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Friday, September 16, 2022

Character Development 1 A Physician who is Burning Out: A blog by Warren Bull


 


Image from JC Gellidon on Unsplash

Character Development 1 A Physician who is Burning Out: A blog by Warren Bull 



If you write about a character who is a physician, or any other medical provider, who is in the process of burning out, you probably already know the description of burnout in the professional literature https://pubmed.ncbi.nlm.nih.gov/29505159/ 


Drivers of this epidemic [burnout] are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work-home conflicts, as well a lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures, and leadership culture. Individual physician-level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians.


But that is the problem as described in an impersonal third-party way. To describe what your character is facing you need to know how your character is feeling.


For a more personal description check out the article below:


https://www.medpagetoday.com/podcasts/thedoctorsart/99581?xid=nl_popmed_2022-07-08&eun=g2049970d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=PopMedicine_070822&utm_term=NL_Gen_Int_PopMedicine_Active 

  

In the article Tyler Johnson, MD describes the emotions involved 


I know that a lot of doctors feel like that ability to actually physically touch patients or to form a more holistic, emotional bond, whatever you want to call it, is being sort of drowned in this rising tide of bureaucracy and electronic medical records and billing requirements and all the rest of it.


And Lisa Sanders, MD, adds her understanding


I have this theory about people who want to go into medicine. People [who] want to go into medicine, have spent their entire lives doing what's expected of them, what they need to do.

Everyone knows the way, knows what you've got to do to get into medical school, then knows what you've got to do to get the residency you want. Then at the end of residency or even during residency. You have to think, what do I want? You know what? That's the thought that many of these kids have never had before. It's, I would call it an opportunity, but it's not, it's kind of a burden because they really have no experience making choices based on their own desires and interests. 

As a former psychologist, I can identify and share what I have felt and been told by, among other people, my personal care physician, my pharmacist, and a friend who is a medical insurance broker. The practice of medicine has become an assembly line enterprise defined by production. Production means how many patients get seen, not how helpful or liked the services provided are.  


There is a constant struggle between time demands for the limited length of visits often based on scheduling by office staff, time spent recording visits, and the allocation of time within visits. I remember in intake dividing my attention between finding out the reason someone came in, recording the information, and forming an emotional connection with the client. 


If you have never been in therapy, imagine pouring your heart out to someone who has one eye on the clock. Someone who loses eye contact with you to tap on a computer. 


I also knew that, whatever problems were presented, there was an arbitrary limit to the number and frequency of visits allowed. I had to figure out what could be dealt with successfully in the total time allotted.


I identified with the television series Mash where the doctors talked about doing “meatball surgery.” Their job was to stabilize the medical conditions of wounded soldiers so the soldiers could survive long enough to reach hospitals far from the front lines of combat. More careful repair and rehabilitation could be done there.  In my firm opinion, our entire medical system functions on a triage model of care.  

2 comments:

Kait said...

Great direction from an insider’s point of view! Thanks, Warren.

KM Rockwood said...

Burn-out is real! Depicting it can be tricky.