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Emotional PPE

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Back in February, I showcased the sobering results of the Medscape Physician Depression and Burnout Report 2024: Of those doctors surveyed, 53% reported burnout and 23% depression. And those disturbingly high statistics had increased from the previous year. 

I recently listened to a Stanford Medcast Episode interview of Ariel Brown PhD called “Physician Distress Miniseries – Emotional Health Support for Health Care Workers.” (You can get CME credit for listening to the podcast and completing the quiz afterward.) According to the session, each year in the United States, one in 10 physicians think about or attempt suicide and around 400 die by suicide. 

At the start of the pandemic, Dr. Brown started a nonprofit with Massachusetts General Hospital Anesthesia Program Director Dr. Daniel Saddawi-Koefka, called The Emotional PPE Project. The organization provides free and confidential psychological counseling for healthcare workers. Here is the website.

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The Medscape Physician Depression and Burnout Survey 2024 is out and the News Isn’t Good

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For the last several years I’ve made sure to blog on the annual Medscape Physician Survey that chronicles physician satisfaction. Unfortunately, it’s pretty much always bad news.

If you’re an optimist, you’ll be happy to hear that burnout rates were lower than last year. You may remember that the numbers skyrocketed during the pandemic. Last year 53% of physicians surveyed reported burnout and 23% reported depression. This year the numbers are 49% and 20%, respectively. If you’re a pessimist, you’ll notice that those numbers are still very high, with approximately half of the doctors surveyed reporting burnout. That’s a very big number.

Of note, emergency physicians are the most burned out at 63%, and the runner-up is obstetrics and gynecology at 53%. Plastic surgeons are the least burned out at 37%.

See more stratification and data by taking a look at the survey results here.

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Beware: Smart People Can Offer Dumb Advice

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Thanksgiving is a time for gratitude and reflection. It’s also a time to consider what will make you happy in the future.

When I was a medical student applying for emergency medicine residency programs, a well-meaning, smart dean gave me foolish advice: I was determining the order of my rank list and was particularly concerned about one program that had an excellent reputation but was in a city I didn’t like. The dean told me, “You’ll be so busy during residency, it won’t matter where you live.” Luckily, the advice rubbed me the wrong way, and I wholeheartedly disregarded it. I would argue that where you live for medical school, residency, or fellowship is as important as the quality of the institution. The reasons are several-fold:

1. Medical education/training is time-consuming, and you want to be in a city you can enjoy fully when you have a few moments to blow off steam.
2. Medical education/training is extremely stressful, and you want to be in a city where you have social support.
3. Medical education/training is not completed in a vacuum. Your personal life continues. If you’re single you may meet someone and end up staying in the city where you’ve trained for the rest of your life. If you’re in a long-term relationship you may decide to have children or may already have them. Down the road you might not want to relocate your family.

Not everyone gets the opportunity to go to medical school or train in a residency and fellowship program in a city she likes. But you can make choices that will increase your chances. Consider these options – and your happiness – as you practice gratitude this week and make professional decisions this coming year.

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Four Thousand Weeks

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I’m currently reading a fantastic nonfiction book called Four Thousand Weeks: Time Management for Mortals by Oliver Burkeman. Four thousand weeks is how much time the average human has on this earth. That doesn’t sound like a lot.

I’d highly recommend the book to those of you who are productivity geeks, folks who are trying to be as efficient as possible with their time – all the time. I’m certainly one of those people.

Unlike other authors, Burkeman recommends that you surrender to the fact that you cannot get everything done and that traditional time management strategies, which are supposed to help you multitask, will fail and cause anxiety. He recommends recognizing that our lives are finite and that we should be in the moment. The author does a fantastic job of persuading even someone like me how important it is to recognize that even if you get your list done, there will always be more items on your next list. 

I’m not much into self-help, but I do recommend this intelligent book.

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Moral Injury

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It’s troubling, but make sure to read this recent piece in the New York Times called “The Moral Crisis of America’s Doctors” about physicians’ “moral injury.” The phrase refers to emotional damage caused to workers – when in the course of fulfilling their duties – they commit an act or acts that conflict with their core values. The piece argues that, in part, our profit-driven system causes doctors moral injury and, in turn, they become depressed and/or burned out.

I remember many times when I had only bad alternatives in directing my emergency patients for follow-up: If they had no insurance, our knowledgeable social workers advised us that our sole option was to send those patients to the public hospital nearby for follow-up care. This meant I would splint someone with a non-operative, non-emergency fracture and advise him/her to then be seen at another hospital’s emergency department with a multiple-hour wait because that was the only way to get into the system for the affordable orthopedic clinic. I found this very upsetting and contrary to what seemed right to me: It was so hard on the patients, and it also burdened the already overwhelmed medical system.

If you’re interested in recent physician burnout statistics, please see this February 2023 blog on the topic.

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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Listen to Dr. Finkel’s interview on the White Coat Investor podcast:

Listen to Dr. Finkel’s interview on the FeminEm podcast: