Focus on Physicians:
Insights, Ideas, and Strategies
Creating Boundaries and Reclaiming Values: My Podcast Appearance on Dr. Bill Lombardi’s Journey to Better
I recently had the great privilege to be invited back to trail-blazing cardiologist Dr. Bill Lombardi's Journey to Better podcast. This is truly one of the best physician-focused podcasts out there.
Bill is a fantastic and thought-provoking interviewer! We discussed a wide range of issues facing physicians today, including the importance of setting boundaries, the crucial role of effective and engaged leadership, and how coaching can work for physicians dealing with challenges of transitions, time management, and leadership opportunities.
I recently had the great privilege to be invited back to trail-blazing cardiologist Dr. Bill Lombardi's Journey to Better podcast. This is truly one of the best physician-focused podcasts out there.
Bill is a fantastic and thought-provoking interviewer! We discussed a wide range of issues facing physicians today, including
⚕️The importance of setting boundaries
⚕️How to integrate the experience of the arts into medical practice
⚕️The crucial role of effective and engaged leadership
⚕️Why defining your personal values can help you to make better decisions for yourself and your practice
⚕️How coaching can work for physicians dealing with challenges of transitions, time management, and leadership opportunities.
You can find our conversation wherever you get your podcasts, including Spotify and Apple Podcasts, or take a listen below. And if you want to listen to my first podcast appearance on the show, you can find it here.
Physician Stress and Burnout: How Mindful Coaching Can Help
Physician burnout is not a new phenomenon, but over the past several years, it has become a true epidemic.
It feels disingenuous to tell physicians to get a grip by doing yoga and meditating. Clearly, we are not going to yoga our way out of this mess. And hospitals and healthcare systems need to do more than offer lip service.
But in the meantime, coaching can help physicians create a more comfortable work-life balance, find greater meaning in their professional lives, or make a well-considered transition to a new position or profession.
An earlier version of this article appeared on this website in December, 2023
Although physician burnout has probably existed for decades, it’s only recently that it has taken on the notoriety of an epidemic. A visit to PubMed.gov tells the story. In 2024 alone, 872 academic papers were published on physician burnout. Compare that to just 129 in 2011—or 4, the year I entered medical school in 1984.
Many factors have contributed to the rise in burnout, both inside and outside the institution of healthcare. Some are relatively new, such as the rapid rise of disinformation and disrespect, while others, including diminishing reimbursement for services and corporate takeover of practices, have been slowly gathering momentum. For years no one talked about it. Today burnout is out in the open, yet a clear path to meaningful prevention remains elusive.
What Burnout Really Means
The term “burnout” itself may sound a little nebulous, but there are methods to measure and define it.
The Maslach Burnout Inventory defines burnout as “a psychological syndrome” that occurs among people who work with others—particularly in high-demand environments such as healthcare.
The key symptoms?
🩻 Emotional exhaustion – feeling like you’ve got nothing left to give
🩻 Depersonalization – distancing yourself from patients, often with growing cynicism
🩻 Reduced personal accomplishment – feeling ineffective, even hopeless
Although it can give you the blues, burnout isn’t a psychiatric disorder. It’s a normal human response to an abnormal, high-stress environment.
We all have tough days, so how can you recognize burnout? One important clue is that when these symptoms become persistent and all-consuming, burnout is likely at play.
The Data Behind the Epidemic
A 2023 Mayo Clinic survey of over 7000 US physicians found that more than 45% reported symptoms of burnout. That’s down from the pandemic high of nearly 63% in 2021—but still higher than pre-pandemic levels.
Burnout rates were highest in:
🤕 Emergency Medicine
🤕 Internal Medicine
🤕 Neurology
Other studies have shown elevated burnout in
🤕Critical Care
🤕Ob-Gyn
🤕Infectious Disease
🤕Family Medicine
It was notable that in the Mayo study, subspecialty surgeons reported lower-than-average rates.
