BURNOUT: THE SILENT EPIDEMIC
Readers always ask: where do I get my ideas? With The Burnout Cure, I didn’t have to look far. While Wolf, Lily, and the characters who inhabit their world are fictional, the issues of physician burnout, depression, and suicide are very real—as are the sobering statistics that Lily quotes about how many physicians are affected.
The first seeds of this story were planted back when I was a young doctor-in-training. As Lily describes, the hours and work conditions were brutal. I lucked out with a residency program that provided wonderful role models and great institutional support. Unlike many of my peers, I didn’t have to race from one hospital room to another throughout the night, drawing blood and starting IVs—our main teaching hospital had in-house phlebotomists and a great nursing staff who were paid to do that. But there were still entire months when I never saw the sun because I was pre-rounding on patients at 4:30 a.m., spending the day in the O.R., doing evening rounds on post-op patients in the SICU (surgical intensive care unit), and then signing out to the night team at 9 or 10 p.m.—when I wasn’t on call myself. Speaking of call, I lucked out there too. I was never on call more often than every third night, and my longest stretch of working straight through without sleep was 42 hours. I had friends, though, who suffered through training programs like Nick’s. They took call every other night, worked a hundred-plus hours each week, and lied to Joint Commission inspectors to keep their programs—and ultimately themselves—out of regulatory hot water for flouting the rules.
Fast forward ten years to another milestone event—or, more accurately, three milestone events—when three excellent, successful, well-respected physicians in our community committed suicide. Our local medical society held a dinner in their memory, and the keynote speaker talked about physician burnout.
I’d never heard about burnout prior to that night. But before long, the term seemed to be on everyone’s lips. As Wolf notes in the opening chapter:
Whenever he opened a medical journal, or stepped into the doctors’ lounge, or went to the ER to admit a patient, there was always someone talking about wellness, burnout, or both.
Practically overnight, it seemed that physician burnout burgeoned to epidemic proportions, and even the popular press started quoting the grim statistics that those of us in the trenches lived with every day.
A few years ago, I came across a TEDMED talk by Pamela Wible, a family physician from Eugene, Oregon. She talks about “Why Doctors Kill Themselves”—and she doesn’t mince words. She describes a broken system that dehumanizes aspiring physicians and perpetuates abuses in medical education and practice.
Dr. Wible’s passion about the topic got me thinking.
What if a woman who is smart, mouthy, and willing to challenge the establishment decides to turn her personal tragedy into a cautionary lesson for other physicians? What if the one man who can help her spread the message is an irreverent, unapologetic chauvinist who doesn’t believe in burnout? And what if they strike sparks off each other, hot enough to burn up the sheets?
And so, The Burnout Cure was born.
Want to read more about this topic? Check out the bibliography below, which includes citations for a few of the sources I found most helpful and compelling while researching the book.
Bernard, R. 5 ways to improve physician mental health. Medical Economics. 2017. http://bit.ly/2A52VBB. Accessed 24 Nov 2017.
Panagioti M, Panagopoulou E, Bower P, et al. Controlled Interventions to Reduce Burnout in Physicians. A Systematic Review and Meta-analysis. JAMA Intern Med. 2017;177(2):195–205.
Peckham C. Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and Burnout. https://www.medscape.com/features/slideshow/lifestyle/2017
Accessed 24 Nov 2017.
Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015; 90:1600-1613.
Sinsky C, Colligan L, Li L, et al. Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann Intern Med. 2016; 165(11):753-760.
Wible, Pamela. Physician Suicide Letters: Answered. Pamela Wible, M.D., Publishing, 2016. http://amzn.to/2Av7plK
On the small screen:
Demania, Zubin. Are zombie doctors taking over America? TEDMED talk. https://youtu.be/QLqrjLBV95o. Accessed 24 Nov 2017.
Watch funnyman ZDoggMD (yes, he’s a real doctor) talk about his journey from burned-out doctor to rappin’ sensation.
Wible, Pamela. Why Doctors Kill Themselves. TEDMED talk. https://youtu.be/qyVAtZ9VZ4Q. Accessed 24 Nov 2017.
On the big screen:
Do No Harm. Exposing the Hippocratic Hoax. A film by Robyn Simon. http://www.donoharmfilm.com
Emmy Award winning writer/producer/director Robyn Symon teams up with Pamela Wible, MD in this 2017 documentary about physician suicide. Here is a synopsis from the project website:
“Jumping off hospital rooftops, hanging themselves in janitorial closets, overdosing on drugs—they’re A students and their suicides are often like well-planned school projects. Doctors are our healers, yet they have the highest rate of suicide among any profession. Medical students and families of physicians touched by suicide come out of the shadows to expose this silent epidemic and the truth about a sick healthcare system that not only drives our brilliant young doctors to take their own lives but puts patients’ lives at risk too.”