Eighteen years ago I had a discussion with a practicing gynecologist in Auckland, New Zealand about my future studies and the best career choice to “secure” my future. I had multiple options at that time in different countries. The options were medicine, dentistry, pharmacy and engineering. I also had a shot in getting into biomedical science and getting involved in research. His reply was “less than 2% of doctors live an uncomfortable life in any country in the world.” Despite my skepticism in that statistic, his statement strongly influenced my decision to choose medicine.
Today, as a practicing physician who reached his American dream, I wish I had asked that gynecologist one more question related to the price we pay to reach that goal. When I compare medicine to other professions, we do have the respect, income and satisfaction of helping others who are in need. The first two are eroding slowly as medicine is advancing to a business model where the bottom line is all that matters. What usually marks my day, however, is a hugging child who comes with his parent to say thank you. For me, such a result is unexpected and lasting, and it is the best part about being a pediatric emergency medicine physician.
But these rewards come with a price tag, and a hefty one that many of us are unaware of when we make the decision to choose medicine.
Despite being the leaders in advocating for health, the majority of physicians live an unhealthy lifestyle. We are overloaded with caffeine to overcome the chronic fatigue we experience. Our busy schedules prevent us from regular exercise. Our changing shift times keep our bodies in a state of chronic jetlag. How many times have we not been able to use the restroom during a shift? How many times have we been starving and have settled for something like a slice of pizza or french fries? Some physicians I know use alcohol regularly to relax after a long emergency room shift. Others I have seen experience family and personal turmoil. How healthy and stable is that?
The Mayo Clinic published a study that surveyed a large sample of US physicians about burnouts and work-life balance. The study identified emergency physicians as the specialty with the highest rate of burnout. It also revealed an alarming 38% depression rate and 6.4% of physicians experience suicidal ideation. The study concluded that medicine can be personally fulfilling, but it also can be extraordinarily demanding and stressful. Many physicians experience professional burnout syndrome (emotional exhaustion, depersonalization and a low sense of personal accomplishment). This burnout can influence professionalism and quality of care, and it can increase the risk of medical error. It also can lead to personal problems, such as broken relationships, problematic alcohol use and suicidal ideation.
Is pediatric emergency medicine different? While a study described our specialty as having the highest level of satisfaction, we are not immune from these adverse outcomes. We are unique in treating a more joyful, healthier population (children) with complaints that are more easily resolved. These factors can provide a sense of being effective. But we need to be the guardians of our own health and wellbeing.
What are your experiences? Please share your comments, experiences and ideas about this topic.