We Don't Need More Joy In Medicine. We Need More Vocal Discontentment.
Originally published on KevinMD.com.
A few years ago, as numbers of burnout, depression, and suicide among physicians continued to rise, the notion of “joy in medicine” was conceived. From conferences and books, to support groups and consultants, another health care-related industry popped up around improving provider satisfaction and fostering workplace wellness. It was well-intentioned, as these things often are, but like the familiar adage about roads and good intentions, joy in medicine seems poised to do more harm than good.
With half of all physicians reporting signs of burnout, the medical community is experiencing a workforce crisis. The demands of care delivery are simply unrealistic: back-to-back eight-minute visits, EHR data entry for nearly six hours a day, constantly changing reimbursement models. And all this comes at a time when 75 million baby boomers require more complex care. It’s no wonder clinicians are overwhelmed.
And it’s not just about staggering rates of burnout and depression; it’s also the stigma of burnout and depression: a kind of weight upon a weight.
And we expect providers to be … happy? This feels like an exercise in cheering up a friend in a bad relationship: the familiar, disingenuous “look on the bright side” remarks that do little to assuage the pain.
The practices associated with “joy in medicine” — mindfulness and happiness journals — may provide some relief, but it’s temporary and individual at best. It’s time for health care providers to come together as a community to acknowledge that they’re in an unhealthy relationship. It’s not working for them. And it’s certainly not helping us: patients. For anyone of us to pretend the status quo is tolerable by feigning satisfaction isn’t going to treat the underlying condition. Indeed, physicians — of all people — should understand that focusing solely on the symptoms will only cause the disease to fester.
The reality is this: None of us are served by a doctor with a skip in their step evangelizing happiness. As a colleague in the medical community recently noted, “Being joyful feels like one more thing I don’t have time for.” The system would, however, be served by a dissatisfied doctor with a megaphone calling for real transformation – demanding the structural changes required to overhaul the system.
When a system isn’t working, we don’t adapt to it: We fix it. We don’t quietly journal our frustration: We yell it. We don’t grin and bear it: We change it. In health care, if we want more joy in practice, patients and providers need more time together. We need a relationship. We need a care team that’s engaged and unhurried. Not only will these and other structural changes yield more joy for providers, but they’ll yield more satisfaction for patients, too.
So here’s to the discontented providers. We’re all fed up. And rather than pretending we’re OK, let’s come together and admit that we’re not. I’m willing to bet we could start something amazing.