Since 2015, I’ve advised doctors to stop using the word “burnout.” Here’s why.
Each year our best and brightest, most compassionate students enter medicine—a career with the highest suicide rate of any profession. Each year more than 1 million Americans lose their doctors to suicide. Jumping from hospital rooftops. Found hanging in hospital chapels.
Classic response? Blame the victim, then cover up the suicide with medicine’s favorite victim-blaming buzzword—burnout—a slang word from the 1970s for end-stage drug addiction—now weirdly applied to doctors! Here’s how it works . . .
Physician “burnout” blames the victim NOT the medical system that actually kills doctors—and patients! Plus it’s a cash cow for physician predators and profiteers—all the burnout coaches cannibalizing the corpses of their colleagues—divided and conquered by bullying, hazing, and sleep deprivation—the foundation of medical training that forces new med school grads to legally work 28-hour shifts treating heart attacks, gunshot victims, and delivering stillborns—with no debriefing for their trauma. No bathroom breaks. No time to eat, surgeons collapse from dehydration and hypoglycemia. Here’s a doc found sleeping on an elderly comatose woman while starting her IV. (All true stories) An ICU doc forced to keep working during a seizure. Another doctor working while miscarrying her baby.
These human rights violations lead to suicide (and families destroyed by suicide) plus lifelong physician PTSD, anxiety, depression, divorce, strokes and heart attacks—when our doctors are forced to work 80, 100, even 120 hours per week—that’s two to three full-time jobs! Criminal in Japan where companies are held liable for suicides when employees work just 60 hours per week.
Now doctors are standing up against the abuse. So hospitals are retaliating with FORCED WELLNESS on the overworked. With mandatory 6 am sleep deficiency lectures (after 24-hour shifts!) and mandatory resilience training for military doctors with crayons and adult coloring books.
FYI: Appointing Chief Wellness Officers while perpetrating abuse is like putting a Band-Aid on a ruptured aorta. Enough burnout bullshit guys. Claim responsibility for human rights violations at your medical institution. Stop abusing your staff. Then apologize to victims (and their families). If you’re being abused, please leave your abuser (who may in fact be your burnout coach keeping you caged in your cubicle).
How to stop human rights violations in medicine
Human rights are universal moral principles that apply to the treatment of all human beings no matter sex, ethnicity, religion, culture—or profession. These are basic freedoms and standards of human behavior protected by law—both internationally and nationally—from birth until death. Sadly, these laws often do not protect medical students or doctors.
Recognize human rights violations in your medical institution and speak up against unsafe and inhuman work hours (> 60 hours/week), sexual harassment, bullying, food/water deprivation, sleep deprivation, hazing, racism, censorship and lack of freedom of speech, intimidation, and prohibition of peaceful assembly after a physician suicide (to name a few).
Since 2012, I’ve been running a physician suicide helpline and have spoken to thousands of physicians suffering from occupationally-induced anxiety, depression, PTSD, and suicidal thoughts as a result of chronic human rights violations—and lack of access to mental health support in a profession that involves constant exposure to suffering and death.
What physicians need now
Protection by labor laws standard in other industries including mandatory meal and bathroom breaks
Protection by the Americans with Disabilities Act including immediate removal of invasive mental health questions on applications for state licensure, hospital privileges, and insurance credentialing.
Access to non-punitive mental health care to prevent occupationally induced lifelong mental health sequelae from chronic exposure to death and suffering.
Protection under the Unites States Constitution that guarantees freedom of speech and a right to peacefully assemble—especially in the aftermath of a physician suicide.
“burnout coaches cannibalizing the corpses of their colleagues”
Hey Pam … I will take that just as personally as you obviously mean it and all I can say is wow. Physician coaches as dementors. Where in the world does that comment come from except your love of creepy alliteration.
Remember I am writing this as a person who has had a beer with you and shared a stage with you at AAFP meetings and I actually like you as a person … or did until I received notice of this online assassination.
It is one thing to call out an issue using language meant to wake people up and it is another to dismiss people like me and my coaches who are dedicated to helping doctors who are struggling make the changes to find meaning in their career again.
A few bullet points
– 95% of leaders in healthcare don’t understand or care about burnout. However those people control your puppet strings if you are working inside their organization.
– You are at the center of the universe of physician suicide. You are seeing a very select slice of the physician burnout spectrum.
– Don’t let your passion blind you to the contribution of others who are doing their best to help this massive and evil challenge to people who want to be healers and chose to become physicians.
