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Sep 8, 2015


As is usual when a person graduates to the next level of the heirarchy, I had NO EARTHLY IDEA how much paperwork and general minutia would be a part of my everyday life as an attending. My first schedule had a few half days with no clinical activity assigned and I thought WOO HOO! This attending life is amazing! Little did I know that those times are built in not only for professional development or meeting with mentors/mentees or going to the dentist but that they are there so you can finish your damn charts.

I've only been a grown up for a few weeks now and already feel so overwhelmed by the amount of paperwork. And, of course, it is not actually on paper but just a thousand little clicks. I wonder what my click-per-hour rate is... If I were a website and getting this many clicks I'd be rolling in gold dubloons.

This is not a new question, but I don't understand how medicine go to be this way. Why is the emphasis on clicking instead of talking? On sitting in front a computer as a data-entry clerk instead of making medical decisions and taking care of people? It is an evolution of necessity for insurance companies and law firms, but both the doctors and the patient suffer.

My father, an old timey country doc, has been complaining about this for years, but it is a sharp contrast for me. As a resident, my job was to take care of people, learn from them, and write down what I saw and did. I thought this was a lot of busywork at the time, but I had no idea how much worse the billing component makes it. I spend more time on the billing and charting than I do with any patient, and it makes me so, so sad. I don't think physicians go into medicine to be data entry clerks, but I think it is why a lot of physicians get out of medicine.

A good friend of mine and I were recently talking and she said how burned out she feels. Exhausted and drained, feeling like nothing she does makes any difference. She says that these phases happen sometimes to everyone and that this one will fade like the others have, but it is disheartening to know that someone who views her purpose in life is to help other people, one patient at a time, feels like she is failing. And drowning. I wanted to lift her up, to assure her that she is making a difference, but that was not the point. It doesn't matter what I see, it's what she feels. And she feels exhausted and tapped out.

How do we protect physicians from feeling this way? How do we bolster and encourage those who sacrifice so much for the betterment of others? Money and bonuses and vacation time help, but in these times of dwindling reimbursements and corporate owned practices, we are unlikely to see an increase in that benefit. And we know from "the good old days" when doctors were better paid that they still were burned out and disenfranchised. In this and all things, financial returns are not the way to happiness.

The answer is to find meaning in the work and value in the care of others and ourselves. Though self-care is largely beaten out of us in our training, we are our most important patient and serve as an example to others. Support among the physician and health care community is critical but clearly deficient. As a new faculty, I need mentoring and support, but it is hard to find because EVERYONE needs those things. But we're all too busy and buried in our charts to help each other.

Surely there is a better way! Being new around here, I don't know what it is yet, but I'm still young and rested enough to want to find it. Because I don't want to feel burned out. I'm so excited to be here, a part of something so big and amazing and yet intimately personal. Being excited is not the same as feeling valued, but I am determined to maintain both.

(image credit: doctordocs.com)

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