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BURNOUT BUSTERS PART 1: "Gentling" our medical culture

It's time for a kinder, gentler workplace for doctors and medical students.

Physicians (across all specialties, levels of training) and medical students are experiencing a burnout epidemic. Medical education and the health care system can be dehumanizing.

We go into it with high hopes of making a positive impact, but within a short while, 2 in every 3 of us experience burnout, according to the latest studies.

We are generally perfectionists, pouring our hearts and souls into making an impact. But the odds are increasingly stacked against us. We find ourselves drained, with nothing more to give. Our efforts seem futile, leaving us emotionally exhausted, insensitive, and irritable.

None of us are exempt. Medical culture can be toxic to humans. It demands perfection, no emotions and no needs.

We suffer physically. During medical school and residency, and in my first few years of practice, I regularly went without sleep, food, hygiene and access to a restroom. I worked over a hundred hours a week, taking call every other night for months at a time. I once fell asleep at every stop light on my way home from a 36-plus-hour shift.

I'm not alone. I'll bet most of the medical students, residents and physicians reading this can relate.

We learn to never call off from a shift, not even if we're sick. The unspoken rule is you always show up unless you're literally dying, because your absence creates so much extra work for your colleagues.

We suffer emotionally also. As trainees, we are thrust into the front lines of human suffering. We witness death and dying, unimaginable grief, illness, and loss, with very little support and role-modeling for how to process this. Where do we go with the feelings we experience? Is it productive for us to learn how to turn off our feelings completely? Does the world truly benefit from doctors who have forgotten how to feel?

To top it off we learn how to be doctors in a setting with no room for error. It's an extreme high-stakes environment. If we mess up, someone could die. Even if the error was not fatal, there's a culture of shame. The person erred is often shunned and ridiculed. I witnessed this several times, and it was dehumanizing, even for me as a bystander.

Doctors are often hypercritical of each other, competing for the highest productivity, the highest pay, the most patients, like a pack of rabid attack dogs.

Add to this the myriad tasks pulling us away from patient care and doing what we believe is right for our patients. Aside from medical charting, we often face endless requirements created by insurance plans, prior authorizations, refills, messages, labs, and a litany of administrative tasks.

Top it off with abusive patients who attack us or file frivolous law suits, creating a depth of betrayal and suffering all its own.

And then sprinkle in any host of personal and family issues, not to mention our own mind drama, guilt, shame over any mistakes or missteps, and our responsibilities to our relationships, kids and partners.

It's no wonder we start feeling exhausted, insensitive, irritable and unfulfilled, the hallmark symptoms of burnout.

We must stick together and encourage each other along the way. It's time to set aside judgment and backbiting. To borrow a term from dog training, it's time to "gentle" our medical culture.

We are not victims in this equation. Patients need those of us who are kind and caring, who actually take time to listen. Let's not consider quitting a solution. Let's instead reclaim our power. Let's redefine what it means to be a doctor.

Let's not narrowly define ideal doctors as robotically perfect superhumans, with ice water coursing through their veins. Let's remember that being gentle, kind, and compassionate are not weaknesses, but vulnerabilities.

It takes remarkable strength and courage to be vulnerable.

There's enough goodness to go around. Let's assume the best about each other and support each other as colleagues. Let's invest in the trainees and early career physicians who will create our future health care force, if for no other reason than they'll be caring for us as we age.

We must forge a kinder, gentler, more forgiving medical climate, that permits us to remain whole as humans. That provides us a safe space for vulnerability. That preserves our precious time patients to do what we do best: healing and teaching. That doesn't shame and ostracize us for our humanity, for simply trying to cope.

Let's take care of the people that shoulder the burden of caring for others.

Do your part to combat the burnout epidemic. Be kind to the doctors, residents/fellows and medical students in your life. They're likely suffering extraordinary stress.

Kindness and love go a long way.

Because, spoiler alert: Physicians and med students are humans, too.


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