Dr. Kat Lopez: “Today I’d like to share with you some words used by the medical-industrial complex to blame doctors for the problems—including human rights abuses—that they are perpetrating upon these poor enslaved employees.
These words include burnout—blaming the victim who is enduring human rights abuse on a daily basis. RVUs. Work-life balance impossible to achieve. Benchmarks. Metrics. Inefficiencies. Efficiencies. Unprofessionalism. FTEs.
The word resilience is a frequently used word to blame doctors who are truly among the most resilient human beings on the planet and need no further training in how to be resilient; they simply need to be treated with respect and valued for the incredible value they have to society. Disruptive physicians who stand up and say no. Availability. Patient satisfaction surveys for 5-15 minute visits.
The concept of residents committing violation of their work hours for meeting the requirements of their residency programs. Patient contact hours which basically means working for free to complete the paperwork etcetera administrative work related to caring for the patients. Quality improvement metrics. Quality assurance. Maintenance of Certification—huge financial racket for unclear benefit in terms of patient care. Population health and its metrics. As well as our favorite, meaningful use.
Now the end result of these words that blame disempowered doctors for the abuses committed by the medical-industrial complex assembly-line medicine and corporate medicine itself is that unfortunately it creates disempowerment, hopelessness, feelings of being stuck, anxiety, and depression that at the end of the day, the year, the residency, the ten years—results in physician suicide.
Here we have an altar composed of our fallen brothers and sisters, beautiful photos of them and their families in their primes, as well as elegies to their love and their incredible patient care over the years of their careers.”
Pamela Wible: “This is psychological warfare on really amazing physicians by a system that perpetuates human rights violations on some of the most beautiful people in the world. What do y’all think about that?”
Doctors: “Yes”
Pamela Wible: “Is there anything else you want to add Kat or anyone? I think this speaks for itself.”
Kat Lopez: “I think this speaks for itself.”
Can you think of any others? Please submit additional words that blame doctors in comment section below.
Pamela Wible, M.D., is the author of Physician Suicide Letters—Answered. Need help? Contact Dr. Wible. Photography & video by GeVe at our fall physician retreat.
Value based care.
Oh right. How could we forget that one.
My father Dr Thomas Gahagan, cardio-thoracic surgeon, husband and father of 7 young children thanks you as do I, and all of his grateful patients and loved ones.
Ah he is right there on the wall. Such a sweet soul.
Sarah I cannot believe this I have been looking for a picture of your Father my whole life today not only did I find his picture but that of the whole Cardio Thoracic team at Henry Ford Hospital, you see I was one of his last surgeries I will be 63 this year. My surgery is 62 years old and I would like to personally thank you for your Fathers work. I have prayed for all of his children my whole life as my Mother told me of his tragic demise.
Thank you- that was cathartic. We need wider recognition of the problems physicians are facing.
Maybe a union is not such a far-fetched idea, after all.
Killer words- “managed care”, “Patient advocate” (if the physician is not the patient’s advocate, we are in a hell of a mess), ERAS, MACRA, HIPPA laws, EHR (in the old days, you were limited by either paper or ink- now the documentation can approach infinity).
The cure to our ails: DISINTERMEDIATION – removing the middle man and that whole middle no-value-added layer of bureaucracy.
So true
personal reflection when the problem is with the system !!System does not change despite personal reflecting for years !!
There is no amount of yoga or deep breathing that will help you care for patients when you’ve been up for 28 hours and haven’t had time to eat. Just the facts. Wellness programs wouldn’t be necessary if doctors had time to be well. We could also save a whole lot of patients too: https://www.idealmedicalcare.org/blog/sleep-deprived-docs-disclose-hospital-horrors/
The mindfulness programs are the most offensive to me. How can I be mindful when I am sleep deprived and inundated with constant calls and pages?
Meditation, yoga, and taking deep breaths are not treatments for human rights violations.
“Teamwork” There is a sense that I just need to be a better team player to get this all to work properly.
Remember never to be a team player on the wrong team.
The AMA made a greedy minded booboo on 09.28.194 destroying Americans and the most honorable discipline of all (besides being a Mom).
We are all slaves to the powerful 1%!!
We are all imprisoned and pimps – thanks to greedy bastards criminal within our ranks!
Medical Fraud Alert of Deadly, Ungodly, Systematic, and Organized Criminal Behaviors Within AMA/CPT/HHS mandated a standard of care.
We all work for the larges organized crime syndicate ever amassed since the beginning of time.
