Two articles appeared in medical journals and were reported on Medscape over the past few weeks, one on the scary rise of professional burnout among physicians, the other warning about their declining intuitive skills. I\u2019m sure reading them on the same day helped me appreciate how the two are connected.<\/p>\n\n\n\n
After a quick mull, I thought there might be a Health Tip in there, especially since so many of our readers are women, whose intuition comes pre-installed at conception. Others of us (male, left-brained, linear me, for example) have to hone our intuitive skills.<\/p>\n\n\n\n
The physician burnout survey was a bit of a shocker to those of us in the medical profession. In a questionnaire sent to more than 35,000 practicing physicians from all specialties, a full 55% acknowledged they were so thoroughly fried they\u2019d leave medicine ASAP if they could afford to. This 55% is almost double the burnout rate of the general working population (28%) and a10% increase from the same physician survey taken in 2011.<\/p>\n\n\n\n
In addition, 47% of physicians reported \u201cemotional exhaustion\u201d and just 41% said their schedules allowed sufficient time for personal and family life.<\/p>\n\n\n\n
The best part of the Medscape article reporting on the survey are the 207 physician comments that follow. These are generally not accessible to the public unless you have a computer savvy nine-year-old around the house, though since with the internet everyone\u2019s a physician these days you could probably register as a doctor yourself and a Medscape membership would slide through. Be aware that Medscape is free for physicians, though, and prepare yourself for plenty of Big Pharma ads.<\/p>\n\n\n\n
Commenting physicians are in full agreement with the survey and generally surprised it\u2019s \u201conly\u201d 55%. Based on conversations with colleagues, the commenters peg it at closer to 90%. From one physician: \u201cThe other 45% are lying.\u201d The commenting group is also eager to report the two causes behind the burnout.<\/p>\n\n\n\n
The single biggest villain is the cancer of electronic medical records (EMRs)<\/strong> forced upon doctors and hospitals by threats of financial penalties from the health insurance industry and government regulators (Medicare\/Medicaid). This isn\u2019t me being a Luddite. The newly elected (and youngest in history) president of the American Medical Association called EMRs, most of which use outdated software, \u201ca point of infuriation\u201d that decimate a doctor\u2019s efficiency and ability to communicate. EMRs appeared well before Obamacare, but because they seemed to arrive simultaneously some blame the outgoing president for them, which is just silly.<\/p>\n\n\n\n It\u2019s hard to convey to the general public why 85% of physicians so thoroughly loathe EMRs. However, the next time you complain that your physician doesn\u2019t make eye contact with you any more, it\u2019s because she\u2019s spending much of your visit pointing and clicking, pointing and clicking, pointing and clicking. You simply can\u2019t watch the body language of your patient when you\u2019re working to get that tiny cursor into a tiny square so you can click \u201cYES: I have inquired about the tobacco usage history of the patient\u201d (this has to be answered at every office visit).<\/p>\n\n\n\n Doctors can\u2019t communicate with each other using EMRs because there are several hundred competing EMR companies and no two systems are alike. EMRs cause most physicians to run behind schedule and on average add two hours (two hours!) of work daily, precious time not spent interacting with patients<\/u>. As I write, it\u2019s Sunday morning and when I finish this Health Tip I\u2019ll go back and catch up on last week\u2019s EMRs.<\/p>\n\n\n\n A second source of physician burnout is the micromanagement of doctors by regulators in positions of power<\/strong>. Health insurance companies tell doctors exactly what they can and cannot do. Hospital and healthcare \u201csystem\u201d administrators, who now employ most of the physicians in the US, press doctors to work faster and generate more income.<\/p>\n\n\n\n An interesting perspective on the concept of stress describes the current situation. You\u2019ll experience stress when you\u2019ve relinquished being in charge of your life and you\u2019re largely controlled by others. This is today\u2019s situation for US physicians. Under the gun from government and insurance regulators, predatory malpractice attorneys, and patients with unrealistic expectations, their professional skills stymied by the relentless point\/click\/point\/click, if they had enough in their IRAs more than half this country\u2019s doctors would delightedly exit the health care stage and head for the wings of early retirement.<\/p>\n\n\n\n In case you\u2019re curious, I myself am not in the 55%-of-doctors burnout group, though I readily acknowledge being among the 85% who loathe EMRs. I avoid burnout because we at WholeHealth Chicago remain highly independent of insurance (except for Blue Cross), government, and big medical group management. My relationship with Blue Cross is more like the one between a crotchety married couple or two porcupines attempting coitus than between a doctor and an insurance company.<\/p>\n\n\n\n If you think about your own intuitive skills, you\u2019ll appreciate they\u2019re the result of attentive observation and a complex, but mainly subconscious, mental activity. When you know<\/em> in your gut that you\u2019ve found the right person or the perfect house, or that something is truly right or wrong, you\u2019ve reached this point by a Google-quick scan of everything you\u2019ve ever experienced in your life, which you retrieved from ports unknown. But the real name of the game is attentiveness. It\u2019s for good reason that highly intuitive people are also called \u201csensitives.\u201d<\/p>\n\n\n\n The title of the Medscape article, \u201cProfessional Intuition Under Assault,\u201d is best summarized by a quote attributed to Albert Einstein. \u201cThe intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.\u201d<\/p>\n\n\n\n In other words, what\u2019s responsible for burnout\u2013EMRs and micromanagement\u2013is causing your physician\u2019s intuitive diagnostic skills to atrophy.<\/p>\n\n\n\n Personally, I know that when I or any of my WholeHealth Chicago colleagues are with you, the patient, we\u2019re using all our skills, clinical and intuitive, to figure out what\u2019s wrong. Likely you made your appointment because you yourself had an intuitive insight that something wasn\u2019t right. You may have tried your diagnostic luck on the internet and, coming up blank, you arrived at WHC for some professional help.<\/p>\n\n\n\n I know that each of us can hone our intuitive skills and I recommend the Four Horsemen of Intuition\u2013Carolyn Myss<\/a>, Norm Shealy, MD, PhD,<\/a> Christiane Northrup, MD,<\/a> and Mona Lisa Schulz, MD, PhD, if you want to learn more. I cannot imagine functioning as a physician without bringing into play what I learned from them.<\/p>\n\n\n\n I\u2019m certainly not alone in this. As physicians mature professionally, they realize medical school facts, useful as they are, take a back seat to attentive listening and observation. Doctors may not use the actual word \u201cintuition,\u201d but a majority of them are fully cognizant of using this skill.<\/p>\n\n\n\n I would be burned out too if I were told, \u201cNo time for that intuition nonsense. Finish your EMRs. You missed dozens of the point\/clicks. And by the way, you\u2019re not working fast enough\u2014be a team player, see five patients an hour, and try not to fall behind. We wouldn\u2019t want to let you go.\u201d In fact, I\u2019d be out the door.<\/p>\n\n\n\n Be well, Two articles appeared in medical journals and were reported on Medscape over the past few weeks, one on the scary rise of professional burnout among physicians, the other warning about their declining intuitive skills. I\u2019m sure reading them on the same day helped me appreciate how the two are connected. After a quick mull, I […]<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,203,3,216],"tags":[1487,152,202,1480,1503,1205],"class_list":["post-7829","post","type-post","status-publish","format-standard","hentry","category-blog","category-health-insurance-issues","category-knowledge-base","category-p","tag-electronic-medical-records","tag-emr","tag-health-insurance","tag-healthcare","tag-healthcare-industry","tag-insurance"],"yoast_head":"\r\nSo how does intuition come into play?<\/strong><\/h3>\n\n\n\n
David Edelberg, MD<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"