– Remember that 90 percent of our colleagues are still practicing traditional medicine within an organization and simply yelling “I’m being oppressed, this is moral injury” at their bosses will only make the workplace conflict worse. It won’t make the changes you are wanting to see. (BTW, what are the changes you want to see??)
– and your DPC model (which you make money off of when you sell your retreats and YOUR COACHING – you bloody cannibal) can’t save all the doctors.
I would never tell a doctor that burnout is their problem, that they need to breathe, contemplate their navel, meditate, journal and get back to work. The central process in our coaching is to help the doctor create their personal Ideal Practice Description and then go make that happen. You know for a fact I have referred at least a half dozen of my clients to your retreat to explore DPC because you are the best at explaining and modeling a micro practice. Good God Pam, where in the world did this “cannibalizing corpses” shit come from??
Please stop slinging shit like this.
It doesn’t look good on you.
My two cents,
Dike Drummond MD
Good Dike, I got your attention. This has nothing to do with who you referred to me (I’m not DPC btw). I’m referencing programs that perpetuate abuse, confuse and oppress victims misinformed of their rights and placed in harms way.
You know my goal has always been to end physician abuse (not just help doctors cope with abuse).
Over dinner I asked, “Don’t ya think all your ‘burnout’ breathing exercises and EMR workarounds just prolong the agony for physicians in toxic working conditions?”
You replied, “Yes.”
I felt sick when you said that Dike. Helping doctors remain in an abusive workplace is not helping doctors. Those who earn income off prolonging physician agony are cannibalizing the corpses of their colleagues.
Victims require truth—definitive diagnoses & treatment plans. Not crayons. Not victim-blaming labels. Not cynicism & academic masturbation. Truth is physicians suffer from human rights violations and occupationally induced mental health conditions that must no longer be covered up by burnout and ‘moral injury.’ Lives are at stake.
My call to action for us all is tell the brutal truth and act on simple solutions I outlined above.
We can all agree there’s no place for human rights violations in health care. Let’s start at the root of the problem. Attorneys already in queue.
I want to believe your motives are integrous. What do you say?
Hey Pam … since you are playing the “half quote” game here … let’s clarify
… if ALL YOU DO do is contemplate your navel, meditate and breathe and make no personal attempt to either change your circumstances or leave and find a better situation then yes, it will only make things worse. It is like a frog in a boiling pot who is taught how to take deep cleansing breaths.
The key is to STOP TOLERATING your circumstances AND learn how to to take better care of yourself and change your job to be more of what you really want.
Which is why we would never recommend anyone only work with mindfulness techniques. Most people can’t see the changes they can make because they are in survival mode.
You would have them accusing their employer of “cannibalizing their corpses” and think that is going to make things better.
There is more to change than a wake up call. Once people are woke, what next besides your retreat? (nice positioning)
Dike, you are right. There is more to change than a wake-up call. Our profession has been in a coma-like stupor for ages which means a slow awakening. In the meantime, many have died. I am all about collaborative REAL change, not administratively mandated victim-blaming programs. That’s all. I have a team of attorneys, consultants, and psychiatrists who work to educate and implement strategic action, litigate and heal those needing these resources. It’s not about one blog, book, or retreat (our retreats for suicidal docs are always free or by donation btw). Education is the wake-up call and requires the brutal truth. Strategic action is the change. Litigation is the required action to combat human rights violations. Healing is what all involved must experience to move forward. Thank you for your comments.
Dear Dike,
My two cents about your HappyMD course
I am just giving you my free advice without any charge.
You need to change your attitude and try to be realistic with crisis’ healthcare is facing.
People like you can push physicians to suicidal thoughts or to into serious depression ; as if PHP is not enough.
While the struggle is to help physicians out of bullying by PHP and current attitude of hospital leaders.
Btw your videos are good and you better focus on pep talk and how to blow and take deep breath.
I obviously don’t need your so called ‘ happyMD ‘ course.
As you see I have seen enough darkness in healthcare system.
The world is changing now. No more racism or discrimination against disability or ESL. By the way 80 % of American jobs are by people with English as second language ( ESL).
Leaders like you caused enough damage to system by discrimination.
I am obviously out of your course. Good luck. Don’t push physicians to depression by your attitude. Serious offense.
Thanks
RAkhi Pal MD.
One more thing
If the term “cannibalizing the corpses” means appealing to burned out doctors as part of a marketing plan for your business
That is EXACTLY WHAT YOU ARE DOING WITH THIS BLOG POST.
