Alpine, California, United States
December 07
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Zanelle's Links

AUGUST 22, 2012 9:26AM

Doctor Burn Outs

Rate: 12 Flag


  There have been four doctors in my recent past that were just burned out by the time they got to my little cubicle.  They had kept me waiting almost a half hour and it was because they were dealing with an emergency.  It must be exhausting to see all they see and make the heavy decisions.

    My mother's gynocologist apologized for being late.  "Someone had to talk," she explained.  They should have scheduled an hour appointment but that is the way it goes.  What is a busy doctor going to do..  say "Your appointment is up take your sorry troubles out of here so I can bring in my next money maker."   She pads her bill.  sigh.

    The doctor who gave me my free medicare physical was almost shaking.  She didn't explain why she was late but it was obvious that what ever she had been dealing with was trouble.   I tried not to be trouble but I was anyway.  Bodies are messy and unpredictable.  We muddled thru somehow and got all checked out.  I think she took care of me in a daze.  I was glad I wasn't really sick.

    We had a meltdown with our former doctor for my mom.  He had been hit on his bicycle and had his arm in a cast.  When he found out we had been to the Doctor Express that weekend he couldn't contain his distain. 
"They change things all around and I can't keep up." he lamented.  He walked out in a huff and left the building.   We changed doctors.

   Our sweet little lady doctor really seems to care what happens to us and we love to talk to her and try to figure out the latest development in my mom's case.  But last time she kept us waiting and then they put us in a room on the far side of the offices.   I think there was something they didn't want us to see or hear.  She was so tired and distracted when she got to us.  She apologized and we were compassionate.  '

   My mom and I both have worked in the medical field.  It gets heavy.  People who come into a hospital to visit have no idea what really goes on in those hallways.  The tv shows only begin to grasp the human drama.  It can rock your world.  You see things and have to make decisions about situations that are incomprehensible. 

   Are we reaching some sort of saturation point?   Can the doctors keep up with all the pressure of what they see and the decisions they have to make?   We are all only human and we all have to die.   Geez.  I know it is heavy but in primitive times even the Witch Doctors got a break.   Are we asking too much, not just of doctors but of all of us?  



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After 10 years in medical insurance and medical office, I can tell you the problem is insurance: it has taken doctors' choices away from them, muted their instincts and second-guessed them into oblivion. To cover liability and office overhead while juggling "negotiated" contractural reimbursements that are (with the power of the insurance lobby) more like extortion, physicians have no choice but to see so many patients per hour (I've seen them scheduled up to 8 patients per hour) and they have no time to solve mysteries, hold hands, or dig deep... This is killing the medical field, sucking the heart and soul from the profession. The pressure to make the "right" decisions in life-or-death situations must be ungodly, and the pressure to pigeonhole diagnoses to just get the patient out of the office is unforgiveable. We cannot blame the doctor. We need to realize that our medical SYSTEM is broken. And if we want to return to the level of care that we used to have in this country, we must realize that if things do not change, they will only continue to degrade...taking our best doctors and our health with it. Nice post!
From 1992-95 my next door neighbor was the Chief of Surgery at the LA County USC Emergency Room. We often exchanged tales around the pool and his insight about Medicare and Medicaid was eye-opening. The practice of medicine and health care in America has been broken for decades and we're not doing much to fix it.

He held the post for four years before he burned out. Eventually he took a gig teaching emergency medicine and surgery in Thailand and now volunteers his services at hospitals and clinics all over Southeast Asia where he feels he can do some good.
i know mostly of nurses and orderlies, also stressed.
they were the ones who showed compassion to my parents
as they declined...doctors/? arg. they hated them...

you bring an interesting perspective to the situation...
many many doctors, zip , her e and gone in a flash, delivering
horrific news about results and options..
i held them , with mom, in utter esteem..

until i had to override them, in my dad's case.