Risk factors: Not Just About Workload
The biggest contributors to burnout will sound familiar to anyone in healthcare.
⭕ Bureaucratic tasks
⭕ Lack of respect
⭕ Long hours
⭕ Lack of autonomy
These align closely with the six factors associated with workplace stress identified by the British workplace health and safety regulatory agency:
⭕High work demands
⭕Low control over workload and process
⭕Inadequate support from management and colleagues
⭕Poor workplace relationships
⭕Lack of clarity regarding professional role and responsibilities
⭕Poor management of change within the organization
Personal factors matter too. The Mayo Clinic study found that women physicians are about 30% more likely to report burnout. And those with strong support at home—often reflected in marriage status—tend to report lower burnout rates.
Why This Matters: Beyond the Statistics
Burnout doesn’t just make you miserable. It affects your confidence, your relationships, your clinical decision-making, and your ability to experience meaning at work.
And while it feels like everyone is talking about burnout, it often seems like nothing is being done about it.
Which brings us to the next question: What can we do?
Beyond Bubble Baths—Real Tools to Tackle Physician Burnout
We’re not going to yoga or om our way out of this mess. It’s a far more tangled web than that.
And let’s be clear: the responsibility to fix burnout should not rest on the shoulders of burned-out physicians. We wouldn’t expect that of our patients. The source of suffering needs to be addressed before meaningful change can happen.
To ensure sustainable and high quality care for patients, including an engaged and committed medical staff, healthcare systems must lead the charge in addressing root causes. But while we wait for structural change, there are tools that can make a meaningful difference. Among the most promising? Mindfulness and coaching.
Mindfulness: More Than a Buzzword
Mindfulness is often dismissed as fluff—but it’s more than the popular notions of deep breaths and apps.
As a certified mindfulness meditation teacher, I define mindfulness the way my mentor Sean Fargo does:
“Paying attention to the present moment with curiosity and non-judgment.”
It’s not about escaping stress, but building awareness of how we relate to it. In other words, it’s about simply being present.
This sounds nice, but how can it possibly help you overcome the powerful forces that lead to stress and burnout?
In a 2020 meta-analysis of randomized controlled trials involving medical students, mindfulness programs led to significantly lower stress scores—even months later. Techniques included:
🌻Body scans
🌻Awareness of thoughts and emotions
🌻Breathing exercises
🌻Walking and sitting meditation
🌻Group sessions and mobile apps
Most programs were once weekly group sessions, while one used a mobile app.
Mindfulness isn’t magic. You won’t suddenly be living in a blissed-out state of ease. But mindfulness can create a powerful shift in your patterns of thought and open possibilities for new and supportive ways to navigate stressful environments.
Coaching: A Practical, Personalized Intervention
Coaching offers another evidence-based path forward—one that’s personalized, practical, and action-oriented.
In a 2019 randomized trial from the Mayo Clinic, physicians who received six coaching sessions by phone experienced:
📞17% drop in burnout (vs. an increase in controls)
📞20% drop in emotional exhaustion
📞Improvements in job satisfaction, engagement, and meaning at work
Other studies, including one from Duke University, have shown benefits for physicians at all stages—from residents to senior leaders.
Coaching gives you a supportive structure to clarify your values, reset your goals, and regain agency. Sometimes, that means discovering a way to achieve a better balance in your current role. Other times, it means exploring new positions. For some, it means leaving clinical practice altogether.
Mindful Coaching: Where Awareness Meets Action
When mindfulness and coaching intersect, physicians get the best of both worlds:
❇️ Awareness of what's depleting your energy
❇️ Clarity around what matters most
❇️ Practical tools for taking aligned, meaningful action
This is not about telling physicians to fix themselves. It’s about providing a safe space to reflect, reset, and reconnect with purpose..
