American Academy of Emergency Medicine

Personal View on Burnout

Read Dr. Walker's article on page 4.

Dear Dr Walker:
I read your editorial regarding a "Personal View on Burnout" and wanted you to know that it has been reassuring that I was not the only one out there with the same feelings and experiences. I left full time practice of EM in July of 2012 after nineteen years as an "ER doc". I was in academics for seventeen years. I worked the past two years for a great bunch of ER doctors, a fourth of which I had trained with or trained them during their EM residency. After leaving EM, I worked from home for a private audit company on the East Coast for three months and decided it was too mundane for me. I have since worked in an Urgent Care working four to eight shifts a month.

Thank you for putting this into words as I hope other physicians will read it and perhaps find a way to salvage their future with the help of their colleagues and family.

Best Regards,
Norberto Adame, MD FAAEM

Dr. Adame:
I am glad my editorial helped. Rest assured that you are far from alone. It frightens me that colleagues twenty years younger than you and I feel the same way we do. It is time emergency physicians and hospital administrators realized that most burnout isn't due to a flaw in the physician. It is because of a badly flawed system in which the doctors and nurses who work in the ED and know best how it ought to work, have the least authority to affect how it does work. Burnout is the inevitable result when good people who aspire to excellence are working in a system that actively pushes them away from excellence, and then blames them for not achieving it.

On a more optimistic note, I seem to have recovered from my burnout and now look forward to going to work again. I am working just 72 hours a month, which helps by itself. More importantly, I believe, I am working in an ED with much better EMR and CPOE software than previously, and with much lower patient volume. I now have time to relax and talk to patients, concentrating on them rather than charting, without feeling crushing pressure to "move the meat" because patients are getting backed up. The majority of my patients still don't have acute injuries or serious medical problems, and many of them are still substance abusers, but that doesn't bother me as much now that I can take the time to see them as human beings, rather than a problem to be checked off my to do list.

-Andy Walker

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