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Burnout: Keepin’ the Doctas Down?
Some evidence suggests a high incidence of occupational “burnout” among physicians, but does prescription of mindfulness for prevention or treatment betray a politically motivated attempt to foster compliance and conformity in the profession?
Yesterday I, along with a very few other members of the Overlake Hospital medical staff, attended a talk by psychiatrist and Washington Physicians Health Program medical director Charles Meredith, MD on burnout and mindfulness. Dr. Meredith’s response when I pointed out that burnout does not appear in the DSM failed to satisfy, and when I challenged him about his support for a “treatment” that epitomizes passiveness and occupies even more of physicians’ short supply of time, further interfering with any sort of activism, he copped out by suggesting that physician organizations should take the lead in changing the system. LOL.
My limited research reveals that burnout, which lacks rigorous criteria, probably overlaps one or more depressive disorders too much to justify separate classification in DSM. The concept also suffers from implicit association with work, which it may or may not deserve. Promotion of application of this ill-defined concept also leads to risk that self diagnosis may delay treatment for a real mental disorder.
Dr. Meredith’s prescription of mindfulness to address the problem suggests to me a strategy to get physicians to devote adequate time to contemplation of our navels so we will learn to tolerate even more abuse and exploitation with a smile and a “Yessuh, Massah!”
I propose a trial of a different approach: Help physicians reverse their learned helplessness, perhaps with assertiveness training. Give them the tools to push back, refuse, resign, set limits, make demands, maybe even disrupt. Disabuse them of the illusion that their professional organizations will do anything to help them.
A rewrite of Randy Newman’s song might help protest use of public funds in the service of rendering physicians impotent.