Doctors are harming patients. What can I do? →

Physician Betrayal

A med student just wrote me:

“Last month on my pulmonary rotation doctors were not serious about contact precautions. Most patients were on steroids and immunocompromised. The doctors did not wash their hands and encouraged me not to wash my hands either! They didn’t even clean their stethoscopes. So basically just carrying infections from patient to patient. On my surgery rotation, I saw surgeons show up an hour after the patient was anesthetized. I’m not happy about this, yet I’ve been told there’s nothing I can do about it. Whenever I share my concerns, they always try to minimize by saying, ‘Yeah we’re endangering patients’ lives, but it’s just because we don’t have time. What are you going to do about it?’ I don’t know what to do. Please help me.”

My advice after more than a decade helping trainees in your situation:

1) Save your soul first. To preserve your mental health, document everything. Follow these documentation guidelines. Keep a personal journal too. Above all, stay true to yourself. To understand the cycle of betrayal in medical training, download my free ebook (20-min read): Physician Betrayal: How Our Heroes Become Villains.

2) Engage allies in collective action. You are witnessing a systemic failure of the medical education system. Nurses are your allies. Be tactful when uniting to address infection control. Hospital-acquired infections are a big deal. To avoid being the sole target of retaliation, join together with medical trainees, nurses, and/or patients to resolve safety issues. Collective action will prevent individual retaliation as this doctor explains:

“We had a professor who would intimidate us during his lectures. He’d point to somebody in the back of the room and tell them to stop doing what they were doing and pay attention or else! Well, our class knew there was nobody in the back making noise. Nobody was discourteous. We checked with the upperclassmen and discovered this had been his routine all along—intimidating the class into submission. We decided that we would not put up with this. The next time, we called him on it. The president of our class stood up and told him, ‘We know what you are doing. There is nobody in the back making noise. We are not staying in your lecture. We are leaving.’ And we got up en masse—all 160 students—and we walked to the dean’s office and reported this. We never saw the professor again.”

3) Attempt internal resolution first. Arrange a meeting for your group with your hospital safety or quality improvement team. Many hospitals have a designated infection prevention and control (IPC) team or infection control officer. You may also bring your collective concerns to your hospital ombudsman—an appointed confidential advocate who helps resolve conflict by facilitating communication between all concerned parties.

4) File external complaints. If internal resolution fails amid a systemic patient safety issue, choose a systemic intervention such as submitting your anonymous complaints to the Joint Commission and to the State Department of Health. NOTE:  Medical board complaints do not address systemic issues as they are usually lodged against individual doctors—and if you complain to your school, AAMC, or ACGME, you may end up facing retaliation.

5) Submit OSHA complaint. If your workplace is unsafe, unhealthful, or hazardous, file a confidential Occupational Safety and Health Administration complaint to trigger an on-site inspection by a compliance officer trained to protect workers and their rights. Then request a health hazard evaluation through NIOSH (National Institute for Occupational Safety and Health). They will perform an assessment of physician work conditions and file a report with recommendations. Three employees are required to request a NIOSH evaluation. Your identity will remain confidential.

6) Pursue media exposure. If you’ve exhausted all options above and nothing has changed, an op-ed signed by your group can be very effective. Bad press may lead to revenue loss and lawsuits. Your hospital may quickly address your group’s concerns to prevent further bad press.

7) Consider legal representation. Taking legal action may be the only way to hold a hospital accountable. When patients have suffered death or disability from hospital-acquired infections, hospitals may be held liable for failure to uphold medical standard of care. To pursue legal action, know your whistleblower protection rights.

For more information, reference Human Rights Violations in Medicine.

Are you a medical trainee who needs help? Contact Dr. Wible.

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Why Parents Force Kids To Be Doctors →

Future Doctor Babies

Do #FutureDoctor Babies Risk Future Depression?

When I see an infant dressed as a “future doctor,” I cringe.

I’m used to helping premeds, not preemies or toddlers in surgical scrubs. How do I stage an intervention with parents of a premed baby?

I’m Dr. Pamela Wible. I run a suicide helpline—for doctors. When I ask, “When did you decide to be a doctor?” Many say grade school—some as young as two!

I used to be in awe of their inner knowing. How can a toddler (not yet potty trained) be aiming for med school?

My friend knew at three. Her dad would always point at her in her diapers and say, “There’s my doctor!” Now she’s a nurse practitioner in her forties with depression—still trying to get into med school—still seeking validation from her deceased dad—still wanting to fulfill his dream.

