Guest guest Posted August 23, 2012 Report Share Posted August 23, 2012 Duh! But what will we do about it? Cote To: Sent: Thursday, August 23, 2012 9:04:22 AMSubject: doctor burn out CNN is running this story today on physician burnout. About 40%. Front line primary care people about 60%. http://www.cnn.com/2012/08/23/health/time-doctor-burnout/index.html Ben Recent Activity: Visit Your Group Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2012 Report Share Posted August 23, 2012 I'm not sure exactly what to do about it, but this issue needs to be part of the public conversation about improving care. Every time I read an article that concludes by recommending that clinicians pursue " individualized decision making " , I think about the mental toll that takes. Not that we shouldn't do it, but it has to be recognized. There is lots of literature now in psychology about the mental tolls of decision-making, but as far as I know it has not really been connected to our work in primary care. If I had a challenging medical situation, I would want the first appointment of the day, because towards the end the doctors are at best tired, at worst completely fried. This is a good NYT article on decision fatigue:http://www.nytimes.com/2011/08/21/magazine/do-you-suffer-from-decision-fatigue.html?pagewanted=all Also, much longer but very interesting is Kahneman's book on Thinking Fast and Slow, good for thinking about cognitive work but also good for thinking about interpreting numbers and data, which is what we are supposed to get patients to do to a certain extent. All that care coordination with the ACAs that they are expecting: we need them to realize that this takes a certain kind of cognitive energy, so they will need to help us on the burnout front if they want us to take it on. leslie-- Kernisan, MD MPHGeriatrics Duh! But what will we do about it? Cote To: Sent: Thursday, August 23, 2012 9:04:22 AMSubject: doctor burn out CNN is running this story today on physician burnout. About 40%. Front line primary care people about 60%. http://www.cnn.com/2012/08/23/health/time-doctor-burnout/index.html Ben Recent Activity: Visit Your Group Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2012 Report Share Posted August 23, 2012 Prior to joining this listserv, a colleague did an informal survey of the docs in her community asking "At what point in your day do you feel that you're pretty much drained of your ability to empathize with your patients" (or something like that) and found a striking consistency "about the twelfth patient."Presuming for a moment that this is a universal finding one is naturally drawn to the conclusion that we ought to limit ourselves to 12 patients per day.This would not necessarily result in a primary care shortage if the payment model shifted from "visit with doctor = revenue" to other models focused more on population outcomes and presuming that primary care received adequate funding to engage in the full scope of work of good primary care.Gordon I'm not sure exactly what to do about it, but this issue needs to be part of the public conversation about improving care. Every time I read an article that concludes by recommending that clinicians pursue "individualized decision making", I think about the mental toll that takes. Not that we shouldn't do it, but it has to be recognized. There is lots of literature now in psychology about the mental tolls of decision-making, but as far as I know it has not really been connected to our work in primary care. If I had a challenging medical situation, I would want the first appointment of the day, because towards the end the doctors are at best tired, at worst completely fried. This is a good NYT article on decision fatigue:http://www.nytimes.com/2011/08/21/magazine/do-you-suffer-from-decision-fatigue.html?pagewanted=all Also, much longer but very interesting is Kahneman's book on Thinking Fast and Slow, good for thinking about cognitive work but also good for thinking about interpreting numbers and data, which is what we are supposed to get patients to do to a certain extent. All that care coordination with the ACAs that they are expecting: we need them to realize that this takes a certain kind of cognitive energy, so they will need to help us on the burnout front if they want us to take it on. leslie-- Kernisan, MD MPHGeriatrics Duh! But what will we do about it? Cote To: Sent: Thursday, August 23, 2012 9:04:22 AMSubject: doctor burn out CNN is running this story today on physician burnout. About 40%. Front line primary care people about 60%. http://www.cnn.com/2012/08/23/health/time-doctor-burnout/index.html Ben Recent Activity: Visit Your Group Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2012 Report Share Posted August 23, 2012 We should submit and post our stories to the Health and Justice project's primary care conversation: http://www.causes.com/causes/767047-health-justice-project/actions/1675663 Just another way to get our voices heard by more people. , MD Palm Desert, California Duh! But what will we do about it? Cote To: Sent: Thursday, August 23, 2012 9:04:22 AMSubject: doctor burn out CNN is running this story today on physician burnout. About 40%. Front line primary care people about 60%. http://www.cnn.com/2012/08/23/health/time-doctor-burnout/index.html Ben Recent Activity: Visit Your Group Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 25, 2012 Report Share Posted August 25, 2012 Agreed. From: [mailto: ] On Behalf Of drhorvitzSent: Saturday, August 25, 2012 11:24 AMTo: Subject: Re: doctor burn out I mis wrote my previous post.I have no burnout from patients. I enjoy my interaction with them.I had approached burnout with third parties.I removed them.I do what I believe to be best for each patient and have no third party whispering in my ear or threatening me.My point is that an IMP should never get burned out, unless the IMP is restricted from doing what they want, which is usually by the third party.I went into FP so I could control my own destiny. I believe that is shared by many on this list. If FP's can regain control of the system, we would have an overflow, as opposed to a fake shortage.Stevestown.> > > > > > > > > > > > Duh! But what will we do about it?> > > > > > > > Cote> > > > > > > > > > > > > > > > > > > > From: " Ben Brewer " <brewermd98@>> > > > To: > <mailto:%40yahoogroups.com> > > > > Sent: Thursday, August 23, 2012 9:04:22 AM> > > > Subject: doctor burn out> > > > > > > > > > > > > > > > > > > > CNN is running this story today on physician burnout. About 40%.> > > > Front line primary care people about 60%.> > > > > > > > > > > > http://www.cnn.com/2012/08/23/health/time-doctor-burnout/index.html> > > > > > > > Ben> > > > RECENT ACTIVITY:> > > > Visit Your Group> > > > > > > > Switch to: Text-Only, Daily Digest . Unsubscribe . Terms of Use> > > > .> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 25, 2012 Report Share Posted August 25, 2012 I mis wrote my previous post. I have no burnout from patients. I enjoy my interaction with them. I had approached burnout with third parties. I removed them. I do what I believe to be best for each patient and have no third party whispering in my ear or threatening me. My point is that an IMP should never get burned out, unless the IMP is restricted from doing what they want, which is usually by the third party. I went into FP so I could control my own destiny. I believe that is shared by many on this list. If FP's can regain control of the system, we would have an overflow, as opposed to a fake shortage. Steve stown. > > > > > > > > > > > > Duh! But what will we do about it? > > > > > > > > Cote > > > > > > > > > > > > > > > > > > > > From: " Ben Brewer " <brewermd98@> > > > > To: > <mailto:%40yahoogroups.com> > > > > Sent: Thursday, August 23, 2012 9:04:22 AM > > > > Subject: doctor burn out > > > > > > > > > > > > > > > > > > > > CNN is running this story today on physician burnout. About 40%. > > > > Front line primary care people about 60%. > > > > > > > > > > > > http://www.cnn.com/2012/08/23/health/time-doctor-burnout/index.html > > > > > > > > Ben > > > > RECENT ACTIVITY: > > > > Visit Your Group > > > > > > > > Switch to: Text-Only, Daily Digest . Unsubscribe . Terms of Use > > > > . > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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