another story.
Great post. Doctors are burned out. My Dr joined one of those "Boutique groups," charging an extra $1200.00 a year just to see them. They have less patients, but put more of a burden on other doctors who have to see more patients because of these groups. What to do?/r
Very thoughtful post, Z. I don't think patients think about how burned out their doctors can get. Caring for patients on our current system must be like trying to get a drink of water from a firehose. It doesn't help that politicians express a jingoistic "USA! USA! USA!" "We have the best healthcare system in the world!" slogan. How does that help the thousands of Americans without insurance or bankrupted by medical costs? They're not addressing the problems!
You post has gotten such interesting comments. I agree with all of them but I think KC has verbalized much of why it is broken -as well my experience that care is so fragmented because we that we are so specialized.
Well today we got a good one. He did what he had to do and was cheerful and full of energy. He must love his big paycheck. sigh. I just hold them to a higher calling. Anyway he gave us the drugs. Someone told me to think of doctors as books. Dont take them personally. My mom loves them way way too much.
zanelle, I waited over an hour to see my gyno after it took me 5 weeks to get an appointment. I didn't even get to see her because I had a rehearsal to go to. She is always running at least an hour behind schedule, because as KC said, she over-books each time slot. I'm not going back to her because the next available appt. was another month away. My GP referred me to another gyno who I'm seeing next week. It is disheartening and unfair to patients, but as KC pointed out, the medical system is broken too. Luckily my other doctors never make me wait. Guess the only way to get perfect service is to be rich and pay out of pocket to out of network doctors!
zanelle, interesting questions. Call me jaded, but I gave up on the medical profession years ago. You're probably right about the saturation. I fail to find much sympathy for them, however - as long as they're taking our money I believe we deserve quality treatment. If they are so rattled and stressed that they cannot give us quality medical treatment then they need to find a less stressful line of work.
Yes, I think we are, Z. All our tried and true systems seem to be falling apart. There aren't enough of just about everything. Since I've retired, I try very hard to be patient with the waiting. It still rankles sometimes, but I try to understand.

In my area there is a trend of doctors employing Nurse Practitioners (NPs) to help with the workload. I live in a rural town where it's hard to lure doctors to practice here because they could be making more money working in the big cities. Before my Dad passed, I would take him to his oncologist every 2 to 3 months (this was after he was pretty stable on his meds and treatment). Half the time he would be seen by the NP instead of the oncologist. Wait times were short and the NP spent a lot of time examining Dad, documenting his case , reviewing meds and ordering tests. She was able to do a lot of what the doctor did and never seemed rushed or burned out. This gave the oncologist the time to spend on patients who were in more critical need of his help. When Dad's condition worsened, the oncologist saw him, but for the more routine visits, the NP did a fabulous job.
Some years back a friend just starting out as an RN was working alone with her supervisor in a hospice ward of a large hospital. They'd been run ragged all day and finall found a couple of minutes to sit down and take a break. A buzzer went off signaling one of the patients needed them. The supervisor told my friend to check the chart to see if the patient had requested "heroic measures" in a life-threatening crisis. "Nope," my friend read from the chart. "Well, said the supervisor, for us to get up off our tired asses right now would be a heroic measure." So they sat and listened to the buzzer, which eventually stopped. The patient was dead when they next checked.
Ahhhhh extraordinary measures. Yes, how much do we want them to do to us? Humans. Thanks for these great comments.
I know from being a Certified Professional Coder that what KC said is correct. The doctor needs to stay in business and that means jumping through all the hoops required for them to bill and receive payment. That doesn't leave much time for patient care if a GP practice is going to pay nurses, medical assistants, office managers, professional coders, billers, receptionists and collection agents and that's just the labor side of the overhead.

The days when you approached the receptionist, saw the nurse then the doc and handed the receptionist a check on the way out are long gone. There aren't a lot of options except volume of patients to meet the volumes of paperwork and documentation to be paid for their work. I can see why most choose to specialize these days, less paperwork and hoops to jump through for higher pay.
The Specialist we saw today is part of a busy hive of doctors. Vast. They are people processors. We went in with our sorry bodies and they had a way to ease our pain. That is powerful stuff.