Pamela Wible MD http://www.idealmedicalcare.org/blog America's leading voice for ideal medical care Mon, 25 Jul 2016 17:31:19 +0000 en-US hourly 1 http://www.idealmedicalcare.org/blog/wp-content/uploads/2015/09/cropped-favicon.512x512-32x32.png Pamela Wible MD http://www.idealmedicalcare.org/blog 32 32 How the word “burnout” perpetuates medicine’s cycle of abuse http://www.idealmedicalcare.org/blog/how-the-word-burnout-perpetuates-medicines-cycle-of-abuse/ http://www.idealmedicalcare.org/blog/how-the-word-burnout-perpetuates-medicines-cycle-of-abuse/#comments Mon, 18 Jul 2016 00:03:23 +0000 http://www.idealmedicalcare.org/blog/?p=2978 ]]>
Illustration by Jorge Muniz, PA-C. Image credit Medcomic.com

Illustration by Jorge Muniz, PA-C. Image credit Medcomic.com

We enter medicine with our hearts and souls on fire ready to serve humanity. By the time we complete medical training many of us have anxiety, PTSD, depression—even suicidal thoughts. Why? Medicine is stressful. Many of us work 100 hour weeks surrounded by suffering and death. We may deliver a stillborn, try to save a teenager with a gunshot wound, and then rush into the next room to help a lady having a heart attack—all within an hour. With no debriefing or emotional support. Medical training glorifies physical and emotional self-neglect and endorses teaching by intimidation and public humiliation. Bullying, hazing, and sleep deprivation is the norm in many of our finest hospitals and clinics. And if we seek psychological support, we’re mandated to report it on all job applications.

Doctors who complain about inhumane working conditions are often labeled with “burnout,” a “resilience deficiency” or even “disruptive.” They’re mandated to resiliency classes so they can learn mindfulness, deep breathing, or yoga. Victims get instructed in work-life balance, boundaries, and other ways to conform to their workplace abuse.

Anger, grief, and depression are normal responses to a sick medical system that forces us to submit to inhumane working conditions. “Burnout” blames the individual. Physicians may then feel unfit for the profession they once loved. The most vulnerable among us may leave medicine. Some may consider suicide.

“Burnout” and similar labels are dangerous to the individual and also distract from the real diagnosis—human rights abuse. (FYI: Meditation, yoga, and taking deep breaths are not treatments for human rights violations.)

The United Nations Declaration of Human Rights Article 5: No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. Article 24: Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay. 

Doctors, if you on a 36-hour shift in the ICU and have not eaten or pooped all day, you are experiencing multiple human rights violations. Patients, if you’re in the hospital and your doctor is bullied, abused, hypoglycemic, and sleep deprived, you should be very, very concerned. Human rights violations will adversely impact your care.

So docs, how do you know if you’re experiencing human rights violations at work? 1) You don’t get lunch or bathroom breaks. 2) You are forced to work multiple-day shifts. 3) You are not allowed to sleep. 4) You are forced to see unsafe numbers of patients. 5) You can never seem to find “work-life balance.” 6) You are threatened verbally, financially—even physically. 7) You are bullied. 8) And if you ask for help, you’re called a slacker or worse. 

If any of this seems familiar, it’s not your fault. You are a victim of abuse. So what should you do? Your goal should not be to cope with abuse. Your goal should be to stop it. Taking deep breaths will not end your abuse. If you’re being abused, speak up. If you’re complicit with abuse, you perpetuate the cycle on the next generation.

Other countries get in big trouble for human rights abuse. Why should US health care get a pass?

Here’s what happens when we are complicit with medicine’s human rights violations:

Pamela Wible, M.D., advocates for a humane medical education system and is an activist in medical student and physician suicide prevention. She is author of Physician Suicide Letters—Answered. Contact Dr. Wible here. Jorge Muniz is an internal medicine physician assistant, illustrator, and author of Medcomic: The Most Entertaining Way to Study Medicine. Image credit: Medcomic.com.

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Meditation is not the treatment for human rights abuse http://www.idealmedicalcare.org/blog/meditation-is-not-the-treatment-for-human-rights-abuse/ http://www.idealmedicalcare.org/blog/meditation-is-not-the-treatment-for-human-rights-abuse/#comments Thu, 30 Jun 2016 18:13:59 +0000 http://www.idealmedicalcare.org/blog/?p=2823 ]]> Meditation

Doctors who complain about inhumane working conditions are often labeled as “burned out” or “lacking resilience” or even “disruptive.”

