I always read Healthcare Renewal myself, but rarely pass it on because I assume you read it too, but there were a couple of recent posts that occurred to me when I was writing about Dr. Healy’s talk to the APA:
The biggest and most comprehensive survey yet of physician burnout published so far showed a striking prevalence of about 45%, more than 50% in the front line specialties of emergency medicine, general internal medicine, and family medicine (and neurology, too). There has been documentation over the last 25 years of growing physician angst, dissatisfaction, and burnout. Given that physicians undergo the most rigorous training of any profession, save the military, it seems silly to dismiss this data as the product of "whiners and complainers," or of the weak, pampered, and spoiled, seems silly. On the other hand, Health Care Renewal has discussed reasons to think that physicians (and other health professionals) are upset by an increasingly toxic environment characterized by concentration of power and ill-informed, incompetent, self-interested, conflicted, and corrupt leadership. Yet despite 25 years of data, the organizations that ought to be most concerned about physician burnout and its causes, starting with medical societies, but also including accrediting organizations, medical and health care foundations, and academic medical institutions, have been very quiet about this. If they address it at all, it is in terms of burnout as some sort of psychiatric illness of physicians. To really reform health care, we will have to start by liberating medical societies, accrediting organizations, medical and health care foundations, and academic institutions from their capture by industry to let them focus on patient care, education and research instead of making money.
and it looks like I got out of academia just in time [1985]:
A large survey of US medical academics showed that one-third are so dissatisfied with their situations that they plan to leave their institutions or academia entirely. Some complex analyses of the data appear to suggest that major reasons for dissatisfaction and the desire to quit include concerns that academic leadership does not support faculty’s core clinical and academic values; is more concerned about revenue that upholding these values; suppresses dissent, free speech and academic freedom; and is dishonest, unethical or deceitful. These results seem to indicate very serious problems in US medical academia, the sorts of problems about which we have been writing for years. However, the leadership of academia, and more surprisingly, the leadership of medical societies, have not exactly jumped to address these problems. As we have said endlessly, a major cause of US health care dysfunction is poor leadership of health care organizations, including leadership that does not uphold core values, is self-interested, conflicted, or even corrupt, and which suppresses dissent and criticism. True health care reform would encourage leadership that upholds important clinical and academic values, and is transparent, accountable, honest, and ethical.
I think as far as Medicine with a capital "M" is concerned, my mind takes me back to the 1950s and the
Beat Generation. I think all these unhappy doctors and academics feel
Beat [because they are] and are just marking time. It’s really not possible these days to be the good doctor you wanted to be, and that people want you to be, so the best you can do is not be the lousy doctor the system tries to make you into. Chronic heroism is hard to sustain…
Nice post.