Physician Burnout Is Physician Abuse

Physician Burnout

Physician burnout is the latest trend among doctors. There are books, workshops, even special breathing exercises for physician burnout. Suddenly every other doctor I meet has burnout. And half of all med students have burnout before they graduate! WTF.

We enter medicine as inspired, intelligent, compassionate humanitarians. Soon we’re cynical and exhausted. How did all these amazing people get so screwed up so fast? ATTENTION medical students and doctors: It’s NOT your fault. 

Burnout is physical and mental collapse caused by overwork.

So why are we blaming the victims? 

The fact is medical students and physicians are collapsing because they are suffering from acute on chronic abuse. At some medical schools, 100% of students report abuse. 

And it doesn’t get better. Physicians are overworked and overwhelmed with bureaucratic B.S. during most of their careers. They are trapped in assembly-line big-box clinics where they are treated like factory workers and berated for not seeing enough patients per day. Some experience human rights abuses in our nation’s hospitals. This doctor worked 7 days in a row with almost no sleep! 

Think this is unusual? It’s not.

Physicians all over the nation are suffering mistreatment.

Folks, this is NOT health care. 

The health care cycle of abuse starts on day one of medical school. Abused medical students become abused doctors who may one day end up abusing patients. Wait! We wanted to help people, not harm them. 

ATTENTION Medical Students and Doctors:

If any of this sounds familiar,  your diagnosis isn’t burnout, it’s abuse. That’s right. If you’ve suffered mistreatment or harm at work or school, YOU are a victim of abuse. 

How do you know if you’re being mistreated? 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 sounds familiar, it’s NOT YOUR FAULT.

YOU ARE A VICTIM OF ABUSE.

So what should you do?  Sign up for a resiliency training? Meditate? Take deep breaths?  Your goal should NOT be to cope with abuse. Your goal should be to STOP it.

Physician burnout is a diagnosis that blames the victim, not the perpetrator. In fact, the term physician burnout IS physician abuse. It implies that you are to blame, not the system and perpetrators of the mistreatment.

To prevent burnout, health care institutions may offer resiliency classes to train doctors to prioritize self-care and manage their emotions. WARNING: You can not meditate your way out of abuse. You can not take enough deep breaths in a year to end your abuse.

WHAT YOU MUST DO: If you are being abused, YOU MUST LEAVE YOUR ABUSER. I know it’s scary. But you are not alone. Need help with your escape route? Call me! I escaped. You can too.

End The Abuse! Stop Being Victimized. Download Instructions: Your FREE No B.S. Guide To Launching Your Ideal Clinic & Telling Your Employer To Take A Hike.

Want an ideal clinic? Join the Physician Teleseminar & Retreat.

YOU were born to be a healer, not a victim.

Pamela Wible, M.D., founded the Ideal Medical Care Movement. When not treating patients, she devotes her life to helping her colleagues find happiness and joy in their own ideal clinics. Ya know, so patients can finally get the care they deserve! Image by Pamela Wible. Videos by GeVe.

Posted in Ideal Medical Care, Medical School, Physician "Burnout", Physician Abuse & Bullying, Physician Retreat Tagged with: , , , , , , , , ,
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38 comments on “Physician Burnout Is Physician Abuse
  1. DrMani says:

    There is is!

    End medical student and physician gaslighting!

    Thanks for keeping the message focused and empowering, Dr. Wible!

  2. MaryJaneLuck says:

    My husband recently was fired (Hospitalist) because he was spending too much time with patients and families. He is truly compassionate and a very bright guy. The Med Director was verbally very abusive. He fired another MD the day or so after my husband started. This put a big staff shortage. Husband and other on the short staffed team each worked 11-12 shifts in a very stressful facility. I am a former RN who left the profession, went back to school and am now in business which I like much better. Being n RN or MD is much different. For one thing, I think the answer is for MDs to form a union. In my present position (Construction/Engineering) the employees would never tolerate the hours, the verbal or mental abuse and gutless wonder administrators that prevail in hospitals. Husband says that the abuse clearly starts in medical school and that they look for students who are taught to be individualists. They do not work well as teams and tend to be loners from what I have seen. He any bright young person would ever go into this field is beyond me. Husband says also that MDs are trained as scientists, not business people and that create problems. I have also observed that economically, many MDs get into debt very easily. Aside from med school debts, many overspend. When I first dated my husband, I was amazed at the high end things many MDs and families spent money on. “Retail therapy” which can be a disaster financially!

  3. Pamela Wible MD says:

    Multigenerational cycle of abuse in medicine. The first step to breaking the cycle is to recognize it and stop using the vocabulary of our oppressors.

