Viewpoint: physicians aren't burned out, they're helpless and demoralized

Nearly two-thirds of physicians report experiencing burnout, but the term burnout misses the larger issues: Physicians are demoralized and losing faith in the systems they work for, Eric Reinhart, MD, a physician at Evanston-based Northwestern University, wrote in a Feb. 5 guest essay for The New York Times.

Physicians have long diagnosed patients with "demoralization syndrome," a condition associated with terminal illness that is characterized by a sense of helplessness and loss of purpose. Now, American physicians are beginning to suffer from a similar condition, Dr. Reinhart wrote.

"What has been identified as occupational burnout is a symptom of a deeper ‌collapse. We are witnessing the slow death of American medical ideology," he wrote. 

One report estimated 117,000 physicians left the workforce in 2021 alone. During the pandemic, as healthcare inequities became front-page news and clinicians struggled to help, 20 percent of physicians reported they knew a colleague who had considered, attempted‌‌ or died by suicide during the first year of the pandemic alone, according to Dr. Reinhart.

The pandemic may be over, but disillusionment among healthcare workers is increasing. The healthcare system is resistant to self-criticism, and systems such as billing codes continue to shape and protect for-profit healthcare, according to the essay. "Many physicians are now finding it difficult to quash the suspicion that our institutions, and much of our work inside them, primarily serve a moneymaking machine," he wrote.

"Physicians can no longer be passive witnesses to these harms. We have a responsibility to use our collective power to insist on changes: for universal healthcare and paid sick leave but also investments in community health worker programs and essential housing and social welfare systems," Dr. Reinhart wrote. "Addressing the failures of the healthcare system will require uncomfortable reflection and bold action … physicians nonetheless hold considerable power to initiate reforms in health policy."

Dr. Reinhart pointed to an organized network of physician unions as an avenue physicians can use to advocate for change. By making proposals and use of collective civil disobedience via physicians' control over healthcare documentation and billing, "visions could become action plans."

"To be able to build the systems we need, we must face an unpleasant truth: Our healthcare institutions as they exist today are part of the problem rather than the solution," he wrote.

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