When doctors speak out about burnout, it creates an opportunity to create a more sustainable way to practice medicine.
This fall, I will join about 17,000 students matriculating into medical colleges across America. For all of us, gaining admission to a medical school was at least a four year long process of first discerning – through shadowing, taking rigorous science classes, and volunteering – that we want to be doctors, followed by studying for the MCAT and successfully completing the marathon-like admissions process. For most of us, gaining admission to a medical school is only the beginning of a decade of training in the practice of medicine.
A grueling work environment upon graduation from medical school apparently accompanies this daunting timeline. Domestically, there is a forecasted shortage of 130,600 doctors by 2025, which will likely be exacerbated by the millions of newly insured people under the Affordable Care Act and the increasing emphasis on preventive care. These changes are both tremendously positive for society, but create challenges in the field of medicine. With only 17,000 of the 40,000 yearly applicants matriculating into American medical schools, compared to 45,000 beginning law school and 100,000 beginning business school, reducing that shortage becomes hard to envision. The physician shortage is even more striking on a global scale, as reported by the New England Journal of Medicine.
We can also expect high burnout rates when we get to work. As I was completing secondary applications last fall, I noticed a plethora of headlines advising Millennials against careers in medicine, with multiple doctors leaving comments to express their agreement. I cannot recall reading even one article during that same time period encouraging students interested in service and science to pursue an MD. A survey by NerdWallet sums up the crux of the issues mentioned in the articles: doctors are deeply unsatisfied with their professional choices and would not choose careers in medicine if they could go back and do it all over again.
Perhaps surprisingly, these articles never made me doubt my desire to become a doctor. Many of the doctors I have shadowed over the years have iterated the power of one positive patient encounter to carry them through the day, to recall as encouragement through the toughest moments. In these interactions between doctors and their patients, I have witnessed the privilege of serving someone in their time of need, the fulfilling skillset of helping someone stay healthy and the lifelong learning that is required in attempting to understand the human body. These memories and observations have morphed into goals and have seen me through 2 am study sessions for organic chemistry tests and the aftermath of medical school rejection e-mails.
Though I haven't obeyed the command of the articles pushing back on medical school, they did lead to honest conversations with doctors about balancing work and family and about the weighty, taxing responsibility that accompanies a career in medicine. To address burnout, Diane Shannon highlights inexpensive yet seemingly effective measures, such as physician retreats and increased day-to-day clinical autonomy. She also points to larger overhauls and paradigm shifts, such as redirecting the reimbursement system to compensate for quality, as opposed to quantity, of care and employing third-parties to cultivate compassionate healthcare, which medical school curriculums also emphasize.
Maybe I am simply on a post-undergraduate-commencement high, but perhaps this deluge of articles from doctors who left their practices is an inception of a long-needed change in the world of medicine: elevating conversations about stress and concerns plaguing doctors onto a larger stage. This change promises to engage doctors before the final burnout and to fill doctor shortages in a sustainable way. At its core, this change is relevant to service sector fields from doctors to nurses to teachers. As a millennial entering medical school, I realize I know very little about what to expect when it comes to a career in medicine, but I am grateful to those who have spoken out. I hope that the attention they have brought to the dearth of humanity allotted to both the provider and the patient is the inception of a policy and culture-oriented journey to correct both.
Anisha Hegde is the Roosevelt Institute | Campus Network Senior Fellow for Health Care.