Blog Archives

Four Thousand Weeks

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

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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Toxic Work Environments Adversely Affect Those in Training

I recently came across a Medscape-sponsored discussion called “How can we make medical training less toxic?” The video is visible here, and you can log into Medscape to read the transcript. The participants – two emergency physicians and one surgeon – discuss sexism in the workplace, corrosive and inaccurate narratives about women residents, the importance of strong mentorship, and diversity training. This topic is additionally important because toxic work environments can lead to depression, burnout, and suboptimal patient care. My experience in residency was marred by sexism and sexual harassment. It saddens me that these problems are still present, but I’m pleased the issues are starting to be addressed.

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Medscape’s Annual Physician Burnout Report is Out and – As Usual – It’s Disturbing

Every year Medscape surveys physicians about career satisfaction. The last few annual reports have been pretty upsetting. Unfortunately, 2022’s results are not happy either.

This year emergency physicians (my colleagues) reported the highest burnout rates of all specialties at 60%. Last year this number was 43%, so there was a large jump in already-high dissatisfaction levels. Next in line were critical care physicians at 56%. But even the specialty with the smallest percentage of burned out physicians – public health and preventive medicine – had rates at 26%. So even in the happiest cohort, one in four surveyed doctors reported burnout.

Looking at gender, fifty-six percent of female physicians surveyed reported burnout; men seemed less dissatisfied, but they were at 36% so that’s not so great either.

Bureaucratic tasks were perceived to be the biggest contributor to physician burnout by their own assessment.

It’s important for those who are considering a career in medicine to approach it with eyes wide open: Take a look at the Medscape National Physician Burnout & Suicide Report 2022 slide deck yourself for more details, and check out my Kevin MD piece on EM burnout here.

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The Main Demographic Factor Associated with Decreased Satisfaction for Physician Work-life Balance is Female Gender

Wow. When I read that fact in a recent piece on time management by Dr. Sandra Scott Simons in Emergency Medicine News, I was a bit taken aback. It’s not surprising once you really think about it, but at first, it’s a slap in the face. 

In her article, Dr. Simons’ discussion of the pitfalls of distractions is particularly resonant for me. If you haven’t already, make sure to familiarize yourself with the concept of Deep Work by Cal Newport. (He has a book, a podcast, you can also find many interviews of him online.)

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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:

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