Additionally, “There’s no question that the significant influx of pain amplification/fibromyalgia syndrome patients into rheumatology outpatient practice has led to a major increase in job dissatisfaction,” says John A. Robinson, MD, a professor with the Department of Allergy/Immunology/Rheumatology at Loyola University Medical Center, Maywood, Ill. His practice has a blanket exclusion of this type of patient, other than MD-referred initial consultations, with the proviso that the patient returns to their primary care provider.
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Explore This IssueJuly 2014
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Treating patients with chronic conditions that don’t always have a cure can likely be exhausting for some practitioners, says John-Henry Pfifferling, PhD, director, Center for Professional Well-Being, Durham, N.C. “The aggregate of that tends to be depleting. If you expected to be in a curative domain, then you’ll have a clash of expectations,” he says.
He also says rheumatologists may feel challenged to manage patients who come to them expecting “miracle cures” from the drugs touted in ads they see on TV or in magazines—drugs that can come with significant side effects.
On the administrative side, changes and expansion to the musculoskeletal code system in the ICD-10 will require greater detail to identify and report a diagnosis more appropriately, says Dr. Rubenstein. “All of these changes may place new burdens on physicians that can lead to burnout.”
Then there are work-life balance challenges, be it managing a career along with tending to kids and aging parents or trying to carve out a thriving professional life along with finding time for outside interests. At certain times of life, this can be a more daunting task.
A December 2013 study in Mayo Clinic Proceedings reported that early career physicians were the least satisfied with their overall career choice and had the most work-home conflicts. Midcareer physicians worked more hours, took more calls at night and were the least satisfied with their specialty choice and their work-life balance. This group had the highest rate of burnout and was the most likely to leave the practice for reasons other than retirement within two years. Late-career physicians had more overall satisfaction than the other two groups.3
“Although leaving the practice of medicine may have personal benefits for the individual physician, from a societal perspective it amplifies the physician workforce shortage and may create access problems in many specialties and smaller communities,” the study authors reported, adding that the cost to replace a single physician can range from $115,000 to $587,000.
Some may think that female physicians are on a more direct path to burnout because of both career and home pressures. However, “The available research suggests that all doctors are at risk—those new to practice and decades in practice, both men and women,” Dr. Ardoin says.