Career and Life Planning Guidebook for Medical Residents

SECTION I: T MINUS THREE YEARS Work overload Intensity Time Working Capacity Lack of control Loss of autonomy Micromanagement Insufficient rewards Getting less for more effort Loss of joy Breakdown in the medical community Undermining teamwork Working harder not smarter Absence of fairness Conflicting values Christina Maslach and Michael P. Leiter, The Truth about Burnout: How Organizations Cause Personal Stress and What to Do about It (San Francisco: Jossey-Bass, Inc., 1997) Business of medicine Electronic health record Meaningful use Coding/documentation requirements wRVU targets/patient volume Non-value-added work Industry consolidation Human factor: impact on relationships Professional: physician colleagues/admin Personal: life partners, aging parents, children Finances Educational debt Declining reimbursements Increasing personal and professional expenses Health Of the aforementioned factors, the easiest to blame andmost commonly recognized ones are those that involve tangible elements: finances, work hours, and the overall “business” of medicine. Significant financial challenges in healthcare organizations have resulted in declining reimbursements. These challenges include price competition, an increasing percentage of patients with Medicaid and Medicare, as well as a narrowing of insurance networks. Simultaneously, requirements for the adoption of electronic health records (EHR) have not only stressed organizations financially as a result of necessary capital expenditures but added a significant clerical burden for staff. Part of organizational responses has been an in increase in performance and productivity requirements forphysicians in an attempt to improve efficiency. Quality measures, patient satisfaction surveys, staffing reductions and public reporting have added additional strain to affected institutions and physicians in varying degrees; all have certainly contributed to the burnout paradigm. R E A D : What Are the Primary Drivers of Physician Burnout? The drivers of burnout are not unlike caring for a complex patient: insidious, often difficult-to-define symptoms overwhelm the basic needs not being met. They are frequently listed in different formats but generally include the following: CAREER AND LIFE PLANNING GUIDEBOOK FOR MEDICAL RESIDENTS 34