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An article titled Medical Student Burnout and the Challenge to Patient Care recently caught my eye in the New York Times. Written by Dr. Pauline Chen, it examines some sad findings from a Mayo Clinic survey of 2,248 students at seven medical schools: While almost 50% of medical students surveyed met criteria for burnout, 11% reported having suicidal ideation.
As I read through the article and scanned the first couple pages of comments, memories of my own medical school experience from a few short years ago came flooding back. Maybe it’s inappropriate to say that these memories came back, because in fact much of what I’ve retained is not far from the forefront of my mind at any given moment.
Although I went to a terrific medical school, with engaged teachers, good friends to turn to, and a relatively benign environment, my years there were the most depressing times I’ve had in my not-yet-30 years. I consider myself an optimist, but many factors left me feeling sad and overwhelmed.
Let me be clear– I was not depressed by medical school itself, but by the experiences I had. Watching your patients recover is incredibly rewarding, but witnessing their deterioration is truly saddening. People are not admitted to the hospital unless they are critically ill, and despite your team’s best efforts, the end results may not be favorable. While many fear death, I learned to fear even more the interminable hospital stays. Patients, so bright and engaging and personable, turn into shells of their former selves when faced with invasive, painful procedures and diagnostic tests, drug regimens bearing side effects worse than many diseases, and the neverending uncertainty.
Each individual is someone’s mother/daughter/sister/friend… and each person reflects images of your own loved ones. It is hard to be close to it all, but even harder to stay away. Medicine, in its correct form as both an art and a science, is a drug– and an addicting one at that. Like any addiction, it is possible to go too far, but unlike some addictions, it is nearly impossible to step back.
Confronted with emotionally scarring scenarios, doctors have a responsibility to provide the best care possible, but afterwards don’t have time to recover themselves. When you work a 30-hour shift, but don’t want to leave because your patient is YOUR patient, nobody knows her case like you do, and you want to make sure everything goes right… well, that’s pretty standard. It becomes hard to sleep at night, worrying about what diagnostic information you might need and how to structure a plan of care so that patients can get out of the hospital and back to their lives as soon as possible.
Other environmental stressors such as week-long fights with insurance agents over procedure approval, general hospital errors, and political posturing also contribute to the general frustration of physicians, who are already emotionally overloaded. None of this excuses inappropriate or uncaring behavior in doctors, but it makes it easier to understand why burnout is so prevalent.
What does all this mean? Medical education is long overdue for a change. Technology has advanced considerably, but maybe what we need is not more information and more statistics, but a way to use that data more effectively and more creatively. Let the machines and devices do what they were designed to do, and let the humans excel at being human.
To reclaim the art of medicine, we must consciously select our future doctors for emotional intelligence as well as intellectual curiosity. It will be a long process, but in the end, benefits will be reaped by doctors and patients alike.
For those who are in training, take a moment for yourself. Breathe. Try to relax, and remember that good things still happen every day. Smile at your patients.
How do you think we should address physician/med student burnout? Do you think patients are negatively affected?
