physician burnout, lunch and learn, dr Berry pierre

LLP127: My Personal Experience with Physician Burnout

 

Let's talk about my experience with physician burnout…

 

On this week's episode of the Lunch and Learn with Dr. Berry I decided to follow up last week's discussion with Aprylle Thompson with my own personal experience as physician burnout.

Over the past three weeks we have heard from our guest discuss not only what physician burnout means to them but also how they have personally been affected. I didn't plan on jumping in the mix for the series but I after hearing these two amazing medical student's stories I figured to add my own experience to the mix.

No one is immune the effects of physician burnout and it wasn't until I finished residency that it began to takes it toll. Listen to this week's episode to find out how I overcame it.

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Download Episode 127 Transcript

[showhide type=””””””””””””””””””””””””””””””””post”””””””””””””””””””””””””””””””” more_text=””””””””””””””””””””””””””””””””Episode 127 Transcript…”””””””””””””””””””””””””””””””” less_text=””””””””””””””””””””””””””””””””Show less…””””””””””””””””””””””””””””””””] Introduction Dr. Berry: Hello everybody and welcome to another episode of the Lunch and Learn with Dr. Berry. I'm your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of drberrypierre.com as well as a CEO of Pierre Medical Consulting. Helping you empower yourself for better health with the number one podcast for patient advocacy, affirmation and education. And this week we bring you an episode, a solo episode this week where yours truly to discuss Physician Burnout on a personal level and talk about my personal opinions on the subject matter. If you've been around for the past three weeks, if you're not, please go ahead and get started on episode 124, starting with Dr. Nicole and leading to soon to be Dr. Kessy Joseph and soon to be Dr. Aprylle Thompson. As we talked about physician burnout on the level from where did it first start. And then we started with how medical students are dealing with the topic. Because I think a lot of times when we hear about physician burnout, we think it's something that happens to someone five to 10 years into practice and we're learning very quickly that even at the medical student level, they are experiencing burnout at a rate that unfortunately, and honestly it's very scary. Because again, they haven't even really hit the rough patch I like to say. Medical school is tough, but residency I think it's a lot tougher and in real life, puts it the bonus on the cake. So it's definitely something that it is definitely worrisome that as a medical student they are started experiencing these feelings that physicians who have been up for 10, 20 years and were just frustrated and fed up I would like to say with the system. Our experience, starting to experience as well. So I wanted to give my personal opinions, what people keep asking, hey Dr. Berry what do you think about physician burnout? What's your personal opinion? And most importantly, have you gone through a patch where you know what, I'm almost done. I want to get out of here. So I definitely want to add my 2 cents this week on the episode before we bring on a couple of more guests to finish this topic of discussion. If you have not had a chance, go ahead, subscribe to the podcast. Again, definitely especially if this is your first time listening, leave us a five star review. Tell us how you think about the episodes. And again start on episode 124 with Dr. Nicole and just lead your way on this amazing series of physician burnout and the discussion that we're having. Episode Dr. Berry: Once again, Lunch and Learn community with Dr. Berry, of course. So I wanted to really talk on this topic. One, because they asked me to do it. They wanted me to talk and give my personal opinion with a topic that we're going on. This is actually the fourth episode on this series of physician burnout and I think we've got at least one or two more left to do that really hit home. Just the impact, because again, Lunch and Learn community, I'd talk about empowering yourself for better health. And I talk about how physicians and those in the health community really are not immune to the need to do it. And a lot of the times where when we talk about taking care of others, a lot of times we don't take care of ourselves and physicians are notorious for putting themselves last when it comes to taking care of their own needs. So with this topic, physician burnout, if this is your first time listening, check out episode 124, 125 and 126. Because we talk about what physician burnout is in general. And what we've been doing is just really touching base with the different levels of being a physician and how they're affected by a physician burnout. So I wanted to talk just how I'm familiar with it and have come to terms with this important discussion on physician burnout that has really played such a role in not only the career choices I've made, but also the career trajectory in and of itself. So as a medical student, you understand that it's going to be a lot of work and then they tell you is gonna be a lot of work, right? It's no surprise, no shock deck. But one thing that they didn't really tell you about it, they don't prepare you for as a medical student is just the level of a strife that is there just in our profession. And when we talk about physician burnout, it's one of those, it's probably one of the common factors that are associated with why physicians aren't happy with what they're doing. Because they go into it with these expectations like, yes, I want to save the world. And they realize that yes, they can still say the world, but there's a lot