Insights about the beleaguered doctor

Our heroes are dropping like flies around us

Since bad news sells, chew on this: doctors are burning out left right and centre and the problem is global. According to stats, 40% of US physicians screened positive for depression. Over 7% had thoughts of killing themselves in the previous 12 months, compared with 4% for the general population. And doctors don’t just think about suicide more than the public - they actually attempt it more often. Greater knowledge and uninhibited access to drugs mean physician completion of suicide is much higher than that of the public, with female doctors more successful than their male colleagues.

According to a study, a large portion of British physician’s reported that they are suffering from some definable form of mental ailment while 66% in Germany declare burnout. China takes the cake at 82%. [Download the full 70-page report below]

So, let’s ask the academics at our alma maters to help us solve our predicament.

Are you kidding!!?

They’ll want to send us back to medical school for more training in psychiatry, and we’re already so pressed for time. Actually, from what I have learnt in the business world, more psychiatry won’t help us, that is of course unless your ambition is to become a psychiatrist, or you are ready to do a stint in a psych ward as patient. What we as doctors need is better strategy. And since the problem is occurring on such a grand scale all around us and may even be affecting some of your friends who are doctors, we need to tackle the problem amongst ourselves, not wait for someone else to come and save us, but from what exactly? Our patients, our mindsets or our jobs?

Why only doctors?

Learning to swallow a bitter pill

Every day we encourage our patients to embrace courage, adopt new coping skills and deal with disease and disability in a more creative or inspiring way. “Show some pluck” or “take it on the chin” conveys the basic idea. But just how plucky are we as doctors? How do we deal with this multidimensional, intangible and elusive concept ourselves?

Attributes of a true hero

Conking in on the job – why do doctors appear more vulnerable to “cracking”?

A common theme when explaining doctor burnout revolves around long working hours and being overloaded with too much bureaucracy. It is also often suggested that doctors don’t feel appreciated. Hmmm, perhaps. Then there are many economic reasons, and although these are real, they are certainly not only unique to doctors. Everyone is feeling the squeeze and healthcare costs are far too high in most parts of the world. You also can’t just ask for more money because of your qualification or status. The reality is that you are in direct competition with many others also making their living from the funds derived from the sick and ailing. To pay Peter, you most likely have to rob Paul (less 10% for handling, of course). But to keep Peter happy, can you count on the continual “cooperation” of Paul?

The rise of patient centricity - turning on the pressure

Many powerful players compete against doctors for a far bigger slice of the healthcare pie. Their income is directly proportional to the magnitude and success of their marketing campaigns and advertising budgets. Since the regulatory framework actively prohibits doctors from advertising or promoting their services in many parts of the world, this highly strategic business process puts doctors at a disadvantage. Even worse, most doctors don’t think about marketing, not themselves, their practices or their professions.

In the meantime, many other players have invested thousands of hours into refining their commercially driven business enterprises via highly effective marketing machines. A key component ensuring their marketing success is centred upon the development of the concept ‘customer service’, the new commercial term for ‘patient care’, but with a subtle difference. Since these players deliberately spend a lot more time, money and effort on keeping patients happy, they can easily outperform doctors.

As a result, patient-centricity is now rapidly becoming a medical buzzword. Since patients are modern consumers, they are more orientated towards self-service and self-help strategies. Statistics indicate that they now increasingly rely on the internet for medical advice and are becoming more empowered to actively engage in how they would like to be treated. This puts more pressure on doctors. Improved doctor-patient communication and patient education have never been as important as it is now, processes that all consume the doctor’s time.

People are draining, even to doctors

The wisdom of not touching poison ivy

Dealing with difficult patients who present you with salvo upon salvo of gripes that may or may not be relevant, but all of which you cognitively need to process before you can make a diagnosis, is mentally exhausting. Even more so if they find it difficult to comprehend what you are trying to tell them, keep on interrupting you with the continual “discovery” of even more complaints, or are not all that interested in the concepts you are trying your best to convey to them. Afterwards, when things have actually not quite gone their way and all their expectations have not entirely been met (according to their own customer satisfaction scale), they will most likely hold you responsible. Their only next option is to consult two far more dependable and obedient doctors for a more preferred second opinion, which can be customized until it sounds about right. This is, of course, Dr Social Media and Dr Internet.

