Just as we begin to exit the latest surge of the global COVID-19 pandemic another challenge to health care is appearing—the efforts to combat physician burnout. One example of a proposed solution is the Clinician Experience Project, which is now marketed to improve health care organizations’ patient satisfaction scores. In the midst of the worst global pandemic in 100 years, it is widely recognized that physician burnout is a widespread problem. Maybe you achieved a new high score on the burnout survey? Possibly you feel undervalued and overworked? Depressed? Considering early or premature retirement? Worse yet, profound despair and discouragement? Without question, stress, anxiety, and physician burnout are real, pervasive problems in medicine only worsening in the last two years. The solution: “There is an app for that.” All we need to do is download the app, follow its directions, and we will enjoy a transformative experience that will allow us to re-ignite our passion for medicine, once again enjoy the privilege of being a physician, and form deep meaningful connections with patients and colleagues. I personally don’t believe any of this. In my opinion, this is yet another way for some physicians to monetize giving advice to other doctors instead of taking on direct patient care, which is much messier and more difficult. The app, marketed and sold to health systems, is intended primarily to improve patient satisfaction scores, referred to as “star ratings.” It is promoted as a tool to enhance physician wellbeing. In previous presentations by the creator, it has been suggested that we as physicians need to listen, adapt, be compassionate, lead, communicate, be good stewards, work well with others, be highly efficient, care for ourselves, help others, and take ownership of our own behavior. Once again, I am reminded of the old saying, “physician heal thyself.” If we could all just concentrate on achieving these admirable characteristics, we would be happy and fulfilled, and the health system would prosper. Just another five minutes of your time every week for the next few months apparently will make it all possible. Perhaps you have mastered these qualities through mentoring, innate nature, or painful professional experience already, but if not, the app will provide all. By the way, your health system receives analytics detailing your level of participation in the program, including whether you download the app and the number of minutes you interact with it. I did wonder for a moment when continuing patient care for hospitalized and acutely ill and injured patients might be prioritized. I have already experienced the effect this indoctrination has had on medical staff members where I practice. I was recently on call and responded to a call from the emergency department when the ER physician I don’t really know first asks, “How are you doing, really”? I’m certain that when I answered, “I am miserable, I have been on call the last three days, and you are the 10th different ER doctor to call me today,” he had no idea what to make of this. His response was, “Oh, I guess I’m not helping, huh”? The gesture of asking about my wellbeing was interpreted as insincere and clearly coached as part of the program our health system recently purchased. Among the recommendations from the program is to make meaningful connections with colleagues and our patients. After completing the prescribed program of sixteen 5-minute videos, I was left with only questions. One has to wonder how many of the physicians involved in creating this “app” cared for violent criminals and drug addicts or continue to take unreferred emergency room calls? Is it wrong to be satisfied with providing the needed care in a professional manner for these patients while maintaining what I consider to be appropriate professional distance? Do we really desire to form a deep, meaningful bond with every individual we care for? If we don’t, are we now “bad doctors”? Will this enhance my personal satisfaction with medical practice or reduce my burnout inventory score? Furthermore, we are reminded to consider the privilege of being a physician. Considering that now includes being subject to online ratings, derogatory patient comments, satisfaction surveys, and angry, threatening patients, does it seem so privileged after all? I completed all of the assigned tasks associated with the program provided by my health system and found that in my individual opinion, the presentations were childishly simple in advice and inapplicable to any physician involved in hospital-based care other than those working limited shifts without additional emergency call responsibilities. I will be enjoying the comments section for a while. Source
