Consider me just another statistic – a doctor who chose to leave. Health care is experiencing an alarming attrition rate with 1 in 5 leaving their jobs, according to a survey released last October by Morning Consult. Many are choosing to leave their career fields entirely. Others are seeking to construct a more balanced job model for themselves. After practicing primary care medicine in my Brunswick-Topsham community for over 20 years, I resigned from my practice in March, choosing to preserve my mental and physical health.
I agonized about the decision, knowing that the health care industry had not yet hit rock bottom. Unfortunately, systemic and seismic changes would not be made at a pace that would leave me satisfied. It was hard practicing medicine day in and day out in an environment where colleagues and staff were burning out and demoralized. The office was constantly understaffed because of illness and staff shortages. Pleas for help and talk of wellness with the administration were mostly just that – talk. No concrete improvements made.
What is driving hardworking, conscientious doctors out of primary care medicine? The health care industry was already overburdened and understaffed before March 2020, when COVID turned the health care world upside-down. Gaps in the health care system became magnified and glaring inadequacies, shortages and obstacles to health care became evident.
The past two years were extremely challenging to navigate in health care. Initially I was concerned about contracting COVID and, even worse, possibly spreading it to my family. Every morning during this pandemic, a flurry of hospital administration emails accompanied my first cup of steaming coffee. These emails were full of new data on the number of COVID patients in our hospitals, communities, state, nation and world. There were details on how to deliver and bill for health care. There were new guidelines on masks, protective eyewear and gowns and new screening questions in order for patients to gain admission through our front door. Thirty minutes later, my coffee was cold.
Telehealth became part of our lexicon and a new care delivery model. This required technological competence and put up yet another barrier between my patients and myself. As the pandemic continued, some of us retrained so that we could assist in the emergency rooms and on medical floors in case the system and our colleagues became overwhelmed. Many of us were happy to volunteer in the vaccine clinics. This was one of the few gratifying moments, as we saw the hope in our patients’ eyes after months of fear.
The pandemic served as a breaking point for those of us who watched hospital administrations pare down ratios of nursing staff, medical assistants and receptionists to providers. Employees are overworked, overwrought and exhausted. There is no live voice at the end of the line when the patient calls the office – only a string of prerecorded triage messages. When the patient finally gets an appointment, they have 15, maybe 30, minutes to race through their concerns. The electronic medical record has exponentially increased physician workloads. Physicians manage emails, messages and paperwork proliferation in off hours and weekends and are urged to churn out patients so that the hospital can maximize their payments.
I remain ambivalent about my choice to leave medicine and my patients, but I am optimistic that new opportunities exist for me. Perhaps I will volunteer in another country and reinvigorate my passion for my profession and my patients. I will not miss the onerous documentation and administration hassles. My belief in my colleagues and profession is unwavering. The trust and confidence that patients place in their primary care doctor are something that few professions enjoy. I hope that hospital administration, insurance companies and consumers see the value in this relationship. Nurturing and prioritizing this sacred primary care physician and patient relationship would allow for mutual happiness for myself and patients and better health care outcomes.
Send questions/comments to the editors.