A Call for Change
Although mindful coaching can help you rediscover your own strengths, burnout is not a failure of individual resilience. It is a consequence of a system that demands too much and gives too little. But within that system, you can still reclaim clarity, agency, and connection through personalized support that connects with your own value system and aspirations.
Systemic change is essential, but it begins with the individual. When you advocate for your own well-being, you’re also shaping a more humane and sustainable future for healthcare.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
References
Berg, S. (2021). Q&A: Clearing up confusion on physician burnout and depression. American Medical Association
Christensen, A. J. et al. (2023). Addressing Burnout in the Primary Care Setting: The Impact of an Evidence-Based Mindfulness Toolkit. Military medicine, 189(Suppl 1), 64–70. https://doi.org/10.1093/milmed/usad277
“Death by 1000 Cuts”: Medscape National Physician Burnout & Suicide Report 2021. (n.d.). Medscape. https://www.medscape.com/slideshow/2021-lifestyle-burnout-6013456#3
Drybye, L.N. et al. (2019). Effect of a professional coaching intervention on the well-being and distress of physicians: a pilot randomized clinical trial. Journal of the American Medical Association Internal Medicine
Garcia, C. L. et al. (2019). Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Medicina
Hathaisaard, C. et al. (2022). Mindfulness-based interventions reducing and preventing stress and burnout in medical students: a systematic review and meta-analysis. Asian Journal of Psychiatry
Health and Safety Executive. (2019). Tackling work-related stress using the management standards approach
Kane, L. (2022). Physician burnout and depression report 2022: stress, anxiety, and anger. Medscape
Maslach, C. et al. (1997). The Maslach Burnout Inventory Manual
Schneider, S. et al. (2014). Physician coaching to enhance well-being: a qualitative analysis of a pilot intervention. Explore
Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Wang, H., Carlasare, L. E., & Dyrbye, L. N. (n.d.). Changes in burnout and satisfaction with Work–Life integration in physicians and the general US working population between 2011 and 2023. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2024.11.031
Physician Coaching or Mentoring: What’s the Difference?
As a physician coach, I am often asked to explain the difference between coaching and mentoring.
The main difference is this: A mentor generally acts as an advisor. A coach does not give you the answers, but will collaborate with you to help you find and follow your own path.
An earlier version of this article appeared on this site in May, 2023.
As a physician coach, I am often asked to explain the difference between coaching and mentoring. It’s an important question, because both options are designed to get you from one place in your professional life to another. And sometimes a combination of both coaching and mentoring can be helpful. In this article, we’ll go over the differences between the two, and how each can help you to achieve your goals and dreams.
Coaching vs Mentoring: The Core Difference
The main difference is this: A mentor generally acts as an advisor. Since mentors usually have seniority and deeper experience in your area of interest, it is assumed they will know the right path to take. And mentoring typically focuses on your professional life only.
A coach does not give you the answers, but will collaborate with you to help you find and follow your own path. And coaching is not only about work. Coaching may be profession-focused, but it usually also encompasses your personal goals and well-being.
The Coaching Approach: Discovering Your Own Path
Coaching often begins by defining your own unique values— what sets you apart, what matters most to you, and how you envision your ideal life.
In coaching, the focus is on setting meaningful, actionable goals that reflect your personal values and current life circumstances. Using your values as a guide, a coach works with you to create the steps needed to achieve these goals, understanding that the desired outcome may evolve over time.
Unlike mentoring, where the mentor may have a vested interest in your professional trajectory, a coach remains neutral, providing space for you to explore all possibilities.
The coaching process is dynamic, and it often spans several months, or even longer, allowing for personal growth and adaptation. Coaches provide accountability and support through the stages of planning, commitment, and execution.
Why physicians seek coaching
A physician may seek coaching for a variety of reasons. Some examples include:
Finding work-life balance
Career transitions
Retirement planning
As you can see, these are often complex topics that do not have straightforward or defined answers. The process and outcome will be different for each person, depending on their own unique desires, circumstances, and stage of life.
