A store cashier sees dozens of customers during a shift. A car tire shop mechanic may work on 20 cars. Workdays can be hard across professions.
Medicine surely does not escape this. We just don’t deal with customers or goods, despite efforts to make it look like that. A simple runny nose visit may be the closest thing to a customer who is there for a simple transaction, and in reality they don’t even need to be there. Yet, they are welcomed additions to the daily treadmill of the “provider” to balance out the complexity of taking care of people with actual medical conditions. After all, it is a numbers game, and we have to meet our numbers.
When all the customers are gone, we sit down to document every bit of the healing transactions. We do touch-up work on the paintings to make them look human and then try to reflect our own humanity somewhere in the picture before signing and dating the canvas. We hold the brush one more time, make a last ditch effort to recall the features of the human faces who have now gone home, but we realize we didn’t spend enough time studying them.
It’s frustrating because yes, I do care about those features.
I remember the first week when I met my numbers at the clinic, and an all-smile clinic manager walked by my desk and celebrated my milestone with a cheerful “look at you, you met your numbers!”. I remember how I felt dead inside, because that was the first week on my job when I felt I failed patients. I just was not able to fully address their issues, was quick to dismiss concerns, to prescribe medications and order tests. And I was exhausted. Therefore no, I was not like a cheerful puppy when I met my numbers.
Life goes on for most of us because we learn to “get over it”. We engineer ways to still be able to care for people in a way that does justice to our oath, but there is only so much we can do within current parameters. The truth remains, that chasing unrealistic numbers is only going to keep hurting physicians and contribute to burnout.
Numbers hurt. A doctor that is rushed will also have frustration that comes from working below one’s best abilities, from learning to care less, from shunning personal growth, and from treating without healing. All ingredients of physician burnout.
Numbers matter. They do, as in every business. However, there should be a sweet spot that can only be found when the system is reverse-engineered based on an non-negotiable end point: let the physician be.
Until then, any other approach to fix physician burnout will be viewed as a willful ignorance of what physicians are meant to be.