Doctors

Doctor Burnout. A World Wide Epidemic.

/ Dr Maxine Szramka / 3 Comments

Burnout is the modern day pandemic affecting the medical profession. It is a condition that many of us are still in denial of. After all, it can’t be seen on a biopsy result or under an electron microscope, so how real can it be?!

Very real.

Up to 59% of doctors are burnt out, and the rates of burnout have increased over the last 10 years. It would be unlikely to consider that this is simply because there is greater awareness of the condition.

50% of medical students and 70% junior doctors are reported to be burnt out.

This is staggering, and these results are across the board globally. Not just the USA and not just UK. These are overall global professional rates of burnout and the rates are deeply alarming.

Even if we had 30% of the profession suffering from burnout, this would still be a pandemic, yet there is not the global attention to this matter that it deserves.

If there was an outbreak of influenza or a critical disease globally that was wiping out even 5% of people and removing them from the work force, there would be a world wide inquiry.

Yet here we have matters where there are 59% rates of burnout, over half of the entire medical profession, including students, and there is no world wide inquiry into what is going on in medicine.

Certainly there is no vaccine likely to be available, but the matter is critical.

Ought not the World Health Organisation be taking a key interest in this matter?

Ought there not be a global inquiry into the culture of medicine and the attitudes of medicine towards doctors and health care professionals? Continue reading →

Medicine in the age of technology. Does the personal matter?

/ Dr Maxine Szramka / 5 Comments

There is much talk about ways we can reduce the costs of health care and to ‘streamline’ health care. There are some conversations that are happening about people putting symptoms into machines to generate diagnoses and then generate a treatment algorithm instead of seeing a doctor. This would of course make the cost of health care cheaper by eliminating the role of the physician, but is this really the best practice of medicine?

Can computers and algorithms really replace the role of doctor, or even nurse?

Even if it would reduce ‘costs’ by eliminating the personal contact in medicine, is this really the way forward in medicine?

Would it offer better patient ‘care’?

Would it even offer better patient ‘diagnosis’?

Many patients come to see me having put their symptoms in a symptom checker online only to be freaked out by the potential of multiple serious diagnoses, only to then find when they see me that they have something quite simple and nowhere near as severe as the symptom checkers had lead them to believe.

It takes skill, connection and experience to diagnose what is happening in a person as no two people have the same presentation of an illness and disease.
Continue reading →

Competition in Medicine. Who does it serve?

/ Dr Maxine Szramka / 4 Comments

To get into medical school we learn that we need to ‘compete’ with others, that ‘competition is fierce’ in order to get into medical school, and ‘being ‘competitive’ is seen as being a very good thing.

But is this really a trait that is desirable in a physician?!

Being a physician is about being with people. It is about dealing with people, it is about caring for people – it is not about competing with people!

So why is medical school set up in such a way to foster and encourage competitiveness from a young age?

Do we really need to inspire this sense of ‘competition’ in people so that they will learn and do well?

Do we need to inspire people to try and ‘do better’ and ‘be better’ and beat others irrespective of the topics at hand?

Do we assume that people will be too lazy to learn or pay attention unless they need to beat others?!

And moreover what does this mean when these particular traits and characteristics are carried over into medical school and then into physician life once one has graduated and entered the treadmill of life? Continue reading →

How at risk of suicide is your doctor?

/ Dr Maxine Szramka / 6 Comments

Did you know that doctors have a higher rate of suicide than the general population? With the highest rates of burnout than any other professional group? 85% of students and 41-60% of doctors.

That’s right, your health care professional is 1.1-5.7 times more likely than you to commit suicide (1).

How is it that our health care practitioners are so distressed that they not only want to but actually follow through and kill themselves?

When you consider the sort of people who start medicine are truly and deeply caring, what goes wrong? What happens?

Do people start out medicine wanting to kill themselves and that’s why they choose medicine?

Surely not……!

