David Bornstein is making a career of empowering, thought-provoking articles on the emotional state of healthcare. In his New York Times op/ed “Medicine’s Search for Meaning” he advocates that as the patient-doctor relationship vanishes, so too will the doctors. He says, “Medicine is facing a crisis, but it’s not just about money; it’s about meaning.” Adding that, “As administrative and documentation burdens have exploded in the past three decades, doctors find themselves under pressure to work as quickly as possible. Many have found that what is sacrificed is the very thing that gives meaning to the whole undertaking: the patient-doctor relationship.”
Bornstein’s piece is powerful, weighing in on the manner with which we doctors handle grief. In his opinion, med school is where the doctor burnout is first felt. Students are pushed to absurd extremes–losing sleep, and being trained to approach medicine in a distant, compassion-less manner, even reprimanded if they break down and cry in the presence of a patient. So is it okay to cry in the presence of a patient? You have to decide for yourself. However, reprimanding a student for doing so is pure Vulcan, cold. But, according to Bernstein, almost half of medical students get burned out during their education. He claims that, “medical education has been characterized as an abusive and neglectful family system.” It places unrealistic expectations on students.
Bornstein then reminds us that five out of six doctors say medicine is in decline; nearly 60 percent would not recommend it as a career for their children. Direct care critics, if you want to talk about a doctor shortage, let’s talk about those stats right there.
As we mentioned in a previous post, Bornstein’s colleague created The Healer’s Art, a course that is now taught in 71 med schools. It’s a class that brings doctors together to share and discuss why they are joining the profession. It was started clandestinely, with concerns that administrators wouldn’t approve of its radical approach to the patient-doctor relationship. However, it took off and succeeded in its effort to curb doc burnout. Our next question is: when will concierge medicine, specifically our “medicine-for-all” model, be taught in med school? Otherwise, as administrative tasks hog more of our time, won’t we risk becoming hypocrites? An ironic pun, since we take the Hippocratic Oath when we begin this life-affirming journey. Sad will be the day healthcare truly fails, and it’s the patients taking the Oath of Maimonides, which goes, “May I see in all who suffer only the fellow human being.” The suffering ascribed to doctors who couldn’t heal their patients, by accepting that they are more than atoms, they are living beings with a story.