  4. Erica says:

    I think language is really important in framing our lived experiences. You are right that the word “burnout” has a different timber than “abuse,” the first word implies self-infliction while the second implies external forces (co-workers, supervisors, administrators, etc).

    I would add that, often, there are subtle forces and attitudes that hang around work spaces and ‘encourage’ certain behaviors among doctors while ‘discouraging’ others. Discouraging self-care while encouraging efficient, cost-effective, and at times inhumane decisions that support the financial goals of the establishment. These are subtle and structural forces rather than direct abuse. But abuse, no less.

    An important question that I think resides at the root of all this abuse: for whom is the current system working?

  5. suzanne says:

    Funny how so many people express outrage when they learn that terrorists are subjected to sleep deprivation as an interrogation method, but nobody seems to care about doctors. I guess if you are perceived as “rich” you don’t matter.

    • Pamela Wible MD says:

      You are on point! Divide and conquer. Control by intimidation and fear. These tactics are not new. Problem is if victims (doctors) are unaware of their real diagnosis and continue to use the language of their oppressors, how can we expect patients and the general population to know what’s going on?

  6. Steve Vaughn says:

    Pam, I’m so proud and thankful for what you are doing! They talk of “the humanities” as though they are pastimes of dilettantes interested in the more obscure trifles of society.
    Realize this: from ALL human societies arises a means of dealing with survival – the acquisition of food, the construction of shelter, the clothing of persons – and the healing of the sick, the birthing of children, the care of the terminally ill. These are societal “ADL’s” – societies which lose these abilities, crumble. Sane societies cherish their healers, not because of obedience, but from rational appreciation of their skills. Ours crushes the healers into empty, suffering automatons – and then expects them to heal other humans. It is insane, not us. Medicine, minus humaneness, minus love, is an atrocity – there’s no way around it. I vote for humanity, I vote for survival. Humans – that’s what we all are.

    • Pamela Wible MD says:

      I’m with you 100%. Assembly-line medicine is an insanity. And currently medical education is highly abusive for many, many students. We are in a cycle of healthcare abuse and we must stop perpetuating it as TRUE HEALERS. We must stop agreeing to be victims and we must stop labeling ourselves with the language of oppression. Physicians need to wake up to the truth.

  7. Dr Matt Levin says:

    RE Hospitalist abuse issues and overload.

    I believe there are national standards of how many pts the Hospitalist association feels is reasonable in a day. If the hospital insisted on more, I wonder if there is a cause of action here.

    Dr Matt Levin
    Western PA
    Solo since 2004, residency in Family Medicine completed 1988
    matlev@comcast.net

  8. Pamela,

    I understand and appreciate where you’re coming from with this.

    I also think you miss the part about physicians brutalizing each other. The abuse you speak of, does not always come from outside “oppressors” or “perpetrators.” We do it to each other, and are often living in survival mode. We become inured to it, and check out emotionally — our focus narrowing to how we can get through the day or night.

    You talk about leaving the “abuser” — but the abuser is also in us. There is nowhere to go. We must clean things up within ourselves, and get clear about who we are and what we want. Sometimes those are painful recognitions. Yes, leave soul-sucking jobs if you must, and create ideal health clinics if that’s in your heart to do. But please, please don’t ignore the fact that many of us have bought into and helped create the inhumane medical culture that exists now. It is an unspoken curriculum which begins in medical training, and which we end up enacting ourselves — unless, of course, we are strong enough to question what we see happening.

    Our best healing is in community. It also includes acknowledging ALL aspects of ourselves, how we may have participated in creating this mess, and what we might be able to do to change it. I believe your retreats are useful as a start, and I’m grateful that you’re doing them. We need to create ongoing, cohesive communities of physician healing that outlast episodic events. We have a lot of work to do in ourselves and within our own ranks, so that we’ll have the strength to change what desperately needs changing.

    Blessings in your work.

  9. anne vinsel says:

    words are important, and thanks pamela for reminding us that if you let the oppressor set the terms of the debate you have lost before it starts. as a nonphysician, there are two things i am forbidden to do, thank a physician or CSuite person for reasoning correctly from incorrect premises, and calling a physician or administrator a liar. important to take back the words, and throw the oppressive ones out.

    • Pamela Wible MD says:

      Words matter. My friend just changed his name so that he no longer has the last name of his slavemaster who enslaved his ancestors. Even your name is a mantra. Pamela Wible (btw) means “sweet as honey” + “little woman.” Words matter.

  10. Brendaline says:

    This blog post is very insightful and eye-opening for any medical student contemplating working in the societal pressure-cooker of a healthcare system. The human rights of doctors should be the forefront of the healthcare team and system, and sadly this is not the case. To be a strong, empathetic healer starts with the right kind of training and mindset from the inception of a medical education. I believe in a work-life balance and it seems that the practical solution is for doctors to empower themselves through the Ideal Clinic system and custom-design their working environment to meet the needs of their patients, themselves and the constituents of the community at large.

