I’m working for a major hospital system in home health and my level of burn out is currently tremendous. Short of staffing, too much documentation, blah, blah, blah. I read about the mass exodus of doctors, nurses, etc… of recent times and the continued projected shortages in all specialties. I wake every morning repeating my mantra “just one more day”. I’m close to the edge, may even be yet this week. I’ve worked so hard to get to a place that makes me miserable. The corporate greed of today’s hospitals trying to make you feel less than for attempting to cling to ethical practice. Feeling driven into the ground with the expectation that the machine owns me. The final straw may be the letter from corporate I recently received outlining why birth control will no longer be covered under our own health plan. I just want out. Anyone else feeling the end is near?
I walked away from active pharmacy practice in 2012, when I realized it was not the profession I had trained for, and I no longer recognized it. I’m still licensed, because Ya Just Never Know, but I’ve had 100% support all along for my decision.
Sad, isn’t it?
Wow, very bold move. It takes nerve and I admire you for acting on your thoughts. Hope you landed in a better place!
I retired 9 months ago after over 4 decades in medicine, as a board certified primary care physician. Over 20 in training and the private sector, over 20 in the public sector, in state prisons. The last 28 months were during covid, where I had over 1100 of my patients test positive for it.
I was burnt out before COVID hit, in part because I was also Medical Director and having to deal with government bureaucracy PLUS private practice consultants and services, along with lack of resources to care properly for too many patients. COVID just made me extra crispy.
I despair over where I’ve seen the medical profession go over my career. Too many physicians spend more time serving the medical machine more than their patients, too much emphasis on production/revenue generation/treating the worried well with things they really don’t need because insurance will reimburse it.
Too much paperwork and meaningless clicking on computers, to buff the electronic medical record, too much having to seek approval from faceless insurance companies for referrals, procedures, tests, meds.
Not enough time with the patient. Hurry, hurry, hurry, you’ve got 5 minutes to figure out what the patient needs, then on to the next room. No, we can’t afford/don’t allow scribes or assistants to implement your directions and orders, you’ll need to do that too.
I can’t recommend primary care medicine as a career anymore either. Too much emphasis on referring patients we primary care docs could take care of, but specialists can bill more for it.
I feel for the nurses, the RTs, the medical assistants, the techs, and especially the patients whom are all too often not served well by our system of health care.
I’m very happy I’m done with it all.
Just two years behind you apparently… less burnt out. Nine years as department chair for our organization really wore on me though. Frustrating. Happily passed that torch on.
I’m not pleased always with the choices my company makes but mostly I am still enjoying time in the office, even if it gets stressful.
No plan on stopping in the near future. Figure I’ll do a temp check as I get to 70 and decide then whether to keep it up.
I retired 10 days ago from a large medical center where I worked as an RN for 36 years.
I’ve never seen it as bad as it is now. I don’t think there is an area that is not short-staffed, and there is very little administrative support because managers are given more and more areas of responsibility. It was not unusual for me to go a week or two without seeing my manager.
Add to this the fact that care is continually getting more complex, patients are higher acuity, the short-staffing vicious-cycles itself into further shortages, and the outdated, unreliable hardware and software we are tethered to means we often have to disrupt and delay care at times when we are already overwhelmed. I will let you speculate on what all this does to staff morale.
I truly feel bad for those I left behind.
mmm
I had a job that was literally killing me (among other things, I’d been in the emergency room and had lost 15 pounds in less than a month; do you have any idea how hard it is for a middle-aged woman to do that?) and I knew I would be a patient IN that hospital if I worked there another day. It wasn’t a decision made lightly, because I had moved for this job to a place where I knew nobody, and worked with really great people.
I have lived ever since in the city that I now consider my hometown, have a home-based business, and no regrets. Yeah, I’ve had people with kids say “I’d do that in a minute, but I still have to support my kids” and my response has been, “If I had kids, I would need to be healthy so I could take care of them.” One of the fix-it guys at the complex where I lived said he’d had to make a similar decision a few years earlier, after having his 3rd heart attack, so he got it. He took enough of a pay cut that his wife had to go back to work, but she had been planning to do that anyway so it wasn’t as big a change as it otherwise might have been, and everyone was much happier.
I have had cancer in the meantime, and healing emotionally from that was less traumatic than this decision was.
I have heard that nursing issues are similar to those facing teachers, and one of them is that decisions are often made by people who do not work in the field, and may never have.
Ain’t that the truth?
Congrats on making it to the finish line. I sincerely hope you are enjoying every day of your well-earned retirement.
Congrats on your retirement. I hope you, as well, find much enjoyment in your new life. You certainly deserve it.