more that goes into it. Again, I tell my parents who are musically inclined, yes, you can love music, but understand that this is a music business. And I think for what happens for a lot of my physician colleagues and of course medical students and residents is they don't realize the level of business that's really associated with taking care of somebody. And it can be very disheartening when what they want to do or what they feel is right to do, isn't usually in the best interest in the business standpoint. Because we take care of patients. That's where they are. They are our patients. They're the ones we love. They're the ones who want to take care of and see do well. But in the business of health, they are our customers. So when it comes to taking care of the customers and how do we take care of the customers and make sure our customers are well taken care of, a lot of times what you want to do for your customer, isn't necessarily what's best for them. And for a lot of us, we deal with that struggle that, I want to go this route and I want to be able to take care of my patients in this certain way. Whether it's not feasible to do so, whether it be the fact that financially I can't do it or socially, their social factors, I can't do it. Or institutional factors that don't allow me to practice the way I want to practice. I remember as a medical student, I remember being naive to the fact, because again, I was still in that and I'm still am, right? I'm still in that stage where I just want to help people. I want to help people. I want to care people. I want to take care of them and starting to get in touch with older physicians who, they were seasoned, right? So they were like, yeah, that's great and all, but what else are you gonna do? How are you gonna pay for that? How are you going to do this? And all of a sudden, thoughts that were never even brought up, never even brought to the imagination. Becoming interjected into your pathway. Because now you starting to think about things that you never thought you had to think about. And it's interesting when we talk about as a medical student and as you're deciding what you want to do for the rest of your life. Because I'm not sure those Lunch and Learn community understand, as a medical student you have about a couple of years to do the medical student thing and then you have about a year and change to decide what you want to do for the rest of your life. Now for some people it's easy. I remember going to school understanding that I wanted to do primary care, outpatient medicine. I knew that was what I wanted to do. So it wasn't difficult for me. My choices were pretty similar as far as either family medicine, internal medicine, maybe PhD. I knew I wanted to do something and those three. But there are a lot of people who go to school and have no clue what they want to do or how they want to do it. So you're already starting, that stress level is already starting to build up because you don't really have as much time as you think you have to choose the career of your life. So you had to choose that career. But while you're in the process of choosing that career, there are many different factors that you didn't even have to think about. One, where are you going to be working at? How much are they going to be paying you? Is that lifestyle conducive to having a family or traveling? Or whatever your advice is. Those are thoughts you're starting to think about it and being interjected. Unfortunately, and I always tell people that when we think about Yelp and those types of review sites, it wasn't made for positive reviews. It was made to say like, hey, I got a problem with this business and I need to let you know about it. Most of the reviews sites have been originated from that concept. So what tends to happen is the same thing happened in medicine. So of course the people who are doing well and who are happy in medicine, they weren't really as vocal about being happy in medicine, which because they didn't. Again, they probably didn't think they had to. But the people who had the negative thoughts, the people who were like, oh my God, I can't believe I got to do this over and over and over again. Those are the people we tended hear about from the most. So you had these people interjecting that dot soon especially were in on that impressionable stage and understanding that what they say holds so much value that all of a sudden now we're making career life choices because of what someone said before you. A perfect example is the amount of people, and it's crazy that I still hear it now, the amount of people who will discourage my female colleagues who want to do surgery, because they say, oh, you can't have a life if you're going to be a surgeon. And the amount of people, again, they don't discredit the men. And we all know how that bias goes. They don't discredit the men on them. They always discredit the women. They always say like, oh, you can't have a family if you want to be a surgeon. And the amount of times I've heard my female colleagues say, oh, I didn't want to do this specialty because I wanted a family. It's such a disheartening fact because again, remember they have no clue about that specialty. All they know is from what people have told them and from unfortunately, again, the people who usually tell them these negative connotations and they've painted such a bleak picture that you have scores of people who don't go into professions because of what someone said about them. So again, imagine if I was primary care and I'm gung ho primary care, but all I heard about was from people who told me how terrible primary care was. Maybe I don't choose primary care, right? Maybe I said, you know what, if primary care is that bad, I need to stay away from