Or is the health care system so abusive towards those in medicine that the inordinate amounts of stresses and strains create isolation and distress and pressure that leads to self harming and self destructive behaviour and ultimately the final act, of removing ones self from life?

Much has been written on this subject. People are supposedly ‘unclear’ about why it is that our health care professionals are killing themselves, tending to blame the characteristics of the sort of people who choose medicine for not ‘stacking up’ to the pressure of everything that is entailed in medicine.

Women in medicine are particularly at risk of suicide, at between 2.5-5.7 times higher rate than the general population. (1)

Its easy to victim blame, and to say ‘oh they couldn’t cope’ or ‘oh they were too sensitive’, but instead of victim blaming, perhaps we ought to look at the system that these people are placed in. Continue reading →

Doctor, who do you think you are?!

/ Dr Maxine Szramka / Leave a comment

Are we the ‘role’ of ‘doctor’? Are we ‘the white coat’? Are we the ‘caring physician’, the ‘selfless physician’, the ‘exhausted surgeon’, the ‘busy GP’, the ‘doctor who can’t go on’? or is there something more to us than the world sees or trains us to be?

Now that’s a question that’s not in our final medical school exams, or our specialist exams! That’s not one that our patients ask of us either.

But actually, why not? Is not who we are within the foundation of everything that we do? Is not that our humanity, which is utterly vital when working in a caring profession that has care for humanity and connection with people at its heart.

And if we don’t know who we are at the end of our training, then what purpose has our training served us in truth, and the people that we serve? Continue reading →

Sensitivity in Medicine – Really?

/ Dr Maxine Szramka / 9 Comments

In medicine we are trained that we need to be tough, hard, strong, and the latest buzz word to come from the NHS – ‘resilient’. ie no matter what comes at us, we need to be tough and hard enough to handle it. Well, we all know how well that works out in the army! Post Traumatic Stress Disorder abounds…

Besides, should we really be treating health care like a battle zone? Come on. Lets get serious here.

Resilience and toughness builds barriers between people. It creates hardness, coldness, efficaciousness, and distance between people. There is no care in resilience, nor love in hardness or toughness.

Perhaps toughness is required for the battlefield where truly awful things are seen and done to other people, but health care is about people; specifically, the profession has the word ‘care’ in it…..

How can we care for others when we are hard, tough, strong and have created protective barriers between us and others? Continue reading →

Are you a doctor, or a person?

/ Dr Maxine Szramka / 4 Comments

In medicine we get taught how to be a medical student, how to dress and how to act, and then we get taught how to be a ‘doctor’, how to talk, dress and act. Most of us go through life thinking of ourselves as being either a ‘medical student’ or then ‘a doctor’ and these roles become so ingrained as part of ‘who we are’ that we are unable to separate ourselves from it.

In my twenties, I remember going out and meeting people, not wanting them to know I was a ‘doctor’ (especially the guys, in case they felt intimidated and ran away… *doh* !!) but then being unable to talk to them as me anyway – even though I was being ‘social’, I was always in that ‘doctor’ mode of question and answer and efficient interrogation with the provision of answers and solutions! It’s how we’re trained to communicate! It was agonising! Nothing I could do could get rid of that way of being with people, it was so ingrained, and then it became so ingrained, that I didn’t even realise I was in ‘doctoring mode’ the whole time… and I know that I am not alone in this as I have seen it everywhere in medicine!

We’re so ingrained to think of ourselves as ‘doctors’ and we spend so many long and ridiculously long hours trying to ‘become’ a ‘doctor’ and then to become not just a doctor, but a ‘specialist doctor’. We are referred to as ‘doctors’ everywhere we go, from census forms, hotel bookings to drivers licenses and bookings for flights. ‘Doctor’ is our title that precedes us, everywhere that we go, but:

Do we ever stop to consider that we are people, the lovely man or woman that we are, and not ‘doctors’?

Continue reading →