I have a cousin. One of his grandchildren is graduating from high school this year. He’s already a registered CNA and plans on going to nursing school I’m very proud of the young man but worried for his future. I don’t want him to get frustrated, as he’s had a bad family situation I won’t go into. I do want him to be happy, he deserves it.
My daughter is a new nurse, working her first job in a hospital. She had a rough time landing this job. All the talk about a shortage of nurses…she didn’t want to hear it. She was barely getting any looks while searching around our region, and finally took an offer in SoCal. Evidently there is a shortage of experienced nurses, but no one wants to train a new nurse. She’s pretty happy so far with the work, and it lines up with what she wanted to do upon completing nursing school. But, I worry a little about the whole system and the future of the industry.
Not me, but a friend who is a nurse said she’d rather drive UBER. She’s switched to home health, wound care. Less “being yelled at” she said
Congrats to him! Unlike far too many other nurses (and other HCPs), he will know what he’s getting into.
There’s a high school in my area that also has a dual HS diploma/CNA program, and IIRC, all they have to pay for are their books, and their uniforms.
You may or may not be surprised to hear that similar issues are affecting the NHS and other public services here, and are a major factor behind the current wave of strikes, including hospital doctors and nurses.
Of course, there are some who will use that as an argument for abandoning the public service model and switching to an insurance-based system - like yours …
This has not been my experience at all. Our facility has been hiring new nurses and plunking them into PICU, something that would have been unheard of ten years ago.
Don’t worry too much. Nursing has a lot of upsides that will be to his benefit. Once he has a few years in the trenches under his belt he will have many opportunities to change his path if he wants to.
mmm
My daughter is a nurse and has been dealing with craziness since the start of the pandemic. She has learned that she is holding good cards. She (and her MD husband) work long hours for three weeks, then travel for a week with their dogs. When her supervisor tells her she can’t take a week off, she says fine, fire me when I get back. So far her job is secure.
Her husband is a doctor who graduated top in his class and is an excellent clinician. His colleagues are always asking him about their patients, and he has made some spectacular diagnoses, but he also gets critique about not generating enough revenue. He is considering some job offers.
It’s all about the revenue. I’ve seen some of the finest physicians in the nation essentially get fired because they didn’t generate enough money, even though they managed the most complex, difficult cases more successfully than anyone else.
Physicians that are not willing/able to work at top speed at all times are not popular amongst their employers, no matter how good their skills.
Use 'em up, burn 'em out, burn 'em out, use 'em up!
Raw deal!
Cut 'em up, sew 'em up, send 'em home, they’ll be fine!
Raw deal!
OTOH from the ancient days … when we were a small group practice … yeah that old … we paid ourselves based on what we produced, after expenses. We just split but if one had been producing lots more and another not much, well we would eventually have revisited. We couldn’t pay ourselves more than what we produced on net. Revenue production and comp were always necessarily tied.
Today’s comp plans are more complicated to be sure. For us it is mostly productivity based on wRVUS (for the non medical a set of measures that give work value units based on the code justifiably used, complex visit codes have greater wRVU than straightforward ones) and some for various quality measures.
Still a model not too different than we were once upon a time.
Not ideal. Of course I think I should be paid more. Of course I have issues with how wRVUS play out and how much I get paid per. And what counts on the quality metrics and how they get calculated. But a less imperfect system than many others.
Not sure what I think about salary docs thinking they should be paid the same whether they see hardly any patients or if they are seeing a full schedule.
Having moved to a salaried system, and managed physicians on that system, we did set some expectations for productivity. But given the prison setting, getting the patients to us could be challenging. You could have a full schedule, but the patient would be out to court, or in lockdown, or off on a job despite his appointment, or just refuse the appointment.
Many of us in that setting did accept a lower salary than our peers in private practice, because it did ease certain stresses and made for a more manageable lifestyle. We had plenty of other stresses associated with working for the government in a prison.
And there was friction at times, when some docs discovered they were working harder than their peers for the same salary. Government pay rules made it hard to give bonuses, but we did approve overtime for some of those folks. And docs that wanted to make more could take more call (all done remotely) which gave extra reimbursement. But it was still a mess.
But in the ancient days, a lot of physicians actually enjoyed a lower pace, more time with patients etc. and accepted their lower reimbursement in exchange for it. It got tougher to do that as time went by, with malpractice insurance rates based on specialty and not on production and other factors. But it was still nice.
We lost a developmental/behavioral pediatrician with decades of experience (board certified) from my private practice because he felt he couldn’t properly take care of patients in the timeslots he was allowed, so our system let him go. A great loss, IMHO.
I don’t know what the ideal system is, but this sure ain’t it, either in the private or public sector. At least in my experience. I do know some folks who are relatively happy in their particular situations, and more power to them. I’ve really only personally experienced the erosion of physician flexibility in these areas.