Are We Putting Excessive Pressure on Our Doctors?

According to the American Association of Medical Colleges, the United States will face a major healthcare threat within the next decade: a significant shortage of qualified medical professionals. The AAMC predicts that by 2025, US healthcare systems will be short approximately 130,600 physicians needed to meet growing patient demand. As hospitals face a potentially dire doctor deficit, experts are posing a key question: are we putting unreasonable amounts of pressure on our healthcare providers? Innovation advocate Dr. Noah Minskoff, life coach Viraj Yadav, and emergency physician Leana Wen weigh in on some of the largest challenges facing healthcare professionals, and the large-scale changes required to overcome them.

Rigorous Educational Requirements, Demanding Workday Hours

The Bureau of Labor Statistics reports in its Occupational Outlook Handbook that physicians and surgeons must adhere to rigorous requirements during educational and practical career preparation. Virtually all health professionals face 8 years of undergraduate and medical schooling coupled with a 3- to 8-year residency or practical internship. Even a basic healthcare education includes “undergraduate work in biology, chemistry, physics, mathematics, and English,” a course load that may scare away potential physicians and surgeons when contrasted with the lighter requirements offered by non-medical degree programs.

According to the Bureau, students will begin to experience the pressures of their future profession while they advance their educations. “Medical schools are highly competitive,” the Bureau reports, and schools tend to weigh not only educational performance but also letters of recommendation, extracurricular, and even personality traits. That means that students who are entering an undergraduate program at age 18, 19, or 20 must be willing to tackle the practical rigors of screening and job applications long before the majority of their peers.

Resistance to Innovation

Dr. Noah Minskoff, a physician who works primarily with biotechnology and consumer-facing healthcare, believes that administrative red tape prevents the sort of large-scale industry innovation that would drive better performance and lower rates of dissatisfaction among doctors. “There is so much pressure on the healthcare system to increase efficiency and reduce cost,” says Dr. Minskoff. “Organizations expect a physician to carve out time, money, and energy to bring better tech to a patient, in a time when doctors are also expected to see more patients than ever before, and in less time than ever before. It’s no wonder there’s a lack of broad physician-driven innovation in healthcare.”

Dr. Minskoff believes that increased administrative management in the healthcare field has led to a defensive style of delivery. “There’s been a shift towards a practice of evidence-based medicine, which begins to look a lot like evidence based defensive medicine,” he notes. “That tendency might have closed some inroads for innovation.”

From a practical perspective, Dr. Minskoff notes that physicians are increasingly instructed to use scholarly articles or studies to drive their patient decisions. As a result, he sees “an enormous resistance in trying something new or innovative” among practicing physicians.

Stress and Daily Pressure

Viraj Yadav, a life coach and member of the British Psychological Society, believes that modern doctors face levels of daily pressure that are difficult for non-medical workers to comprehend. “Doctors face extraordinary amounts of stress on a daily basis,” Yadav writes, including “traumatic situations and life-altering events.” Yadav believes that even for medical professionals working in top-of-the-line facilities, “stress is the one threat that can never be avoided.”

He notes that stress buildup brings along with it “a recognized pattern of behavior” that includes constant fatigue, short-term memory loss, perpetual anxiety, and irritability. Along with these consequences come a host of physical issues, including high rates of substance abuse, illness, and depression, that can potentially de-rail medical professionals, forcing “many talented and compassionate doctors out of the field of patient care” altogether.

According to Yadav, significant daily stressors include frustration with the overall healthcare system, administrative red tape, and a lack of support from healthcare executives.

Combating Doctor Burn-Out

The emotional and physical demands of the healthcare profession are clear. As the need for physicians increases, what can be done to prevent these burdens from weighing down top physicians and scaring away young medical professionals?

According to emergency physician Leana Wen, increased emphasis on transparency and trust may alleviate doctor stresses while increasing patient care quality. “That openness, that trust [between doctors and patients], is only going to be more important as we move from the infectious to the behavioral model of disease,” says Wen. Better relationships between patients and their medical caretakers may improve physician job satisfaction while empowering healthcare systems to better accommodate patient needs.

Wen recognizes that transparency is an intimidating concept for physicians and healthcare conglomerates alike. “You feel naked, exposed, and vulnerable,” Wen admits, “but that vulnerability, that humility, can be an extraordinary benefit to the practice of medicine. When doctors…show our patients who we are and what medicine is all about, that’s when we begin to overcome the sickness of fear.”

Life coach Viraj Yadav believes that doctors can combat job pressures by upgrading a few key daily processes. Yadav recommends relaxation techniques, including creative visualization, yoga, and exercise, to keep daily stress at a manageable and healthy level. Yadav also recommends “behavior changes such as improving skills in communicating, negotiation, expressing feelings,” and time management to help physicians feel supported and respected. Viewed through Wen’s lens of transparency, Yadav’s suggestions must be implemented by healthcare organizations at the highest level to ensure that professional efforts to decrease stress are supported from the top down.

The AAMC highlights a few practical considerations for lawmakers. “America’s medical schools are increasing their enrollments…[and] students have responded with applications and enrollments reaching new highs,” the AAMC notes. According to the organization, to retain these positive trends, “Congress must do its part by lifting the cap on the number of federally supported residency training positions.” The AAMC notes that lawmakers must “act now” to increase residency programs and drive new applicants towards the medical field, particularly in light of projected physician shortages within the next decade.

Dr. Noah Minskoff, who is currently the COO and CSO of medical tech develop company InnovoSciences, believes innovation is the key to increased physician support and satisfaction. “Right now, we look backwards to find the formula that answers the question, how do I treat this patient?” Dr. Minskoff notes. “That has slowly whittled away the inventive spirit of medicine in general. Administrators must begin to prioritize, support, and reward innovation. Innovative healthcare solutions will only lead to positive developments for overworked physicians as well as underserved patients.”

Despite mounting physician pressures and a threatening increase in doctor demand, Dr. Minskoff believes that through innovation, a revolution in healthcare remains a viable possibility. “This change is possible, and essential, to the future of healthcare,” he says.