In contrast to popular wisdom, the brain is not like a computer, built to go on ad infinitum and easily topped up with plugged in RAM. It is more like a muscle, limited by a finite energy resource. You can only lift a weight so many times before your arm will no longer cooperate. Thinking ‘too much’ does the same to your brain. Wasting working memory and cognitive energy on humbug and hooey leaves far less for high-level decision making, the stuff you actually need to do well, or people may die on your watch.

So, unless you are a masochist, do not try to run through the forest of poison ivy, especially when in the nude. You may end up in ICU, where, according to the lore, you’ll be treated like just another lump of meat by a team of burnt out colleagues, too busy contemplating their own mass-escape from medicine to worry about poor delicate you and all your many peculiar needs.

Sanitising your mind

Freeing up your time and getting rid of processes that inflict daily mental torture will be the only way you can start regaining self-fulfilment, mental enrichment and a sense of accomplishment. You are actually entitled to enjoy your career as a doctor. Here are a few suggestions:

1. We need to find simpler and more efficient ways to achieve the same output with far less input.
2. Accept the responsibility for dealing with our own problems as doctors and develop and implement our own methods, models and frameworks to do so. We can start by pooling our resources, sharing our knowledge and collaborating with each other.
3. Identify and delegate repetitive and boring day-to-day activities to systemised automation just like the businessfolk do. This will free up your mind to more interesting and stimulating tasks, the stuff that helps keep you sane and inspire your mind.
4. We should become far less submissive and resist adopting more systems from outsiders, primarily focused on their needs, or what they assume are ours.
5. We also do not need more technology design – today’s technology can already deliver almost anything we can dream of. Our problem lies with the value concept of technology design, in other words, doctors are lagging in the creation of value through technology.

What will really benefit us as a profession is to figure out how to simplify our worlds through innovation more focused on our personal needs. Knowing very little about IT must not be a deterrent. Nowadays, IT skills are a dime-a-dozen, and if we are clever about pooling our resources as doctors, we can easily modify existing solutions to suit us and our unique requirements.

Employee of the year award

For a moment, imagine you had a practice assistant / manager / receptionist / working for you, proficient and skilled in the following fields. Here is an extract from this person’s CV:

1. Sociable, responsible and highly dedicated.
2. Capable of assisting patients with almost any medical information they seek, intelligently, any time of the day or night and at no additional cost.
3. Ability to source and collate a vast library of authoritative medical content just in case you need it one day.
4. Competent and capable of taking patient education off your hands.
5. An understanding of advanced medical matters and capable of post-consult patient counselling and guidance (like how to use an inhaler properly).
6. Resourceful and fully equipped with tools to help you accelerate the extraction of information from patients, especially when you can see that they are tongue-tied and that you just know you are going to struggle to get the facts that you need before you can proceed.
7. Able to help find methods to reduce healthcare costs for patients through the elimination of wastage, inefficacy and over-service.
8. Analytic and discerning, able to filter and customise new medical information, news, CPD training, pharma reps, pharma products, etc. for relevance and value in advance, so that you can avoid wasting your time.
9. Has advanced knowledge of digital marketing and digital content management. So advanced, in fact, that this person’s skills will easily enable you to compete with your three colleagues, Dr Social Media, Dr Internet and Dr Fake News as equals.

Yes please, I want to employ this one! But does such a super-human even exist?

This is our future. There is hope and help out there. We help patients, so why not help each other? We’re all in this together and collectively with some basic technology and a few good ideas we can easily get back to enjoying our careers. Two gestalts are better than one, but a smorgasbord of minds may be the real-McCoy of magic genies.