it. So that's what was happening. That was happening now. And that starts early. Again, when Episode 125 and 126, you heard our two medical students talk about just dealing with the strife of a distress of medicine and dealing with expectations that weren't their own and being put in positions where it became too overwhelming. So as a medical student, I was pretty rock solid. I knew like, yes, I want to do medicine. I want to do outpatient clinical medicine. So I'm fine. So I'm pretty unshakable. I didn't care what people said. It didn't matter if they thought primary care was weak or they thought primary care didn't pay enough, that wasn't ever my motivation behind it. So those words can affect me. What would happen, when we fast forward and we get to my residency and as a resident I'm doing well. But again, as a resident I'm still like, yup, outpatient medicine, outpatient medicine. That's the thing to do. Because that's what I want to do. Because that's what I love. And fortunately they didn't dissuade me as a resident. They didn't dissuade me to go away from outpatient medicine, but they also didn't encourage as well. I tell people all the time, as a resident, I probably did 2/3. Maybe about 70% of my training was done inside the hospital. 70%, which is a lot. And I didn't get that many opportunities to do outpatient clinical medicine but I knew it was something that I always wanted to do. It didn't matter. It wasn't gonna deter my thoughts and my wants. But despite not having as much experience in outpatient clinical medicine, I still went forth. And I still did that. And having a decision, I knew it was. Because again, even though I remember my first couple of years where I was, I don’t have my book, I don’t have my phone. I'd constantly be looking up medications, be looking up like, oh, what type of cream do I put on for here? I had no shame. I would tell my patients like, oh, give me a second, I need to look up the dosage. And I had no problem. My patients loved me, so it didn't matter to them. They knew I was fresh out of residency, so they knew I was learning along the way. But they trusted me with their health care so that was fine. And then I started really getting what the business of medicine was like. I went to work for a company, actually for a hospital who had some outpatient practices. So I went to work for them and started realizing that there was a lot of decisions that were being made that wasn't really in the best interest for the patient, but really for the best interest of the organization. And it was conflicting because again, remember as a premed, I was like, I want to save people, I want to help people. I want to care. We all know what the personal statements read like. I want to do it because I care. But here I was being played in positions where I was almost having to battle with my employer of what we should do for the patient. And then here I was also being put in positions where I was having to battle the patient's insurance for what I wanna do for my patient. And my outpatient clinical docs already noticed very well of the amount of work and stress that's related to dealing with insurance companies when trying to get the best possible care for your patient. It's a daily process. Some people estimate that your productivity goes down by like 20 to 30% in a regular outpatient office, just because you're dealing with the outside stressors of an insurance company denying claims and not approving authorizations. And again, for them it's a business model. Because they understand if 20% of the docs out there get their claims denied, their orders not approved, you know what, there's going to save them billions of dollars a year. So it's a business model that baked into the fact that they just don't improve some of that stuff they don't approve. So I'm here dealing with that level of stress, dealing with that level of a concern as far as like, what should I do, what's the best for my patient? And then I had my employer like, well no, you should do this, you should do that. So again, we were starting to kind of butt heads and then I started realizing that I was in a position where I was an asset to a company that didn't really thought I was an asset to their company which is a funny position to be in, right? When you know like, hold, you should be really treat me better because hey, I am the physician. I'm literally the reason why the lights on in this building right now. I was the only physician in the office. So again, if you don't have a physician at office, then you don't have a manager in office. You don't have an office staff in office. You don't have all the medical tools. I'm literally the reason why the lights are on in that building. But you would make it the way they would make it seem as if I was just some accessory portion. And I think that's where, I'm gonna speak for all of the physicians who feel burned out or feeling burnt out. But I think that's where a lot of us, a lot of the distress is being derived because you put all this work in. You have all these sleepless nights. You have to all those long hours in the library and then you run into a system that makes it seem like, no, you're just a one little cog that can easily be replaced. You're just one little penny here that we could just put somebody else in and keep it moving. And I think that's the disheartening aspect of a medicine. You know, as you're getting older, especially when you're not walking the light that you need to be walking. And I know a lot of physicians who are in this same position and this is, regardless of the specialty, regardless of the pay, and I tell people all the time, medicine is not the thing that you go in for pay anyways. Imagine you spend, almost like 12, 13 years of your life