About
What's wrong with medicine?
Burnout is a part of modern life. All working adults experience job-related stress, but the intensity and the consequences of physician burnout are alarming. The exact numbers vary, but even before the pandemic half of physicians identified themselves as having at least one symptom of burnout. Burnout has three manifestations:
- Women tend to feel the “emotional exhaustion” that crowds out every aspect of life.
- Men tend to “detach emotionally” from the human beings in front of them.
- Many feel a “sense of hopelessness” – feeling that their training, their sacrifices, and their sincere best efforts aren’t enough to make a difference in the lives of their patients.
What our patients don’t realize is that burnout is eroding physicians from the inside out. Inside many of us is a war. We cherish the craft of medicine and the trust our patients place in us, but we resent the administrative aspects of American medicine. Patients rightly feel rushed in their few minutes with us. They have no idea that we might spend twice as much time documenting the visit, justifying our reimbursement, and haggling with insurers. In no other industry is the most highly trained individual responsible for most of the data entry. The fact is, precious little has been done to address the system-level changes needed to improve physicians’ experience and strengthen the physician-patient relationship.
How are physicians responding? We grin and bear it, we change locations, we reduce our hours, and we quit. In the piecemeal, profit-driven American medical ecosystem, the patient-physician relationship is undervalued and each physician is replaceable. The well-being of physicians does not seem to be a priority.
Problems intensified by pandemic
In 2009, the swine flu epidemic revealed how unprepared health systems were to protect their staff. Unsurprisingly, in 2020, hospitals could muster only adequate PPE for their physicians and staff.
In the first months of the pandemic, physicians and staff encountered unprecedented trauma. Many doctors spent weeks away from their own families to stay on the front lines. Some physicians were required to work in areas outside of their training. Others were furloughed and forced to abandon their patients. Many physicians quit. Too many physicians died.
Burnout vs moral injury
Wisely, Canada has quantified the cost of physician attrition. Unlike the US, the Canadian government funds medical education, so the government expects a certain number of decades of work in return for the investment. Millions of Canadian dollars are lost when physicians reduce their hours and retire early. And retire early we will. Studies confirm that physicians who intend to reduce their hours or quit will do so within two years.
Physicians nationwide are fed up with the increasing burden of maintaining board certification, the lack of transparency in state medical boards, and the anti-competitive hospital systems that monopolize communities. Physician autonomy is at an all-time low. We are pressured by our employers’ attention to the bottom line and by unsafe metrics such as patient ratings. But it’s not just about us.
Daily, we physicians witness the disparity between what is and what should be. We know how many amputations could be avoided if diabetic patients could get the insulin pump for which their insurance refuses to pay. It pains us to learn that some of our (insured) patients are forced to choose between paying their bills and paying for the medications we prescribe.
The term “moral injury” is more accurate than “burnout” in describing the heartache that physicians and medical staff endure. This chasm between what is and what should be is wider than ever.
Physician seekers and influencers
In my view, there are two groups of physicians. The first is questioning their current careers while the second has discovered answers for themselves.
“Physician seekers” might want to learn how to add a side-gig to their existing medical career, how to open a med spa, or how to negotiate their hospital contract. In my experience, neither search engines nor social media groups offer sufficient depth, variety, and/or anonymity for these physicians with questions.
“Physician influencers” are medical doctors as well as entrepreneurs, coaches, and podcasters (to name a few). Each has a unique point of view that represents a subset of physicians. We were trained to “see one, do one, and teach one” and this is precisely how we are supporting each other. The number of physician influencers grows each year, thanks to the work of pioneering physician coaches and conferences.
Physician seekers have more options than ever but are divided by specialty, by generation, and by preference for social media platforms. THE PHYSICIAN PROJECT is designed to bridge the gap between physician seekers and physician influencers, for their mutual benefit.
Why The Physician Project?
I am neither a coach nor a social media maven. But I do possess certain qualities that make me suited to tackling this challenge.
I’m both a seeker and an influencer. I can relate to different perspectives. Being multiracial, I have never fit neatly into any category. In college I took all sorts of classes, enjoying environmental justice as much as human virology. Even now, I have one foot inside medicine and one foot outside. While I treasure the teachable moments with my patients, I’m frustrated by the American medical model that is unable to prioritize holistic wellness and longevity of patients and providers.
This dual motive is at the heart of my business model: I genuinely want physicians to find support as much as I want physician coaches to reach more clients. I intend for both physician seekers and physician influencers to us THE PHYSICIAN PROJECT free of charge. No commission will be levied on influencers and no premium features will coerce money from seekers. Who pays, then? I plan for advertising to sustain the site.
I’m ridiculously thorough. I prefer to work behind the scenes, get to the bottom of something, then share it with others. In med school, I loved microbiology despite its being taught at warp-speed in Spanish (I am not a native Spanish speaker.) After each lecture, it took me hours to type and organize my notes, but it helped me learn and I was happy to share with my classmates.
I’ve been exploring resources for physicians since 2011. Since my residency, I have been trying to find alternate career paths for myself. I began accumulating physician-oriented resources then shared them with friends who had similar interests. This collection became the foundation for The Physician Project.
I crave meaning. I feel most fulfilled when I can translate my experiences into something useful to others. Many of my experiences during my training were harsh and disappointing. I struggled, feeling like a cog in the system.
I cherish any opportunity to mentor trainees. I can truly empathize with students and residents. Being a sounding board as they process their thoughts and navigate the system, makes my ordeal worthwhile.
I’ve got time. I have chosen to work part-time. I feel privileged to be free to invest my energy as I wish.
I considered becoming a coach but realized that I wanted a more macro approach. I admire the additional time and money that physician coaches have invested and the incredible impact that they make. What suits me is to be a virtual guide. I want to point curious physicians toward these fantastic coaches in an organized and interactive way.
Website in beta
This entire website is completely DIY! I discovered that it was within my power to build an online database where physicians could browse topics of particular interest to them. I’m still astonished by what I can figure out on my own, thanks to WordPress and YouTube.
In March 2020, I bought the domain and made my first attempts at designing the site. In 2021, I added the learn page which allows physician seekers to browse by category and topic. In 2022, I developed the share page which allows influencers to add themselves to The Physician Project. In 2023, I worked to allow influencers to update their own content and promote their events. As of 2024, I’m refining the website with the help of physician influencers who I met through the Leverage and Growth Summits hosted by Dr. Peter Kim.
We physicians are in this together
We physicians have a powerful shared experience, yet historically we haven’t been very good at supporting each other. But this is changing. I’m heartened by the increase in physician solidarity and empowerment, and I look forward to contributing to it.
My role is to promote existing resources that might make the journey less onerous for trainees and less isolating for physicians. Stay tuned as I develop a platform where physicians inspire each other.
Carmen Joy Holmes, MD
Revised August 2024
My haiku dabblings
What we do is… wow.
Both mundane and heroic.
Indescribable.
1/2024. It’s the human connection that we make with patients is what makes medicine special. The same is true for anesthesiologists and urgent care doctors.
Multifaceted.
We are more than just doctors.
Creative humans.
8/2024. Inspired by The Physician Accelerator Summit by Peter Kim, MD