Mentorship: Guidance from Experience
Mentorship, by contrast, tends to have a more defined pathway. If you seek a mentor, you likely have a specific goal in mind. That might be mastering a complex procedure, advancing to a leadership role, or establishing a successful practice. A mentor often has years of experience in your field and can outline the steps to help you avoid common pitfalls.
Mentors are invaluable, especially early in your career. They provide guidance, often within a hierarchical, career-focused relationship. Mentorship is about learning from someone else’s expertise to follow a clear, predetermined path.
How Mentorship Complements Coaching
While coaching and mentoring are distinct modalities, they are not mutually exclusive. Many physicians benefit from both coaching and mentoring, depending on their specific needs and the phase of their professional life. For instance, someone entering into a leadership role often seeks support from both a coach and a mentor. Or a physician dealing with burnout might seek out a mentor to help with specific aspects of practice management while at the same time choosing a coach to help traverse the complex issues that burnout can uncover.
Key Differences Summarized
Coaching is about self-discovery and personal growth. Coaches help you set and achieve your own goals, both personal and professional, by empowering you to take charge of your journey.
Mentorship is about learning from someone with greater experience in your field. A mentor can provide specific advice to help you achieve a well-defined goal in your profession.
Empowering Physicians: The Coaching Experience
Coaching is a process that brings clarity and honors your own values. It’s an exploration of possibilities, and a supportive experience that allows you the space and time to discover your own path.
If you have questions about coaching and how it might work for you, please contact me through the website, or schedule your complimentary 30 minute discovery session.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
Coaching for Healthcare Leaders
As a member of the American College of Cardiology’s Physician Well-Being Working Group, I am fortunate to be part of the change that’s happening within cardiology and healthcare in general.
Coaching is increasingly recognized as a way to support and retain physicians, an aid for reducing burnout, and a tool that can improve the healthcare environment for physicians, staff, and the patients that we serve.
The first in a series of webinars put on through the ACC was presented in early 2024. You can watch it here, or maybe take it along with you and listen during your commute to work.
As a member of the American College of Cardiology’s Physician Well-Being Working Group, I am fortunate to be part of the change that’s happening within cardiology and healthcare in general.
Coaching is increasingly recognized as a way to support and retain physicians, an aid for reducing burnout, and a tool that can improve the healthcare environment for physicians, staff, and the patients that we serve.
The first in a series of webinars put on through the ACC was presented in early 2024. You can watch it here, or maybe take it along with you and listen during your commute to work.
Stop Being So Hard on Yourself: Five Reasons To Celebrate Physicians
As a physician coach, I’m fortunate to work with a group of professionals that consistently inspires and energizes me. Yet it’s easy to lose site of your value. Healthcare today faces unprecedented challenges and stressors, and it’s sometimes hard not to take it personally.
Physicians in particular are some of the worst at self-flagellation, frustrated and disappointed when they feel as if they haven’t lived up to their own ideals, or those that are imposed on them. Some days it can seem as if being a doctor is a thankless task. So I’d like to share why working with doctors is not only a privilege but also a deeply fulfilling experience.
If you’re like many physicians, it may be easy to lose sight of your value. Healthcare today faces unprecedented challenges and stressors, and it’s sometimes hard not to take it personally.
Physicians in particular are some of the worst at self-flagellation. It’s common to feel frustrated and disappointed when you feel as if you haven’t lived up to your own ideals, or those that are imposed on you. Some days it can seem as if being a doctor is a thankless task. Doctor’s Day comes once a year, but your work is never done. So I’d like to share five reasons that you deserve to be appreciated and celebrated every day.
You Want to Do Good in the World
Medical practice is a field that naturally attracts individuals who are both highly intelligent as well as driven by a desire to impact the world positively. But wanting to do good and actually doing the work are two very different things. You do the work. Although your efforts may not always be acknowledged, your actions, big and small, directly affect the health and well-being of your patients and your community.