studying for something. And trust me, the amount that they paid doesn't equal to the amount of work that you put in. So it's not for the money, right? This is across specialties. These are people in specialties who get paid half a million dollars a year and they're miserable. Absolutely miserable having to go to work. Absolutely miserable of having to deal with the day to day stressors that medicine has placed in them. And for reasons that don't have to deal with the patient. Just stuff that's above their hands that they can't even affect or control. And when you get into a position where you can't affect or control what's happening and it’s just stuff that's just happening to you that beats you down on daily. Trust me, I'm in a few physician groups who feel this way. Some physician groups that like outer career. It's almost like hey, outside of the physician career, what else can I do? And you should see the amount of people who are in these groups. Amount of physicians who are in these groups who are looking for a way out of medicine. I saw an article recently that talked about how a majority of physicians would not recommend their family members go into the practice of medicine. Which is sad. And I would tell my daughters and son all the time like, hey, please come join me and become a doctor. Because I know that there are certain factors that are at play that affect us. I know there are certain factors that attribute to us wanting to be tired, wanting to be burnt out. And there's ways to get around that. And I think that was one of the big things that, I was very happy, especially with our last two guests when they talked about how in the school, they're instituting processes to try to get around the fact that like, hey, we know we have a system that routinely beats you up and beat you down and discredit you and makes you become depressed. We know that. And I think that's the big thing. This is not a secret anymore. The system of health care is almost made to beat people down. You have to install measures to avoid that. In residency, we call that resident wellness. You have to install measures to avoid the beat down. You'd have to install measures to let your residents know, like, hey, we are here for you. Please relax. Please go to sleep. Please do these things that any common person would probably do. But because of the system that you're in, because of the healthcare institution that you're in, you probably don't realize that those opportunities are afforded to you, or you probably realized that if you tried to take some of those opportunities, someone else may try to discredit you, which is crazy, right? Again, we physicians and mental health, that's a whole long discussion. But because we don't take care of ourselves, we deal with some of these stressors that we don't have to deal with. So I think especially when we talk about just in my position where I'm like, hey yeah, I don't like where I'm at right now. I don't like my job. And again, it's not like I didn't love my patients, I loved my patients. But the position that my job was putting me in was something that I realized I had to go. But now I was very fortunate. And again, I know I've talked about this in the past. Working with my coach and my business coaching who helped guide and open doors and open just a different mindset associated with what health care was and helped turn life around and almost always do like a complete 180 on just this process of burn out. At this time I'm the happiest I've ever been in medicine. And it's funny because again, I'm only five years out of medicine. I'm only five years out of residency. So I'm not the season vet who's been around 10, 15 years. I'm five years out. But I was already experiencing symptoms of burnout that quickly. And we, you know, just again, if you catch episode 125 and 126, that now medical students are feeling that burn as well too. So we understand that this isn't a process that's gonna only affect us after you've been in for 20 years, it's not the case anymore. And you're having more and more people decide a way from this profession. Or having more and more people decided away from certain specialties because they don't want that risk of burnout or the risk of burnout is less because like I said, you can be burnt out in every single specialty. Because if the systems and the powers that are above you aren't letting you practice the way you want to practice, aren't letting you take care of your patients the way you want to take care of them, you're going to feel that way. So to my colleagues now, I want to just talk about some of the things I did. I really had to ask myself like, all right, what am I doing this for? What am I doing this for? Who am I doing this for and what can I envision myself doing? And that's when I really started to make the change. And really started understanding like, hey, I love medicine. I love being able to take care of people. But the fact that I'm limited by who I can take care of just because of proximity is a problem for me. And it was becoming such a problem that it was starting to build and build and build. And that's what I said, I need some way to be able to teach and educate and care for the masses as much as I possible. And that's why we started doing the videos. And that's why we started doing the blogging. That's why I eventually did the podcasting. Because I realized that a part of what was holding me down, holding me back was this need to really want to help more people than I was just able to help. And then helping utilize social media and everything else to expand the message along. And again, I thank my coach for that. That was one of the things he instilled in us. How to get out of the box of medicine that is suffocating you. Because a lot of