Within medicine, the ubiquitous culture of self-sacrifice allows us and is often necessary to become a physician. However, self-sacrifice has, at times, been taken too far, and is partially responsible for burnout
and lack of professional satisfaction.
For a new physician, the outward demonstration of their commitment to medicine and patient care can be exciting and somewhat rewarding, but constantly putting others first takes a toll. As this culture persists into early, mid, and even late career, the pressures accumulate. In some settings, if a physician says they need a break, time off, or even just reduced clinical demands, it can be perceived as weakness, when in fact it may be precisely the right thing to do. The physician is often seen as the leader, willing to make sacrifices. While this is slowly changing, we still have work to do.
The airline industry had a similar culture, and some high-profile accidents catalyzed a significant shift that made air travel much safer. Now, if a pilot has worked too many hours, they simply state this, and it’s seen as noble and appropriate.
Imagine if a doctor told you he couldn’t see more patients or perform surgery after a night on call. The ability to acknowledge one’s weakness or limitations as a physician is exceedingly rare.
There are times when patient acuity surges and demands placed on physicians and the healthcare system will be greater, like with the COVID-19 pandemic. However, when high demand becomes persistent and unsustainable, the system breaks down and results in burnout. When unstainable physician demands and expectations arise, be it self-imposed or system-imposed, overt or implicit, we are all are far less likely to be at our best, and we all suffer as a result.
Many factors influence the push for physicians to do more and measure productivity. However, this is highly skilled work that ebbs and flows and is in no way constant. The culture of team-based care, collaboration, and
physician workload must be continually reexamined. “Physician, heal thyself” is far more than a phrase; we must begin to change our own language and our own self-imposed expectations before we can fix the system.
Only then will we truly be able to improve the health of our nation.