Portland Direct Primary Care
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Beyond 7 minutes

I trained as a Family Doctor so that I would be ready to help patients with any challenge. The old school family doc used to take that skill set out into the community on house calls, sports sidelines, and town hall meetings. At some point the job description was boiled down into a job that started and ended with a 7 minute office visit. That setup is not good for patients, and it's not good for doctors. In this column I hope to start to push the boundary of where the doctor patient interaction takes place - onto the page, into the community, and beyond 7 minutes.

A Firsthand Perspective on Physician Burnout

Residency training is between 3 and 7 years. All Resident Doctors carry a medical

degree and have passed all the necessary training to provide medical services. In

fact step into any major hospital in the US and your treatment from start to finish is

likely to be carried out by a resident doctor.

Some might question how someone could become burnt out only 3 years into a

career that is supposed to last decades. Picture this: 28 of your last 30 days have

been spent in the hospital. Each of those days has consisted of waking up at 5AM

and facing one life-threatening crisis after another. After about day 14 of this you

think, “I’ve hit my breaking point.” The day consists of working, sleeping, and eating

in that hierarchy. You do this willingly day after day, year after year because that is

what doctors do. And after you think you’ve found a balance, where this just might

be sustainable, something breaks.

For me that breaking point was my Grandma getting critically ill. She was in the ICU.

It doesn’t take a doctor to know that it isn’t good news. Everyone processes these

kinds of things in a different way. I went to the chapel, closed my eyes and cried. I

cried for my grandma. I cried for my family who was about to enter a medical

system fraught with hard decisions that is all too often not personal. I cried for

myself because I was at the edge and I truly felt I had nothing left to give.

I am incredibly lucky to have a supportive family as well as colleagues. I write this to

illustrate that one unpredictable event in a physician’s life can push them from what

is already a stressful job over to the point of burnout. For me this story has a happy

ending. My Grandma is OK, she made it out of the hospital. I’m also OK. I have

chosen a career outside the hospital in Direct Primary Care where I have more

control over my hours and stress level. History has shown that the same cannot be

said for other Resident Doctors in my position experiencing burnout.

Being a doctor is a privilege and an honor. We do not deserve special treatment. In

fact, I think that we need better working conditions for all people. I can only speak

from my experience in my chosen career. At the very least there needs to be a shift

to accommodate bereavement time for physicians who find themselves in a position

such as mine. We should not encourage a system that pushes physicians to the point

where they are only one family crisis away from going over the edge of critical

burnout. It happened to me, I know it has happened to others, all I can hope is that

future generations of healers my have more protections than we do now.

A version of this story was also published in the June edition of the West End News

Oren Gersten, MDDPC, physician burnout, primary care, direct primary care