We recently recognized Doctors’ Day, and many well intentioned people greeted their physician friends with, “Happy Doctors’ Day.” Yet, many aren’t happy.  Being a physician has always come with great sacrifice, responsibility, and burden.  There have always been patients who’ve not done as well as expected, and we’ve all made mistakes because we’re human.  Dissecting what has happened in the last 10 years would be like revisiting the cranial nerves in anatomy class, messy and confusing.  I’ve asserted in the past, as have others, that resentment (and in some cases remorse) is a key negative emotion that drives burnout.  The more a person resents the things they’ve done or are doing, the more likely burnout is to occur.  There are 2 buckets of resentment: 1) doing stuff you don’t want to, and 2) not doing stuff you do want to. I’ve always surmised it’s the latter that really matters. 

In the case of today’s physician, many feel like they aren’t getting to those important things they want to do because of things they’re required to do, which they feel don’t add value.  Spending time with family and friends, attending to human responsibilities outside of work, and having a hobby or two are among the things many aren’t getting to do. Yet, I think there is more to the story.  The value physicians are getting out of their core work has lessened, creating an imbalance hard to overcome. Endless work that never seems to get done without joy is a bad combination.  

For some it might be a financial issue, meaning their purchasing power isn’t what they expected, and yet they feel like they’re working harder than expected.  Fair enough, but I know plenty of 2 doctor families who have more money than 99% of the population and burnout still occurs. Perhaps for some there is a expectation that there be more outward recognition for their work from those in charge or even from their own team members. I’ve learned as a leader, that just like compensation, the impact of saying thank you, is fleeting. I don’t buy that these two things, financial and recognition, are major sources of burnout.

Perhaps more importantly, the joy of working with and helping patients and their families has diminished. The reasons for this are complex and likely vary from physician to physician.  This lack of appreciation appears in multiple forms such as less than stellar patient satisfaction scores, patient complaints sometimes expressed in social media, misplaced anger and blame directed at the physician, a sense of entitlement, a cultural hubris of “well, I know… everything, everywhere all at once.”  Or just a lessening of smiles and thank you in general.  It’s not easy sacrificing so much and thinking no one appreciates your efforts.

The workplace has changed as well. Relationships are important to physicians, and work place relationships have been strained. Respect from health care colleagues for what physicians do and the burdens they carry has diminished. There are many systems issues that need to be fixed and although there are some changes happening, they’re small.

Although this won’t help, I still say, “Thank you.” Thank you to all physicians for choosing to take on the sacrifices, the responsibilities, the burdens of being a physician.  Thank you for devoting your professional lives to helping people.  Thank you for being caring and compassionate despite all the challenges and non-value added tasks.  For those who provide health care to children, the children are why we do this, and the difference you’re making in their lives is immeasurable, priceless as they say, and far above anything else.  Thank you!