You Do Hard Things Every Day
Physicians face an array of challenges daily, from navigating complex medical and social issues to making life-saving decisions under pressure. On top of that, societal, economic, and administrative pressures may add levels of frustration that test your empathy and determination. The work of a physician requires an extraordinary level of resilience and fortitude, especially when, despite your best efforts, things don’t always turn out as you’d hoped or expected. It is no exaggeration to say that this level of commitment and grit far exceeds that of most other professions.
You Are Passionate About Your Work
Passion is the lifeblood of innovation and motivation. Physicians often pursue their profession because of a deep-seated passion for healing and discovery. This enthusiasm is often what spurs you to continually learn, grow, and push the boundaries of what is medically possible. Even on days where you feel less than enthusiastic, your years of focus and commitment drive you to do your best work.
You Come from All Walks of Life
Each physician comes to the profession with a unique array of backgrounds and experiences. Whether you come from a rural town or a large urban community, from a US metroplex or a country thousands of miles away, each physician carries a distinctive set of perspectives and skills. This diversity enhances your ability to connect with and care for a wide range of patients with a rich mix of cultures and viewpoints.
You Are a Change-Maker
Physicians are often at the forefront of change, not only in their clinics or hospitals but also in the broader context. Collectively, you have the power to initiate significant health policy reforms, improve patient care standards, and lead community health initiatives. What you do makes a difference in ways, big and small, that ripple out into the world.
As a doctor, you are not just a healthcare provider or a widget in a faceless system. You are a resilient, passionate, and dedicated professional committed to making the world a better place, one patient at a time. Most importantly, the work you do matters.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Why Should Healthcare Systems Invest in Coaching?
By January 2022, nearly three quarters of all US physicians were employed by hospitals or corporations. Nearly half of physicians reported burnout in 2022, compared to about 25 percent in 2000. Clearly our healthcare system bears some responsibility. Coaching by itself will not turn this ship around. Yet an investment in coaching is a positive step towards engaging and empowering physicians who practice within these systems.
Changes in the administration of medical care have accelerated at a frenetic pace over the past decade, amplified by changes in practice ownership, healthcare law and COVID-19. With a few exceptions, the time of the solo practitioner, or even the single-specialty group practice, is well past. A recent report from Avalere Health noted that by January 2022, nearly three quarters of all US physicians were employed by hospitals or corporations, with a 19 percent increase over the preceding 3 years.
This consolidation of care comes with important benefits, including cost savings, ease of quantification and other metrics, and streamlining of care. Yet whether they intended to or not, large healthcare systems have also taken on an enormous responsibility for the satisfaction and well-being of their employed physicians.
Although healthcare administrators are a diverse group, and many have some background as healthcare professionals, they may not fully understand or embrace the qualities that lead individuals to pursue the life of a physician.
In general, physicians are highly intelligent, extremely motivated individuals. That’s individual with a capital I. Physicians are typically empathetic yet driven perfectionists. Many see their profession as a personal calling. While admirable, this may put them at risk for exploitation, since physicians with this mindset may find it difficult to say “no” to added responsibilities.
Recognizing these character traits makes it all the more concerning that in a recent survey, nearly half of physicians reported burnout in 2022, compared to about 25 percent in 2000. COVID is partially to blame, but so are systemic changes in healthcare, including less autonomy and greater documentation demands.
Clearly, our healthcare systems bear a substantial responsibility for the amelioration and reform of many of these underlying factors. This includes workload, clerical and documentation burdens, and leadership culture.
How can coaching help?
Coaching is not the answer to burnout, but it’s an important tool. A study from the Mayo Clinic found that after 6 coaching sessions by credentialed coaches, the rate of burnout decreased by over 17 percent. In the control group, burnout actually increased by nearly 5%. And rates of emotional exhaustion dropped by nearly 20% in the coached group but increased 10% in controls.
