Is burnout the global warming of healthcare?

“Maybe they should just get tough” is not an uncommon reaction from older physicians to the growing number of younger doctors who are experiencing burnout. Many would argue that these feelings are outliers from the general population of senior physicians and they may be right. Except that there are dozens of conferences focusing on how to change healthcare cultures to be able to early detect and rectify challenges with clinical wellness and burnout.

The fact is that burnout is not very different from global warming and climate change. Regardless of this summer being the hottest on the globe since records were collected, many will just call it a typical cyclical heat wave.

Like the climate change deniers, many burnout deniers operate from a “back when I was an intern” frame of reference. This is rooted in the mentality that everything has stayed the same as back in 1978 other than those now entering the profession having thin skins. Many will argue that the reason there is burnout is that medical schools have gone soft on rigorous training in a way that leads to a disconnect between the actual pressures of the profession. This is the equivalent of saying I breathed polluted air for decades and I’m just fine with having a climate that allows us to do that today, future generations notwithstanding.

The difference with clinical burnout deniers is that, unlike with climate, they’re experiencing the deep effects of losing a talented medical workforce daily. Add to that the ripple effect of higher patient load less patient time and dramatic increases in documentation on EMRs with fewer support staff to do it.

It’s the equivalent of saying “I didn’t believe the earth was warming until my home and family were washed away in a flood.”

As we know from the pandemic, countering the beliefs of deniers is tricky and almost inevitably turns political. Using facts and data is rarely convincing because the legitimate source is always questioned, even when compared to a source-free denier. I digress, but there are some interesting research findings related to party affiliation and death from COVID.

So how do we convince the burnout deniers that the problem is real and reaching epidemic levels?

One of the more obvious solutions is the fact that despite the shortage of young physicians, entering the profession, especially in some ethnic groups, there is an increased awareness among these demographics of the causes and severity of the burnout problem. These demographics and more technology savvy know that tech can be both a solution and a cause of the problem.

Many of the burnout deniers were tech-phobic and calloused after years of long hours and little quality of life. That’s not the case with most of the new entrants who now serve as wellness evangelists with their peers, and ironically as mentors for the boomer-doc who simply do not understand that this is not your father’s Marcus Welby-style medical profession.

Finally, the element that leads to a greater understanding of the crisis among doctors young and old is the actual the patient. During a 100-day COVID-19 hospitalization, I realized that the emotional toll of COVID-19 on my caretakers was arguably as debilitating as it was on me.  I’ve written that many COVID wards were what I called a “Lonely-Palooza” of doctors and patients sharing the same stressors and depression. Having many candid conversations with my doctors and nurses gave me tremendous insights into how burnout can result in poorer patient outcomes.

Add to this the COVID-deniers who found themselves on ventilators and how “compassion fatigue” among their caretakers could affect their recovery.

For this reason, I would argue that any solution for the burnout epidemic must include the “customer,” who is the ultimate benefactor of solving this mental health epidemic.