Their employers respond by mandating resiliency classes so they can learn mindfulness, deep breathing, or yoga. Victims get instructed in work-life balance, boundaries, and other ways to conform to their workplace abuse.

Here’s the problem: Meditation, yoga, and taking deep breaths are not treatments for human rights violations.

Doctors, if you are running an ICU on a 36-hour shift and have not eaten or pooped all day, you are experiencing multiple human rights violations.

Patients, if you are in the hospital and your doctor has been bullied, abused and is suffering from constipation, hypoglycemia, and sleep deprivation, you should be very, very concerned.

I’m not making this stuff up. This is health care in America:

The UN Declaration of Human Rights: Article 5. No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. Article 24. Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay. 

Other countries get in big trouble for violating human rights. Why does first world health care get a pass?

The solution? Start by telling the truth.

“Burnout” is a misdiagnosis.

Lack of resilience is a misdiagnosis.

Diagnosis is human rights abuse.

Doctors need to eat, poop, and sleep just like everyone else. It’s true.

The deadly end result of not addressing these human rights violations:

Pamela Wible, M.D., is a family physician, an advocate for human rights in medicine, and an activist in medical student and physician suicide prevention. Please support our documentary to expose the truth.

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Medical student: “They’re training us to abuse patients in assembly-line clinics.” http://www.idealmedicalcare.org/blog/medical-student-theyre-training-us-to-abuse-patients-in-assembly-line-clinics/ http://www.idealmedicalcare.org/blog/medical-student-theyre-training-us-to-abuse-patients-in-assembly-line-clinics/#comments Thu, 16 Jun 2016 02:57:25 +0000 http://www.idealmedicalcare.org/blog/?p=2740 ]]> AssemblyLineMedicinePleaseShare

Dear Dr. Wible, 

So I just walked out of clinic today and I have to tell you I feel awful. Just awful. I was so excited to work at this particular clinic and now having seen how we went through patients like they were scraps to be tossed out, it is so disheartening. 

The doc I was working with was lovely. She was very nice. But she kept telling me that I was making the “classic mistake of trying to ask patients about their problems” (!!!) apparently we don’t have time for that.

Another doctor told me, ”you only get sued if you are an asshole, so always pretend to be interested.” My mentors are kind, but they’re also so disconnected. They were clicking through visit logs to point out the “slacker” docs with 25 patients in an afternoon because we saw 30. 

I just can’t. Holy crap.

I can’t imagine practicing like that, celebrating the fact that we went in told someone they had diabetes to go “lose weight” and walk out 5 minutes later and we’re supposed to be proud of ourselves for efficiency?Completely brush off the trauma a patient is telling us about her rape and PTSD because whatever we don’t have time. 

It just kept going and going.

I felt like breaking down and crying every time I walked out of a room. How could I possibly be okay with turning my back on these people so grateful to see us?? But  honestly now I’m just terrified. Of residency. I always knew it would be like that, and I do want to do it and get board certified, but holy crap. How could I ever survive that?  

Eventually I’ll open my own clinic, you’ve inspired me too, but I always felt like I want to “work” for a bit, get comfortable with being a full-fledged doctor, and have a steady salary and savings before plunging into opening my own clinic. That I could just “survive” residency the way I’ve been surviving med school, but now it sounds awful. Is there really a residency that won’t crush my soul??

Sorry for ranting. I just needed to vent, but I’m alone in California on this internal medicine rotation and I know you will understand. They’re just training us to abuse patients in assembly-line clinics.

Thank you for being a shining light, and a great example. Without the hope of my own ideal clinic someday, there’s no way I could do this.

~ Jonathan

* * *

Hey Jonathan,

My best advice is to open your ideal clinic as soon as possible. Do not delay. Every day you wait, you continue to support this sick system that abuses you—and your patients. If you are a true healer, you can no longer be a victim. You must stand up for human rights. Yours. And your patients. 

I’m here if you need help. . . .

~ Pamela

P.S.  These videos with totally inspire you! Don’t let your job suck the life out of you and How 4 doctors found their dream clinics (and you can too!)

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