American Association for Physician Leadership

Where Has the Awe in Medicine Gone? Part II

Neil Baum, MD


Nov 7, 2024


Healthcare Administration Leadership & Management Journal


Volume 2, Issue 6, Pages 289-290


https://doi.org/10.55834/halmj.9499030144


Abstract

This is the second part of a two-part article on the loss of awe in medicine. In the first article, I defined awe and discussed its benefits to healthcare providers. Today, we are experiencing unprecedented levels of burnout among healthcare providers, resulting in doctors leaving the practice of medicine in unprecedented numbers. Most physicians who are retiring don’t really want to quit. What we really want is to rekindle the meaning and joy that we once had. We really want to put the awe back into medicine. This second article discusses several approaches to replenishing the sense of awe in healthcare.




As physicians, we have taken an oath to do no harm. However, we may have lost sight of the fact that medical interventions may be a source of harm and even mortality.

As a society, Americans are overmedicated. For example, 40% of adults over age 65 are taking more than five drugs daily. Acute conditions such as infections are effectively treated with medications. However, chronic stress-related conditions are not as amenable to medications. Medicines used to treat psychiatric disorders are responsible for nearly 500,000 deaths annually.(1) A 2016 study found that medical errors in hospitals caused 250,000 deaths annually in the United States.(2) Medical errors are becoming the third leading cause of death, after heart disease and cancer. There are an estimated two million cases of severe adverse drug reactions each year, resulting in 100,000 deaths annually.(3) This is compounded by deaths caused by drug abuse and illnesses caused by antibiotic resistance, which is implicated in one million deaths worldwide each year.(4)

The United States is the wealthiest country in the world, spending trillions of dollars each year on healthcare. Still, we can’t match the life expectancy of other countries, such as middle-income countries like Costa Rica which has an age-90 life expectancy for males.(5) The nation’s health problems cannot be solved by spending more on drugs. We can put the awe back into medicine by combining the physical and psychological approaches. We need to overcome our biases against mind–body connections to solving medical problems. We could use empathy to help patients with conditions that can’t be cured die with dignity. Now, we can respect patients as equal participants in their care. We need to arrive at the mindset that chronic medical problems aren’t just physical or psychological but often are a combination of both.

Every time I visit the doctors’ lounge, I hear so many of my colleagues complain about their practices and their uncertainty about the future of medicine. I often hear that they are discouraged by decreasing reimbursements, rising overhead costs, and diminishing incomes. However, some physicians are more optimistic about their practices and would still choose to be a part of the healing arts. After interviewing a few of my colleagues, I compiled a list of reasons to be a physician.

Physicians are fortunate to have a growing demand for our services. With the aging of the baby boomers, there will be more patients in need of healthcare.

Although many physicians have opted to be employed by hospitals, many others continue to work in small groups where they are on track for partnership and ownership of the practice. You have the luxury to control your work environment, which includes the number of hours you work each day, the number of patients you see, and the amount of vacation time you take. The stress level goes down, and the enjoyment and satisfaction from practicing medicine go up when you oversee the practice, make the decisions, and are your own boss.

It is amazing how many doctors complain about their incomes. If one compares the average physician’s salary with those of other professions, one finds that doctors are close to the top. The average physician made more than $300,000 in 2023.(6)

In medicine, there is no forced retirement. For the most part, the work is not physically demanding, and a man or woman can work well into their 80s. The other unique feature of medicine is that if a doctor cannot afford to retire, they can still supplement their income by continuing to practice part-time. Many physicians choose to work as locum tenens and have the luxury of accepting or rejecting a job whenever and wherever they want.

Many physicians enjoy the lifestyle benefits of our profession. Most physicians have regular hours, are not on call 24/7, and have a life outside of practice. For the most part, physicians can work in any geographic area they choose. They can determine where they would like to live before starting their careers. Medicine offers many unique opportunities to craft the kind of practice we most enjoy.

Restoring awe in medicine involves recognizing and emphasizing healthcare’s profound and inspiring aspects, reconnecting healthcare professionals with a sense of wonder and purpose in their work. Here are several ways to foster awe in medicine:

  • Support continuous education and learning for healthcare professionals. Explore new technologies, research, and advancements in medical science.

  • Promote a patient-centered approach to healthcare. Emphasize the importance of understanding and addressing each patient’s unique needs, values, and preferences.

  • Build meaningful relationships with your patients, fostering empathy and compassion.

  • Share success stories and positive outcomes with the healthcare community. Highlight instances where healthcare professionals made a significant impact on patients’ lives. Put these stories in your e-newsletter, blog, and social media.

  • Acknowledge and celebrate the achievements of medical professionals, not just in medical breakthroughs but also in compassionate care and patient advocacy. COVID-19 was an example of the medical profession being front and center in caring for patients during the pandemic. Physicians, nurses, and allied healthcare providers enjoyed increased respect from the public. They demonstrated how important we are in solving medical crises.

  • Remind healthcare professionals of the human side of medicine. Encourage storytelling and sharing experiences to connect with the emotional aspects of patient care. There isn’t a medical practice that doesn’t have an awe-inspiring story that needs to be told.

  • Foster a supportive and collaborative work environment that acknowledges the challenges faced by healthcare providers and promotes resilience. Now is the time to demonstrate diversity, equality, and inclusion in our profession.

  • Support and invest in medical research and innovation. Showcase the exciting developments and breakthroughs happening in the field. Be an early adaptor in the use of technology in medicine. Telemedicine is an example where we have learned that we can treat patients safely and effectively without touching the patient. Now is the time to participate in research and innovation, providing opportunities to contribute to advancements in medical science. If you are in private practice, you can participate in clinical research.

  • Integrate mindfulness practices into medical education and daily routines. Share your experience with mindfulness with your patients. Encourage healthcare providers to take moments for self-reflection and appreciation of their impact on patients’ lives.

  • Create opportunities for dialogue and discussion about the ethical and philosophical aspects of medicine.

  • Engage with the community to raise awareness about healthcare and its importance. Create initiatives that promote health education and preventive care. Participate in screening programs in your community.

Finally, we must recognize the importance of mental health, and that physicians are susceptible to the same concerns regarding anxiety, depression, and even suicide as our patients. Implement measures to reduce burnout and stress, fostering a healthier and more fulfilling work environment. This means encouraging a healthy work–life balance and providing resources for mental health support.

Bottom Line: By implementing a few of these strategies, the healthcare system can create an environment that fosters awe, inspiration, and a sense of purpose among medical professionals, ultimately improving patient care, increasing overall well-being in the medical field, and preventing burnout.

References

  1. Gøtzsche PC. Deadly Psychiatry and Organised Denial. Denmark: ArtPeople; 2015.

  2. Kavanagh KT, Saman DM, Bartel R, Westerman K. Estimating hospital-related deaths due to medical error. J Patient Saf. 2017;13(1), 1-5. https://doi.org/10.1097/PTS.0000000000000364

  3. Ray SD, ed. Side Effects of Drugs Annual: A Worldwide Yearly Survey of New Data in Adverse Drug Reactions. Elsevier; 2021.

  4. Salam MA, Al-Amin MY, Salam MT, et al. Antimicrobial resistance: a growing serious threat for global public health. Healthcare (Basel). 2023;11:1946. https://doi.org/10.3390/healthcare11131946

  5. Rosero-Bixby L. The exceptionally high life expectancy of Costa Rican nonagenarians. Demography. 2008;45:673-691. https://doi.org/10.1353/dem.0.0011

  6. Kane L. Physician compensation reports for 2023. Medscape. April 14, 2023.

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