Vivek Murthy, MD – our new Surgeon General – spoke at the yearly meeting of the Association of Health Care Journalists. MedPage Today quotes him as saying:
"The suicide and burnout rate is very high, and this is concerning to me because we're at a point in our country where we need more physicians, not fewer; we need more people entering our profession, not fewer," he said. "If we have people burning out, it really goes against our needs… "As I think about the emotional well-being for our country, I am particularly interested in how to cultivate emotional well-being for healthcare providers. If healthcare providers aren't well, it's hard for them to heal the people for whom they are they caring."
I hear from patients almost every day how they have tried to get help from the conventional medical profession, and how that profession has failed them. “The doctor only wanted to reach for his/her prescription pad. He/She was not interested in what I was saying, or in discussing the root cause of my problem.”
I hear lots of talk about physician burn-out and physician suicide, and how awful it is that our colleagues get stuck in the downhill slide to addictive dependence - on drugs, on alcohol, on work... But the discussion seems to ignore the fact that we, as physicians, are placed in boxes which do not allow us to exercise our clinical judgment or explore new avenues of therapy. Following the clinical guidelines is the new mantra – never mind that these guidelines ignore both our individual genetics and our epigenetics, our lifestyle choices over the years.
Physicians tend to be very creative people. When their creativity is stifled they either become anxious or angry. They tend to express these emotions in various "acceptable" ways - working themselves to death, going home and having a drink to relax, castigating nurses and house staff, throwing instruments, denigrating their colleagues by word or gesture, and stifling their patients efforts to improve their health by searching for "outside-the-box" solutions. Our Medical Boards play a part in this situation. Yes, they were created to protect the public from poorly trained and dangerous physicians. But it seems more and more that the physician members of the medical boards are so anxious to toe the line, follow the "accepted" clinical guidelines, that there is no room for individual discretion any more. If you are disciplined in one state (as I have been) by one Board, then all the other states in which you have a license simply fall into line and do the same thing. If your license has been revoked in one state - no matter how unjust or unreasonable - then no other state or licensing board is permitted to even consider your application for licensure. One of my colleagues, one of the most brilliant and innovative physicians I know, is planning to go into real estate. What an incredible waste of talent. And the only thing he did "wrong" was to use unconventional and harmless means to improve the nutritional status of a child with osteosarcoma. And treat someone for Lyme disease who subsequently did a charge-back on the credit card (after his health improved dramatically), and then fire off several one-line "anonymous" complaints to my colleague's licensing Board.
Colleagues in multiple states have been treated in the same punitive way - Texas, Washington, California, New York come immediately to mind. Many other colleagues have simply retired from the profession, deciding that teaching their peers is a less risky way of spreading new knowledge. This is a travesty of so-called justice and common sense. The whole situation has had the effect of helping me to realize how very political our profession has become. Or perhaps I am simply naive... Washing of the hands between patients caused one physician to be thrown out of his medical association. Maybe we have not come so far after all...
When we are so angry that we become incoherent in our expression of rage, how can we possibly even think that was can help others heal? We can only help others along the road that we have ourselves traveled.
I hope that Dr. Murthy will be able to transcend the politics of medicine and the pharmaceutical industry, and restore some freedom and some light to our profession - which used to be an honorable one.
Martha M Grout, MD, MD(H)