“I don’t like ass kissers, flag wavers or team players. I like people who buck the system. Individualists. I often warn people: “Somewhere along the way, someone is going to tell you, ‘There is no “I” in team.’ What you should tell them is, ‘Maybe not. But there is an “I” in independence, individuality and integrity.'” Avoid teams at all cost. Keep your circle small. Never join a group that has a name. If they say, “We’re the So-and-Sos,” take a walk. And if, somehow, you must join, if it’s unavoidable, such as a union or a trade association, go ahead and join. But don’t participate; it will be your death. And if they tell you you’re not a team player, congratulate them on being observant.” ~ George Carline
Thank you doctor Lopez. I am a nurse practitioner and while on the job face the same “word” games as you describe. Now we are “team” building…ok, but I still get to work at a breakneck pace with no additional pay and even less respect than my physician colleagues. I love my patients, truly, but I am facing an even more daunting schedule as administration has decided to use this “team ” to make it possible for me to see even more patients. Female nurses are committing suicide also, due to job stresses, anxiety and depression. I have a 5 year plan to get out of clinical medicine, because the thought of working this much and not getting paid or respected is not in my mission statement.
Everyone is health care is impacted. Nobody is immune. Our leadership has chosen short-term profit over long-term care of people.
By the way Marybeth, you don’t have to escape. I would recommend you open YOUR ideal clinic where you can care for yourself and your patients. You don’t need to be managed by middle managers. Trust me. I’m here if you need help.
Just got this email from a doc:
“Hey Pamela, I just back from a short vacation and was catching up on my emails today. It was so funny because I just spent the last two hours listening to a “well-being” lecture mandated by the ACGME. And all they talked about was burnout and what we as residents can do about it. And then I opened your email and saw a woman pointing to the word burnout – words that blame doctors. I sat there for two hours and nothing was accomplished. I sat there and listened because I realized there was no point in vocalizing my opinions. The speaker had no intent, no plan of action!!! Why speak for 2hrs about burnout without actually putting a plan together- to enforce “well-being” in residency! And the senior resident next to me sat there doodling on his handout – it will never change. This is sad. After the speaker asked us residents what we could do and the overall consensus was that it was out of our hands to change the system and up to the faculty. That we brought up issues to them before and they had ignored it. But yet the speaker insisted it was our job as residents to cause change.
At the end of two hours I finally asked the speaker if she had asked the faculty the same question- what could they do to improve the residents well-being. Her answer – they never discussed it
I don’t understand how ACGME can change our calls from 16 to 24 hours in the blink of any eye without any sound evidence but they can’t implement a program to prevent doctors from killing themselves. One doctor dies every day from suicide and they still call it ‘burnout.'”
I then shared letter (published with permission) this with a hospital CEO along with this blog and he replies:
“I think you are right on the money and why is this not being addressed by the md professional groups. Stay at it!”
I think that we shouldn’t lose the big picture. This is a symptom of a larger problem which is the lack of competition among residency training hospitals because of their virtual monopoly on training residents. There is no incentive whatsoever for a hospital to improve the residents well-being or the training as a whole, the GME money is coming from Congress anyway without accountability. The ACGME? It’s a creation of the same hospitals. It is true that the residents lost the battle of the anti-trust to the AAMC which lobbied Congress and got exemption in 2004 but that doesn’t mean they should surrender instead, they should change the tactics and find allies in the states which can put political pressure on Congress in order to receive,the states, the medicare funding for the GME themselves and subsequently manage it according to the states’ needs not the hospitals’ and that would remove the monopoly and trigger competition among hospitals to improve the GME as a whole. In addition, the states can coordinate that with their requirements for licensure.
Unprofessionalism!!!! This is one of the words that I’ve heard several times and can’t help but feel blamed for actions that I consider to be in protection of my rights as a human!! I currently deal with depression and anxiety and have recently gone through three harassment and intimidation situations within my residency program. During a meeting with my program director I tried to speak out against the mistreatment, but was hit with the words “Delusional” and “unprofessional”. Since, I’ve been placed on probation for this so called “unprofessional” behavior, forced to take a LOA, and more recently, taken off of a hospital medicine rotation. (Apparently, attendings that I’ve spoken out against refused to work with me again without my apology). I have so much anxiety about resuming my training now and I’m very reluctant at this point to return. What is professionalism really? And exactly what is considered unprofessional??? Please explain because I never considered it to be speaking out against harassment and intimidation!!
I have some great advice for you. I’ll email you now.
Standardization, cultural competence, empathy training, streamlining, interoperability, alarm fatigue, data privacy, clinical decision support, user experience, workflow…