a working environment that allows doctors to be doctors is beneficial for everyone. And having healthy, productive doctors leads to better patient care, which leads to better outcomes overall.

There is a proverb that goes, “Physician, heal thyself.” It means to attend to one’s own faults, in preference to pointing out the faults of others. The phrase actually refers to how physicians are ready and able to heal sickness in others while sometimes not being able or willing to heal themselves.

But this does hit close to home. As the persons in charge of taking care of other people’s health, physicians do often neglect their own. This is not just about physical health, but mental and emotional health as well.

And while we strive to find meaning in our work, the demands and stress of our medical practice — plus everything else in life — can take its toll. After some time, physicians can experience a loss of motivation, a decline in job satisfaction and can start to feel detached and cynical.

This condition has been termed as physician burnout. It is defined as a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment. It is more common that we think, affecting 50 to 80 percent of physicians.

The causes of physician burnout are complex. Having more work to do in less time, trying to catch up with changes in technology like electronic medical records, chaotic work environments, unproductive bureaucratic tasks required by health insurance companies and endless paperwork — these are things that prevent us from doing what called us to this profession in the first place: Patient care.

With the rates of physician burnout on the rise, there are stories of doctors who have drastically cut back on the number of hours they work or have quit their practice altogether, retiring early and even switching to a non-medical field by becoming a stock broker or a restaurateur.

But they’re the lucky ones. There are other tragic stories of doctors having heart attacks at a young age, collapsing at work, sudden death and, sadly, substance abuse, depression and suicide.

Physician burnout has already been recognized as a public health crisis in some countries because as it affects physicians’ personal lives and work satisfaction this can also threaten patient care and safety.

If doctors stop practicing or retire early, patients have to find new doctors. If doctors are distracted or demoralized they may be paying less attention and may make poor decisions. Lack of empathy can lead to a deterioration in bedside manner, causing patients to feel dissatisfied. This can also cause a breakdown in communication with peers and other co-workers in the hospital.

Unfortunately, not much has been done to address this problem. Taking physicians out for a movie night or a spa day, free yoga classes or having the occasional party is not the solution. Neither is just telling them “tiisin mo na lang” (just endure it) or “kaya mo yan” (you can do it). It is not having them listen to talks about resilience, work-life balance and self-care and then sending them on their way to deal with the same drudgery that weighs them down.

There appears to be some awareness with physician wellness being incorporated into the curriculum of some medical schools and training institutions. In some countries dedicated staff are available to identify physicians at risk and for physicians who seek help.

Addressing physician burnout on an individual level will not be enough. The root causes should be identified and meaningful steps should be taken by all relevant stakeholders to address this growing crisis.

There needs to be a shift in how institutions look at outcomes. It’s not just about generating revenue. Placing demands on physicians without transparency, open communication and full involvement of the said physicians in decision making and implementation will eventually be met with distrust, resistance and resentment.

It is possible that the physicians who are most committed to providing safe, high-quality, and patient-centered care are especially prone to burnout if their efforts are frustrated by a dysfunctional system. These physicians are the ones who might leave when in fact they are the ones who should remain in the workforce.

Having a working environment that allows doctors to be doctors is beneficial for everyone. And having healthy, productive doctors leads to better patient care, which leads to better outcomes overall.

Physicians who experience burnout should also not be stigmatized. As much as doctors desire to be accessible to patients to address their needs, patients should also realize that there are some limits to their doctor’s availability and boundaries within the doctor-patient relationship. Empathy is, after all, a two-way street.

And with so many healthcare innovations for patients that are rapidly being developed, it is time to use these medical advances to benefit the health and well-being of all people, including physicians themselves.