people feel suffocated. Again, I talked about this, a lot of physicians who are in the burnout process, feeling the burnout, it's not like they're quitting, they're not quitting. They are still taking care of your mom, your grandpa, your grandma, they're still taking care of family members. They're just not doing it in the most efficient way possible. They're not doing it in the most happiest state possible. So if you had to choose like, hey, I gotta choose Doctor A who's extremely happy. He loves what he's doing, has no experience of burnout and he need to take care of my grandma or physician B who sad, haste that they even have to come into work. Dreads the drive into work. Can't wait till they leave in, clock out for work. Which physician do you want taking care of you? And I said, that's all I ask. So it's just to understand like, yes, this is a problem at hand. This is a problem that affects a lot of people. Again, I can’t say everybody, but it affects a lot of people from that standpoint there. So moving forward when we talk about some ways to help decrease your feelings of burnout. I think it's important to understand that you know what, you have to take care of you first because if you don't take care of you, if you don't address what you need out of this life, which we call medicine, you're going to be a trouble. So understanding who you are, understanding what your needs are is going to be the first step because that's how you're going to be able to go say, hey, you know what? Now that I know what my needs are, how am I about to go in fulfill those needs? How am I about to say like, all right, I know I need to be able to do this, this and that with my life while doing medicine. Let me make sure I'm doing that. So everybody else is well taken care of. And then when you go on and really acting on it. As a physician we're so selfless when it comes to our patients, but we're not selfish enough when it comes to ourselves. We don't take care of own selves. We don't get our own doctors checks. We won't seek a counselor when we're grieving. We won't do all of these things that any other time you would tell your patient to do. We don't do any of that stuff because we don't do any of that stuff. We are putting ourselves in harm and eventually we're putting our patients in harm. And if you had to say like, is your goal to put your patients in harm? Of course their answers are going to be no. So you have to take care of yourself. Be selfish, right? Be selfish, understand, when you're hurting. Understand when you're depressed. Understand when you need it. Just get awake. I would talking to a colleague of mine when I suffered a broken fibula for those who may not know, I suffered a broken fibula chase down to my son. When I suffered that broken fibula, I was out of work for about five weeks. When I tell you the last time I had to think about my longest vacation was in between graduating from residency and starting my job. Now I get most of it. Most physicians aren't taking a whole month off. But I think the longest stretch I've been out of work as maybe like a week or so. But it comes so few and far between that I can almost remember when I did it and understanding that like, oh, you know what? This break is actually good for me because I need to get away. I kind of need a refresh time, you need to reenergize. And it was such a good experience. I was like, okay, I gotta make sure I actually start instilling these times, right? So instead of saying like, oh, I'll just take a day off here and I'll be back. No, it may take two days off, maybe take three days, maybe take a whole week. And don't feel the burden of like, oh, I found gone for a week. I'm going to have so much work from me when I get back. Don't worry about that. Yes. Take a week off and enjoy your week. Understanding of the work is there, the work is there, it's not going in anywhere. You are going to have to do it regardless. So might as well, enjoy your week off while you're doing it. So be selfish. Understand who you are. Understand you know your needs, and then that's how you're gonna fulfill the patient. That's how you're going to avoid this process. And these processes and again, I call it a process, avoid this process of burning out. Because it doesn't happen overnight. It beats you up when you're a medical student. It starts chipping away when you're a resident. It really hits home. But for some people get speed up, some people just slow down, but it eventually does it. Because that's unfortunately the way our system is set up to do. So that's my thoughts. And I've talked a lot than expected. That's my thoughts on burnout and my personal experience with burnout and then what I think you should do if you're starting to experience that. Be selfish, it's okay, right? Because if you don't take care of yourself, again, how are you going to take care of others? I typically ask my guests, how is what you're doing helping to empower others to take better control of their health? So usually we're talking to Lunch and Learn community but this time I'm really talking to my colleagues here who I know listen to the show as well. Understand that if you don't give yourself the power to take care of you, no one will. Alright. So being able to take care of yourself always starts with the person themselves. They have to be able to, I tell my patients, you have to be able to say, yes, I want to get healthier. Yes, I want to do better. If you don't do that, whether it's verbally, whether you're writing it down in a book or a journal. If you don't outwardly say, yes, I want to do this thing. It'll never happen. You guys have a great and blessed weekend and we're gonna see you next week guys. [/showhide]

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