Did you know that National Doctors’ Day is on March 30? It was proclaimed as an official national holiday by President George H.W. Bush in 1991. Included in this proclamation was the statement that common to the experience of each of them are “hard work, stress and sacrifice.”
Despite such stress and sacrifice, most physicians were very satisfied with their profession in 1991 and, by all accounts, were in good mental health themselves. That satisfaction was not primarily from making a good living; it was from the opportunities to fulfill our calling as healers.
However, ironically, around that same year of 1991, medicine began to become more of a big business as for-profit managed care, insurers and pharmaceutical companies came to transform medicine, including mental healthcare. As I discussed in my 1997 book “That Ethical Way: Challenges & Solutions for Managed Behavioral Healthcare,” business ethics came to trump healthcare ethics. Mental healthcare in general, and psychiatrists in particular, were early targets of cost cutting.
For psychiatrists, the shift toward big business has proven to produce quite a bit of harm. Our rate of depression, suicide and burnout has gradually increased. As the American Foundation for Suicide Prevention now notes, psychiatrists have higher rates of those mental health problems than the general population. Our burnout rate is reaching epidemic proportions.
Though the data is less available and publicized, there seems to be similar concerns for psychologists, psychiatric nurses, social workers, counsellors and others who work in our mental healthcare systems. We work best as a coordinated multi-disciplinary team with overlapping skills and knowledge.
The cause of such burnout does not seem to be in any particular vulnerability in ourselves but rather in many of our current systems of care that disempower us and put too many obstacles in the way of our ability to provide the care we know we can. Among the practical problems are electronic health records, which take too much time away from interacting with patients, along with decreasing time scheduled with patients. Administrators also seem to be caught in the burning-out process.
Indeed, there seems to be a correlation with clinician burnout and poorer quality of care for patients. Diagnostic evaluation is rushed, mistakes are made, and medications overused.
Personally, I can only recall one or two times in my 40-plus years of being a psychiatrist when National Doctors’ Day was recognized in any way in my workplace. But, this year, we need to pay special attention to it because of these developments.
So, in preparation for National Doctors’ Day, why not have a day of appreciation for all staff and administrators? Let patients know so that they can participate in some way and convey their own gratitude. Use the day to think of ways to improve the system of care to enhance wellness for all those who work in the system. All our lives may depend on it.