    This is highly liberating and a surefire solution to our growing healthcare problems on a whole. A great post and very encouraged to see doctors respecting their profession enough to end the factory-mentality and societal pressures.

    All students contemplating entering medical school, already in medical school and physicians should read this post. I will definitely share this highly insightful and worthwhile post!

  11. Dr. Jay says:

    Wow.
    Never thought of it this way. You’re Right! Implies there’s something wrong with the clinician.

    Words matter.

  12. Mark M. says:

    I am at the end of my career and would not go into medicine now because one of the things I wanted was to be an independent professional. You cannot serve two masters. Being an employed physician is a prescription for stress as you are held to be responsible for the patient by law but do not have the power to exercise that responsibility. I would love to employ people in that situation, though, if I wanted to take advantage of them.

  13. Jordan says:

    Interesting point here. Physician burnout should be something every hospital and practice should be on the look out for and trying to prevent, not swept under the rug. Thanks for sharing your thoughts on this.

  14. Dana says:

    Hi Dr. Wibble, I’m a fourth year med student and been following your blog and posts on KevinMD for a while now. I just wanted to let you know, you’re an inspiration for those of us who struggle in the medical profession. I’ve been blogging for 3 years now as a means of dealing with the pressures of med school, mental illness, and life. I find writing is liberating, and it makes me immensely happy to see awareness and advocacy for physicians and med students is a movement that is actively growing. Also, I find putting myself in such a vulnerable and public spot by having a personal blog so publicly out there has been key in my managing my recovery process. Please keep doing what you do, and know you have a fan here. 🙂

  15. Pamela Wible MD says:

    Another slimy move by a physician employer shared by a doc: “The last place I worked gave a book on physician burnout and all the things you can do to help yourself. One paragraph actually said that when they tell you that you are going to earn less money, that instead of getting angry, you need to embrace it and be thankful you have money. haha. the audacity!”

  16. Carole says:

    First and foremost- woman to woman, I’m way past impressed and I don’t have to know you personally to be proud of who you are and what you have accomplished. You did all the right things to make a better and happier you, and thank God for all of those who benefit from your genius and creative mind. Your beyond awesome!

  17. Dawn says:

    Pamela, thank you for all you do!

    I’m a family nurse practitioner. I worked in family practice for 10 1/2 years and it almost did me in. That was 4 1/2 years ago. I’m still recovering.

    I’ve been working locums assignments since I left family practice. I’ve worked from Barrow, Alaska to Maine. I work as little as possible because I’ve found working in conventional medicine is toxic no matter where I go.

    I see medical providers leaving medicine in droves everywhere I go. Most places where I have worked, people just can’t find or keep a primary care provider because the providers leave. It’s a crisis.

    I love health and helping people. I’ve been studying functional medicine and hope to start my own little holistic practice in my hometown in the next year to two.

    Thank you again Pamela! You and the IMP community are such an inspiration.

    Dawn

  18. Josh says:

    As you said, first step it to recognize when we are abused. It’s not only about us, but also about patients or even mostly about patients and our professional service we should provide.

  19. Danie Botha says:

    Pamela, spot on!
    It’s totally a hands-off topic: because it “doesn’t exist” – physician burnout/abuse. And if Medical bodies reluctantly acknowledge the entity of burnout (never mind “abuse”), the next response is: poor MDs, they’re failures, have-beens, probably never meant to be doctors in the first place.
    It’s a bit trickier to start your own independent clinic when you’re an Anesthetist – you’re not exactly an “independent practitioner.”
    Comments?

    • Pamela Wible MD says:

      Will email you privately, but I have had anesthesiologists in the teleseminar who plan to open independent pain clinics. HUGE need among patients by the way. Built-in patient base. And they’d happily pay cash for great care.

  20. Hi Pamela. I am an anesthesiologist in a government hospital for about 12 years. I resigned two years ago. I just can’t take the working conditions and I don’t have a work- home balance for as long as I can remember. Now I don’t know if I can still go back. Right now I am attending seminars, webinars and training to be virtual professional. I just don’t know if I can still practice as an anesthesiologist. All I want is to be at home and to spend time with my kids and family.

