To the Editor:
The article by Shanafelt et al
1
published in the December 2015 issue of Mayo Clinic Proceedings describes the very serious and worsening problem of burnout among American physicians, and the editorial by Ariely and Lanier2
attempts to elucidate the causes, noting asymmetrical awards, loss of autonomy, and cognitive scarcity. I could not agree more on one point that Ariely and Lanier made, that the “micromanaging of physicians' time and decisions” in the name of productivity by their corporate overseers is a major factor in the burnout and that it needs to be addressed.The social and cultural influences that have altered the ethos of medical practice are complex, and I have described them in detail elsewhere,
3
along with possible remedies. In addition to that analysis, I strongly believe that medical societies need to be more proactive in developing and advocating positions to resist and modify the corporate control of medical practice. It is not a coincidence that physician burnout has grown exponentially and in parallel with the increase in the corporate control of medical practice. This organizational change has occurred without the careful scrutiny of serious research on the long-term unintended consequences such change engenders in health care processes. Both research into and advocacy for maintaining and strengthening the role of medical professionals in the face of managerial technocracy are urgently needed.The scrutiny of the quality of medical care is here to stay, but quality medical care also requires professionals with a satisfying work environment who find their work appreciated and respected. No one expects to eliminate the corporate entities that control medical practice today, but with effort, we can get them to be mindful that respectful interaction with clinicians is essential to quality medical care and physician well-being.
References
- Changes in burnout and satisfaction with work-life balance in physicians and the general US working population.Mayo Clin Proc. 2015; 90: 1600-1613
- Disturbing trends in physician burnout and satisfaction with work-life balance: dealing with malady among the nation's healers.Mayo Clin Proc. 2015; 90 ([editorial]): 1593-1596
- The Ethos of Medicine in Postmodern America: Philosophical, Cultural, and Social Aspects.Lexington Books, Lanham, MD2014
Article Info
Footnotes
Editor's Note: When publishing a letter that comments on an article published previously in Mayo Clinic Proceedings, it is the journal's policy to invite the author(s) of the referenced article to publish a response. Drs Shanafelt and Ariely were invited to respond, and although they were supportive of this letter, they felt the content of the letter did not require a reply.
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Copyright
© 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014Mayo Clinic ProceedingsVol. 90Issue 12
- Disturbing Trends in Physician Burnout and Satisfaction With Work-Life Balance: Dealing With Malady Among the Nation's HealersMayo Clinic ProceedingsVol. 90Issue 12
- PreviewRecent data analyses reveal the disturbing decline in well-being of contemporary US physicians. This trend has captured the attention of not only affected physicians and researchers but also physicians' patients and the general public. For example, the September 7, 2015, issue of TIME Magazine featured an article titled “Life/Support: Inside the Movement to Save the Mental Health of America's Doctors.”1 The article addresses many troubling facts about the state of physicians in the United States, including that as many as 400 US physicians are dying by suicide each year, a number comparable, the author points out, with the graduating classes of two or three medical school classes annually.
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