Beyond addressing burnout, coaching can help physicians navigate the challenges of daily practice. Discovering the underlying causes of inefficiencies and working through time management practices with coaches may help physicians stay more organized and reduce wasted time. This in turn can improve quality of life for physicians as well as foster patient engagement, staff satisfaction, and timeliness of medical records.
Burned out, dissatisfied, and disconnected physicians are more likely to leave healthcare, which is expensive and disruptive for the system. According to the American Medical Association, it may cost anywhere from $500,000 to $1 million to replace one physician. And burned-out physicians may increase healthcare costs and decrease patient satisfaction. Ultimately this results in lost revenue and loss of social currency. More importantly, quality of care may also suffer and medical errors increase.
As hospital and healthcare systems navigate the years ahead, retaining high quality, satisfied, and engaged physicians will become increasingly important. An investment in coaching is a tangibly supportive and mutually beneficial use of resources.
Coaching alone won’t solve the problems facing healthcare. But when used as part of a comprehensive strategy to enhance physician well-being and streamline efficiency, coaching may ultimately improve patient care and satisfaction, enhance teamwork, and foster a happier, healthier medical staff.
An earlier version of this article originally appeared on this site in August 2022.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Coaching for Physicians: A Guided Journey to Goal Setting, Overcoming Obstacles, and Finding Fulfillment
If you’re curious about physician coaching, and want to know more, this article is for you. As someone who loves getting outdoors, I like to use the metaphor of a hike or journey when describing my coaching process. In this coaching journey, I serve as your experienced companion, providing support, insight, and encouragement, helping you navigate both familiar and new terrain, and celebrating with you as you discover your destination.
If you’re curious about physician coaching, and want to know more, this article is for you. As someone who loves getting outdoors, I like to use the metaphor of a hike or journey when describing my coaching process. In this coaching journey, I serve as your experienced companion, providing support, insight, and encouragement, helping you navigate both familiar and new terrain, and celebrating with you as you discover your destination.
1. The Trailhead: Preparation and Goal Setting
Just like preparing for a hike, the first step in coaching is to understand where you are right now and where you want to go. This involves an in-depth assessment of your current professional and personal landscape, identifying both the peaks (successes) and valleys (challenges) you face. Whether you’re dealing with burnout, challenges with time, professional transitions, or finding the right work-life balance, together we’ll set specific and achievable goals. You can think of this as choosing the right trail that aligns with your current fitness level and hiking experience. Don’t worry if this is all new to you. You may be surprised at the ways your strength and endurance will naturally grow along the way.
2. Gathering Gear: Equipping for the Journey
After setting the goals, the next step is to equip you with the necessary tools and skills. This includes exploring techniques for time management, stress reduction, and effective communication. Similar to choosing the right gear for a hike, these tools are personalized to fit your unique needs and circumstances, ensuring you are well-prepared for the journey ahead.
3. The Hike Begins: Embarking on the Journey
With goals set and tools in hand, we begin the coaching journey. This phase is about action and moving forward. Regular coaching sessions serve as checkpoints, where we assess progress, celebrate achievements, and address any new challenges. The journey may involve steep climbs and unexpected obstacles, but with guidance and support, you keep moving towards your goals.
4. Difficult Terrain: Navigating Challenges:
Just as a hiker encounters rough patches along the trail, you may face challenges in your professional journey. Burnout, difficult workplace dynamics, and balancing personal life are common terrains we navigate. Together, we develop strategies to overcome or get around these obstacles, building strength, creativity, and adaptability, much like a seasoned hiker learns to navigate through challenging paths.
5. Scenic Views and Rest Stops: Reaching Milestones
Along the way, it’s important to recognize and celebrate milestones. These are like the scenic views or rest stops on a hike, offering a pause to appreciate how far you’ve come, recharge, and reflect on the journey. Although it’s tempting to keep pushing forward, these waypoints are crucial for maintaining motivation and perspective.