Parental pressure to pursue a medical career leads to depression—which may worsen as a physician.

Last year, I got this three-word email: “Please help me.” I called right back. A woman answered—with a noose around her neck. First-generation Korean American. Her parents always demanded, “Either be a doctor or pharmacist.” Her sister’s a pharmacist. So she’s the doctor (in a toxic residency). She felt her only way out was death. I talked her down. Today she’s alive—after a career change.

Both women were branded #FutureDoctors as babies. Both were nudged in subtle—and not-so-subtle ways—since birth to pursue a profession with high rates of depression and suicide.

Why do parents pressure children to go to medical school? Is this a form of child abuse by well-meaning parents who only “want the best” for their kids?

Top 10 reasons parents force babies to be doctors

1. Trophy children

Social currency and bragging rights. A physician trophy child with the best test scores means superior genes. How important is the trophy? After losing their son to suicide in med school—a family was given the option to sign a nondisclosure agreement—to never speak about their son’s death—in exchange for his diploma. They chose the diploma.

2. Proof of great parenting

A medical diploma proves mommy and daddy did everything for their kids and were the best parents ever!

3. Financial security

Babies are an investment and parents want a financial return. “We’re poor, so we’re counting on you to be a doctor or we wasted our lives.” My friend’s parents actually say this to her.

4. Parent’s dream

Family members will implant (even subconsciously) their own unfulfilled dreams in their offspring. Students have told me, “I hate medical school, but my parents want me to be a doctor.”

5. Tradition

Some families want baby boys to have matching circumcisions, others want babies in matching professions. A sad med student from India told me she had “no choice”—everyone in her family is a doctor!

6. Playing it “safe”

Is choosing a “non-risky” career for your newborn better than letting your kid pick a  job they’d love? Parents believe sending their child to train in a hospital with hundreds of doctors is the safest place on Earth—until they lose their #FutureDoctor to suicide.

7. Peer pressure

When Jewish mothers say, “my son the doctor,” other Jewish mothers—like my grandma—want the same thing. As a mama’s boy, my dad was told to be a doctor. He planned to be a sculptor and work in motion pictures—but ended up a theatrical pathologist sculpting corpses in the morgue.

8. Pinnacle of success

The doctor-as-God image makes medicine feel more like a religion than a profession. Giving birth to a #FutureDoctor must feel like birthing Jesus.

My ex has audio of his mom reading him a book: “A Trip to the Doctor” at age two. In her Brooklyn accent she pleads, “Don’t you want to be a doctor to help all the boys and girls?” He screams, “No! I don’t wanna be a doctor!” She keeps repeating her question—until he agrees.

9. Peace of mind

When your kid is well paid and can save your life in the middle of the night with the best medical care ever—you’ll have no more worries.

10. Parental love

My divorced parents are not-so-emotionally-available workaholic doctors. Both tried to talk me out of medicine, but I knew as a kid the only way to spend time with them was to tag along to work in the morgue and psychiatric hospitals (and I loved it!).

When I became a doctor, I interrogated my parents on why they became doctors. Separately (so they couldn’t cheat). Both listed the usual: help people, good money, stable job. “But why?” I pressed them for the real reason. Dad poured another glass of vodka and murmured, “So my mother would love me.” Mom got pissed before spewing out the truth, “Because I thought my mother would finally love me.”

So yep, I get really creeped out by these #FutureDoctor onesies.

Future Doctor Onesie

 

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Doctor Buys Patients Gym Memberships →

Fear and isolation have led to alarming rates of anxiety, depression—even suicides—in our community and exercise is a great way to shed ‘pandemic pounds,’ improve mental health, and combat social withdrawal—all while supporting a local business—a win-win for everyone.

So I’m announcing a philanthropic community partnership with IN Shape Fitness to help combat the devastating physical, emotional, and economic setbacks to my friends, neighbors, and patients with free gym memberships.

I’m Dr. Pamela Wible and I run a suicide helpline—for doctors—a profession with a high rate of suicide. We can all see the emotional toll of the pandemic on patients—and doctors. When I’m not on the phone with suicidal med students and doctors from around the country (& even as far as India) you can often find me at the gym.

My goal is to inspire people to exercise—a great first-line intervention for anxiety, depression, and suicidal thinking—and get back in shape physically and emotionally.