We both reach out to burned out doctors for a single reason. We can help. Not to cannibalize and feed off their suffering (I am completely insulted by the insinuation, however I also fully expect the online trolls to come out of the woodwork on this comment).
Shame on you for such accusations. Arrogance of the highest order. Who appointed you Saint Pamela?
~ D
Not part of a marketing plan Dike. My mental health support for docs and retreats for widows, families, and those impacted by suicide in medicine have all been free. I’ve provided all-expense paid trips for surviving widows at zero cost to those in the aftermath of tragedy. My suicide prevention work has been largely philanthropic.
Have you seen this 2018 lawsuit filing against the University of Missouri by a former resident for abusive work conditions and wrongful termination? The abuse is meticulously detailed in this court filing. Thought you’d want to know.
Right. As a more than naive intern, after finding out that I was pregnant, during my internship physical, my not to be named institution suggested that I get an abortion–they would pay. I declined the offer, and was assigned to a kidney transplant unit, rife with TORCH viruses. Luckily, the no nonsense Chief RN told me that she wouldn’t allow a pregnant RN to work there, and I shouldn’t either. She suggested, nay ordered me, to talk to my Chief Resident to get me reassigned, which I requested of him, and which he did. I am forever grateful to both.
Later, when I started spotting and was worried about miscarriage, I was told that “nothing can be done,” and kept working the 110-120 hours/week with 36 hour shifts, due to every third day call followed by a full working day. I was so tired that the RN’s kept telling me to sleep (during the night) and that they would call me only for true emergencies. My peers were supportive, but the administration, not so much.
Luckily, I was allowed to stop work on my due date, which I knew to be incorrect (due to my husband’s and my call schedules, LOL) and too early. This allowed me several weeks of much needed rest prior to the birth. Of course, the institution that was following the pregnancy now thought that I needed to be induced, so I signed away my rights to allow my daughter to complete her gestation and be born at term spontaneously. I was lucky to then get a month off for maternity leave. A friend in Ob-Gyn who delivered around the same time was only given 2 weeks to recover, and started to bleed on the floor after returning. She ended up switching specialties…
I have to agree with the [modified] RBG quote about not requesting special favors, just that our brethren [the machine that medicine has become], remove their feet from our necks.
As a patient who has seen the medical system in the US and in Chile, S.A. I would return in a heartbeat to Chile and once more have their healthcare system. I can’t due to my health and being on disability, how ironic! Yet, if I could have for one year, insurance and the ability to cover my costs there, I know I would recover and be healthy once more and return to work something that the US hasn’t been able to do in these past 18 years. Sad at 56 when I was a translator and ESL teacher but you see I fell into the I couldn’t go back to work-hence needed state help-hence had limited doctor care-hence couldn’t get the best care-hence have kept getting 10 minute doctor appointments-hence not solutions-hence not sent to the best hospitals that might solve my problem that are out there (I’ve done my homework)-hence it costs so much to do so-hence in Chile it doesn’t cost an arm and a leg-hence they spend an hour with you-hence solve your problem-hence one of the best healthcare systems in the world.
Sadly, I’ve completely understood the list of suicidal doctors because I have a friend that committed suicide because of her health. She wasn’t getting the best care, she was getting survivable care, like me. I’ve had 5 spinal surgeries and live with Chronic pain and on pain medications that I don’t like and I know there is a surgery that probably would solve it but it is done at top prestigious hospitals and clinics and yet not in my State, oh well it is not “approved” yet. I was a genuine pig for an FDA thing that was approved and now is standardized surgery. Why? Because I was willing to do anything before to solve my issue. If I had been seen by the top specialist in the condition, as they do in Chile (You choose the specialist you want to see, you choose the hospital you want to go to), I would probably be pain-free now and had returned to work and not be a pain (ha) to the taxpayers! Sadly, my own mine goes to my friend’s choice and think that maybe this should be my choice as well and stop being a burden to the State, my family, and my 10-minute doctors.
Awesome
So true. It seems like my thoughts in right words
So much bullying and harassment and if you compliant of termination of job due to inability to perform inhuman physical work , CEO s get humanitarian award.
Just unbelievable.
I’ve been in disbelief about these atrocities x years. Now I see the extent of the complicity & intergenerational wounding that has allowed these tragedies to persist. More here: Free ebook PHYSICIAN BETRAYAL