6. The Evolving Trail: Continued Growth and Adaptation
The journey doesn’t end at the first summit. Like a trail that changes with the seasons, your professional life will continue to evolve. Ongoing coaching can help you adapt to these changes, develop new goals, and continue growing. The journey is continuous, and as your coach, I am there to guide, support, and celebrate with you every step of the way.
7. The Lookout Point: Reflection and Forward-Thinking
As you reach significant milestones, we’ll take time to reflect on the journey. From this vantage point, much like a lookout on a hike, we’ll assess the path taken, lessons learned, and obstacles overcome. From there, we’ll plan for the next phase of your journey. Together we’ll chart out the travels ahead, including strategies for keeping burnout and inertia at bay. As you move into the future, you’ll be empowered and well equipped to stay engaged, inspired, and energized.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
What the Failure of the ER Match Says About the State of Health Care
Over 550 residency spots went unfilled by US med school grads in the residency match this month. Some centers had zero applicants match to their programs. Compare this to 2021, when only 14 ER residency spots were not filled.
The reasons? Just about any physician in the US can tell you.
And How Physician Coaches Can Change The Story
When I was in medical school, the cool, smart kids went into ER medicine. It was a hotly competitive residency, and there was no guarantee that you would match. Now things are entirely different. Over 550 residency spots went unfilled by US med school grads in the residency match this month. Some centers had zero applicants match to their programs. Compare this to 2021, when only 14 ER residency spots were not filled.
The reasons? Just about any physician in the US can tell you:
Disrespect fueled by social media personalities and irresponsible "news" outlets
Dangerous working conditions
Overloaded ERs being used as a source of primary care, often because people lack insurance or access
Corporatization of medicine with a focus on numbers of patients seen and metrics that often don't relate to patient care
Management of physicians by business people and those with less responsibility and training
Intrusive, redundant, and burdensome EHR requirements
Lack of adequate support staff
Some of my best friends are ER physicians. They are some of the hardest working people I know. These are the doctors who will save your life at 2 am, no matter who you are or whether or not you have insurance. And they are also the doctors that are tasked with waking up their colleagues at all hours of the night to request a consult or hospital admission. Most manage their work with grace, strength, and courage.
The steep decline in the desirability of ER residencies is a really scary trend. It’s easy to say that doctors can be replaced with mid-level care providers, but the truth is that the expertise, skill, responsibility and knowledge that an ER physician provides requires years of education, training, and commitment. Mid-levels can reduce some of the burden of less complex patients, but they are no substitute for a physician.
This sudden and shocking shift should be a call to action for hospital directors, ER directors, and the corporations and private equity firms who own and manage many of these practices.
As we wait to see how this recent revelation will impact the decisions and practices that affect ER physicians, it’s important that physicians take steps to stand up for ourselves and our profession. This is a new way of thinking about medical practice, but times have changed irrevocably. By learning how to work within the systems we now have, we can start to make important changes from the inside out. Ultimately, such changes will benefit not only physicians, but also their patients and indeed the very institutions and corporations that currently control our healthcare systems.
How can coaching help? Well clearly, coaching will not fix the problem. Coaching means working with one physician at a time, very much like patient care. But coaching will help you clarify your goals, identify your frustrations and obstacles, and give you the tools to create your way forward. Will that be
Negotiation, understanding your own value?
Creating a streamlined workflow that will allow you greater efficiency?
Acquiring new skills to make your time more effective?
Courage to make a lateral move to a new facility?
A switch to a different type of practice altogether?
A change in working hours?
Reframing conflicts so that you are able to create a more positive working environment?
Honing interpersonal skills?
Advocating for change in EHR management?
Regardless of your specialty, the healthcare world is shifting. The work you do matters. By recognizing your own worth and power, and by taking action that is beneficial to both you and your patients, you will be able to create a happier and more sustainable life.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.