I invite you to join IN Shape Athletic Club—your new full-service fitness facility featuring free weights, Paramount circuit training, modern cardiovascular equipment, tanning beds—even childcare. You’ll receive a free orientation with your own certified personal trainer to demo proper technique and provide the right exercise plan to achieve your health goals. Enjoy group yoga, dance, strength-training, and Zumba classes—all free with your membership.

Are you ready to get IN Shape?

Call 541-687-2200 for a personal tour of our spacious, safe, clean, and friendly club with staff who always welcome you by name—with a smile. Plus I’d LOVE to exercise with you! 💕

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Is Premed Depression Worse than Medical Student Depression in Medical School? →

Is Premed Depression Worse than Medical Student Depression in Medical School? Do mental health issues caused by being a premedical student get better when accepted to medical school?

Being premed is not easy with all the premed stress. Premed stress can be worse than medical school stress for some students.

Practicing doctors may not recall what it was like being a college student with the intention of attending med school. Premed anxiety and premed depression can be serious issues. I know of several premedical student suicides.

I’m Dr. Pamela Wible and I run a doctor suicide helpline. I also hear from medical students and premedical students who may be suffering with suicidal thoughts.

Premed students often study around the clock. They are focused and determined to be successful. Getting into medical school is their ultimate goal. I was a nervous wreck as a premedical student studying for the MCAT. I broke out in a full-body psychoneurotic rash during the exam.

What about premed student burnout? Premedical students work hard and study hard, often forgetting to take care of their physical and mental health. We often discuss physician “burnout”—which is really the result of abusive employers and hazardous working conditions that may lead to suicide.

 

Premedical students may develop a mental illness or physical illness, such as high blood pressure. Premed depression can result from identifying closely with academic success, and not taking time to rest and recover from an ongoing intensive workload.

Are premed programs good for screening out candidates who will not survive med school?

Some premedical students get “weeded out” during the process of preparing to apply to medical school. Unfortunately, they may be the very people who would have made excellent doctors.

Imagine a student who realizes that the emotional exhaustion caused by an intensive premed program is not worth the stress—and then decides to change majors and career plans.

For students who realize they do not want to pursue medicine early on, while still premed and in college, they may have dodged a bullet. Working in medicine causes severe anxiety for many doctors—a profession with a high suicide rate.

Students who thrive in premed and continue thriving in medical school are the ones who are willing to take on any amount of work and stress, regardless of the toll it takes on their health. The medical education system screens for people who are willing to submit to abuse.

How can premed depression be prevented?

College students in a premedical program should be better prepared for what’s coming ahead. Rather than focusing on acceptance to medical school as the ultimate goal, they should investigate what life will be like as a medical student and a doctor.

Many doctors are plagued by suicidal thoughts—especially when they discover that a medical career is not what they expected. Doctors have one of the highest suicide rates of all professions.

Read more ›

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Are Burnout and Medical Errors Among US Surgeons a Major Problem? →

Are Burnour and Medical Errors Among US Surgeons a Major Problem?
Surgeons are not Navy SEALs and should not be trained or treated like frontline special forces.

We must remember surgeon burnout when we are addressing health worker burnout. Surgeons suffer burnout more than most other medical specialties.

I’m Dr. Pamela Wible and I run a free doctor suicide helpline. I hear from physicians from all specialties—including surgeons. Doctors tend to minimize their suffering by using terms like “stress” and “burnout.”

First, I want to point out that referring to stress caused by an abusive workplace as “physician burnout” is offensive—and covers up what amounts to human rights violations in medicine. Instead of talking about doctors being burned out, we should focus on workplace abuse that leads to real mental health diagnoses—depression, anxiety, PTSD—even passive and active suicidal thoughts.

Free doctor suicide helpline.

Yet while I strongly disagree with the use of the term physician burnout, I will use it here, because it is a term we are familiar with. In fact, for the last forty years large healthcare corporations, residency training programs, and medical boards have loved talking about how they are going to fix doctor burnout. Yet doctors are faring worse than ever. Why?

Healthcare institutions are complicit in causing the burnout problem, yet now, they want to help. They want to seek out which cogs in the machine are broken, so they can be discarded. They have no real interest in helping. Though they have figured out how to make money from burnout workshops and “forced wellness” activities.

Here’s how medical institutions use the word burnout to blame doctors for hazardous working conditions:

Residency programs push their physicians in training to the breaking point. They are overworked until they suffer from emotional exhaustion and physical exhaustion. Some even attempt suicide or die by suicide.

Read more on how to prevent surgeon burnout, medical mistakes, and even suicide . . .

Read more ›

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