  21. Hannah says:

    hi. I have been seeing the same doctor for 6 years now. I have extreme chronic depression, horrible fibromyalgia, chronic migraines, bipolar, terrible PTSD, I am an addict and alcoholic in recovery, post pardum depression, chronic pain and fatigue, ADHD, body dismorphyia, in recovery from a long battle of anorexia that almost killed me (I suffered since a very little girl, it always went back and forth from drastic to being able to hide, until 19 when I had to leave school and was hospitalized and in centers for years, including a 6 month stay in the ICU, I was kicked out of many programs, in programs multiple times, but mostly given up on and abused, told by doctors there was no hope for me ,my parents and loved ones and left me and my own parents were told by doctors to start planning my funeral, and the sad thing is they actually did,…I had addiction follow this horrible disease and was told I would not live until 30. I will be 30 years old next month and have an amazing, healthy, beautiful 17 month old daughter. Back to the point though, this same doctor who I have seen 6+ years every two weeks, or sometimes and more often now monthly, not by choice but because he has become too busy to see me as much. He helped me so much before and still does when he will see me. He also diagnosed me with Ehlers Danlos Syndrome, and C-Fibre polycistneuropathy (not sure of spelling)….. I have been receiving treatments from this doctor for several years now on a regular basis for my fibromyalgia, chronic depression, and ptsd, chronic pain, fatigue and migraines. it’s a newer treatment ,ketamine treatments. They have been the only thing that has extremely helped me with all of these problems. I have not been able to see him for over a month and have been feeling very ill. I have been in so much pain, not able to function normally even, and my meds are now all messed up because I need my prescriptions, I have been out of my meds and not able to see him. Last night they scheduled an emergency appointment for me to see him and also receive a treatment today. My boyfriend had to take off work last minute because I need a driver after treatment, and someone to watch our daughter during my appointment. We live two hours away now but I still drive to see him, we had to miss very expensive private swim lessons for my daughter this am as well to be there on time, besides the fact that I feel so sick I want to go to the hospital. We were getting in the car to drive there and his office calls and says “I’m sorry but we need to cancel your appointment today, there is a sort of crisis going on and now he can’t see you,” I expressed my need for my medication, that this was an emergency appointment and how horrible I feel, also that we are losing money and time. They also said the next appointment available with him isn’t until January if I want it. I said no being so angry and asked if they could please do something, in the past he has figured out how to squeeze me in, seen me on his lunch, or even stayed late, I used to have such a good relationship with him and his office,I trusted him so much and practically considered him family. The receptionist said hold on let me see, came back on the phone and said no he just can’t see you anymore. If you want I can have him call you later , which how they have been lately I doubt will happen. I am so upset I am having a panic attack and in tears, I need to be seen so I can take care of my daughter. I reminded them once more that my appointment was an emergency and I desperately need to be seen. I can’t go to the hospital because it won’t help, I don’t have another doctor, and he is one of the only drs around that does that treatment. In Santa Barbara where he is located, he has partners, there is a very good hospital with a psych unit and doctors he works very closely with. I have nothing here. Is this even legal so last minute? Especially being in the condition I am in right now, or was I not clear enough about that? I don’t know what to even do! I am so upset and just want to be seen and treated like I was supposed to be. I am at the point that I am so angry, frustrated, and feeling very neglected and ignored by him. I want to file a report or complaint even but don’t know how or where to do this. I’m so upset becausee this is not the first time this has happened either! Can you please give me some advice or recommendations or options of things that I can do? I read an article about a woman who actually started charging her doctor late fees and if later than 20 minutes, missed appointment fees, as well as last minute cancelations….just like the doctor would do for her. Are people allowed to do that? I need help and I want to call them back and make him see me, even if I have to wait! why did he have to cancel my appointment and not someone elses, why can’t he squeeze me in earlier than a month from now. I feel so neglected, and like I am not important. now my health is getting worse. Sorry to go on and on, but I just really need to be seen and if you could comment at all on this, how to be heard, maybe get them to see me, if what they did is allowed or against my rights as a patient? Especially when my health is so fragile and getting worse by the minute. So anything you can tell me or say would realay be appreciated and make me feel a little better and at least know more of my options or what to do. thank you.

    • Pamela Wible MD says:

      First I would try a non-adversarial approach. As this article reveals (I hope you watched the videos above) doctors are not able to be as compassionate and caring as they would like due to fear and abuse (and so many more factors). I would write a letter to your doctor from a place of love (I know this is hard to do now. Try it anyway because anger will never help you heal). I would try to salvage the relationship you had with your doctor. If you can not then find another doctor who will respect and honor you and treat you the way you want to be treated. What patients often don’t understand is that their doctors are victims of the same system that victimizes patients. Keep the faith. Be strong. You can do it! <3

  22. Congratulations on telling the hard and brutal truth Pamela. The core problem is toxic leadership which crushes people in many organizations and professions. Check out my blog on this dynamic at https://www.linkedin.com/pulse/leadership-alert-youre-still-delegating-enough-baird-brightman

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