A Modest Reform Proposal

The past few decades have been difficult for many doctors in the United States. Physician anxiety is increasing in many ways, attributable to workplace violence, pressure to provide healthcare to a sicker population with fewer resources, and/or grueling work hours with little opportunity for a satisfying work-life balance. As a result, many physicians are unhappy and stressed out. This has important implications for U.S. physicians as well as for patients, their families, and society as a whole. Concerns Continue to Grow Extreme stresses, such as violence against physicians—particularly psychiatrists—are a growing concern, but more mundane pressures are also taking their toll. Surveys have shown that constraints on time spent with patients are the leading source of dissatisfaction among physicians. Other sources of dissatisfaction include: Loss of autonomy and control due to increased cost pressures. Fear of medical errors and litigation. The psychological burden of dealing with daily illness and death. Studies estimate that as many as 40% of surgeons report feeling burned out; for oncologists, that number jumps to as high as 60%. Career dissatisfaction is not just the province of middle-aged physicians—nearly half of all third-year medical students report burnout, and some studies have linked medical student burnout with suicidal tendencies. Dissatisfied doctors are more likely to leave clinical practice or relocate, disrupting continuity of care and adding to physician shortages. Existing physician shortages are expected to worsen, with huge implications for costs and access to care, especially in rural and poor areas. Healing the Profession An important step toward overcoming these issues is to help doctors reconnect with the human dimension of medicine, a reason many physicians...