Physician Burnout: Often Diagnosed, Never Treated

June 13, 2019

Burnout makes news all the time, so why does it seem like nothing is ever done about it?

There were a few news-items this past week about “physician burnout.” This sort of thing happens now and again: An outfit like Annals of Internal Medicineshowcases a study that was done, and other media put various spins on the subject to make it of greater interest to their reading/viewing audiences.

There was, for instance, “What’s Doctor Burnout Costing America?” “How Doctors Diagnose and Treat Burnout.” “Burned Out: Overworked Doctors Need Some Help-and Fast.”

It’s interesting to see such attention being given to a subject that’s hardly news. One doesn’t need a highfalutin’ academic study to know that it’s there, nor does there need to be any prolonged soul-searching, think-tank churning, or governmental/regulatory dithering to effectively address it.

In medschool, one of the most important things a would-be doctor learns is that an overwhelming majority of diagnoses are (or should be) made on the basis of clinical history. That is, by talking to the patient and perhaps family or other caregivers, you get most if not all of the information you need to figure out what the problem is.

Related article: 7 Reasons Rads Burn Out-And How to Cope

I heard the number “90%” get thrown around a lot. Not sure who came up with that figure, how they arrived at it, or how precise it is, but it’s reasonable enough: Given the chance, 9 out of 10 times someone can tell you all you need to zero in on whatever problem is besetting them.

Physicians have not been quietly waiting for anyone to ask what’s troubling them, either. Many have been telling anyone who will listen, for quite some time now. I know I was hearing about it even before I applied to medschool: Almost 30 years ago, I remember a practicing doc, hearing that I was pre-med, responding, “Oh, the poor boy.”

So we’ve got a vast number of intelligent, educated professionals, many of whom are eager to tell of all the ways their profession needs fixing, and this has been the case for decades. Even if we’re to assume that none of them has been vocal enough (especially with the amplifying power of social media), they have organized within hundreds of professional societies, such as the AMA. Presumably, at least a few of these have grown large, financed, and networked enough to collect and direct all of this diagnostic information to whoever has the authority and ability to fix what’s broken.

But it hasn’t been fixed. Rather, from all appearances it’s getting worse.

For me (and a fair number of other doctorly types I’ve encountered over the years), it’s hard to size all of this up without concluding that it’s not a matter of docs’ woes going unrecognized. “Willfully ignored” seems to be a more-apt descriptor. Maybe because the powers that be decided that physicians are fewer in number and/or less likely to make a real fuss than other groups (insurance companies, for instance) would be if the docs’ concerns were addressed.

In other words, the diagnosis has been made, repeatedly. But treatment, when administered at all, has been of the palliative variety. No, doc, all of the things that are burdening you aren’t going to be changed. But look! We’ll have some token write-ups and forums about how to recognize burnout.

Heck, some of the articles this past week were toeing the water about equating burnout with depression, and one of the interviewees commented that “we have really good interventions for it.” Maybe one of the next attempted fixes will be doling out antidepressants to any doc who complains that he’s being worked too hard. After all, if legions of docs are all telling you about the same problems in their professional field, clearly the proper conclusion is that they’ve got a collective mental disorder.

Maybe there will be a pleasant surprise someday, and a seismic shift in the balance of power will result in a genuine effort to remedy the various factors that continue to burnout hundreds of thousands of physicians on a daily basis. In the meantime, if all docs expect is an occasional pat on the back and a “There, there,” they won’t be disappointed.