The Mass Exodus From Medicine

Medicine, a profession long enshrined in prestige, is starting to lose its appeal. For some physicians, the desire to serve their community and share the benefits of accumulated years of knowledge, experience and application, has been overshadowed by severe burnout.

What is burnout and how does it present in doctors?

Burnout is chronic work-related stress. Among physicians, burnout has a very particular flavor and texture characterized by several features:

  • Emotional exhaustion: feeling completely drained with nothing left to offer at the end of the workday, with feelings sometimes mapping closely onto depression;
  • Depersonalization: reaching the point where patients are treated with less personalized care due to exhaustion or overstretched resources;
  • Reduced personal accomplishment: a sense of inefficacy in supporting patients with their problems, and a reduction in meaning attached to patient care.

Burnout has serious consequences for doctors’ professional practice: burned-out doctors are more likely to make errors in their work, work less efficiently, resist organizational initiatives or refer their patients to other professionals.

Burnout can also detrimentally affect doctors’ personal health, well-being and happiness, with physicians who suffer from burnout more likely to indulge in substance abuse, experience troubles in their relationships, psychologically withdraw or feel trapped.

However, many will suffer in silence due to fear of being penalized for seeking support. State medical boards responsible for monitoring vulnerable medical professionals can be stigmatizing, and drive vulnerable physicians into the shadows.

Most alarmingly, U.S physicians have among the highest suicide rates of any profession, with one physician committing suicide every day. The suicide rate of physicians in the U.S. is double that of the general population. The link between physician burnout and suicide is incontestable.

Why is burnout so prevalent among doctors?

Burnout manifests in the individual, but is in essence an indication of a major health system dysfunction. Most physicians agree patient care has been subsumed by the demands of bureaucracy and documentation, more colloquially known as “desktop medicine”.

The diagnosis and treatment of illness has been surpassed by an administrative burden which absorbs vast amounts of time, effort and energy, while the system still demands unwavering dedication and exceptional standards in patient care.

As one prominent study noted, burnout increased across all medical specialties between 2011 and 2014, but remained stable in the general population: irrefutable proof that this a systemic issue.

Some of the greatest challenges and inadequacies of this system that create undue stress include:

  • Inflexible computer scheduling
  • Demands of coordination of care across multiple providers
  • Complex regulations governing the use of EMRs
  • Increasing patient volumes
  • Poor work/life balance

How are doctors responding to burnout?

While there is growing recognition of the need to reduce stigma in providing mental health support to doctors and reduce clerical burdens, for some doctors, it’s already too little, too late.

For those who have been living in a state of burnout with no real hope or definitive change on the horizon, the most appealing option is to exit the profession. A survey of 6880 surgeons, carried out by the Mayo Clinic in 2017, found that one in 50 physicians had expressed the intention of leaving medicine altogether in the next two years, and one in five had planned to reduce their clinical hours in the coming year.

Already, there are prolific articles online, advising doctors about how they can utilize their skill sets in other roles to derive greater pleasure from their work without the stress of their current roles.
Where to next for dissatisfied doctors?

This is where things get interesting. For many doctors who have settled on leaving general practice, diverse alluring professional opportunities beckon: working in pharma, health tech start-ups, management consultancy work, lecturing or medical freelance writing, to name a few options.

For others who wish to stay more connected to their medical and surgical roots by treating patients, the next logical step is to look to aesthetic medicine. Many aesthetic professionals today hail from diverse specialized medical backgrounds, but share the common goal of treating and caring for patients by helping them meet their aesthetic goals.

Aesthetic medicine is rewarding on a personal and also financial level. The aesthetics market is booming: by 2024, the aesthetic medical market is expected to exceed $26.5 billion dollars, at a compound annual growth rate of 12.8% between 2017 and 2024.

This boom in aesthetic medicine has been driven by several noteworthy factors:

  1. Constant advances in laser technology improving the quality of non-invasive procedures: for example, lasers such as Fraxel can provide skin resurfacing and tightening results that are akin to a subtle facelift;
  2. Growing awareness and education among consumers regarding aesthetic procedures and their benefits: patients are more educated and savvy than they have ever been and hyper-aware of the latest cosmetic trends and innovations;
  3. An increasing shift from surgical to non-surgical procedures, or surgery with minimal downtime: body sculpting and skin rejuvenating procedures are becoming less invasive and more effective, as driven by consumer demand.

How does a doctor transition to a career in aesthetic medicine?

Until now, the field of aesthetic medicine has been fiercely guarded by doctors with specialized training in plastic surgery, cosmetic surgery or dermatology. This is no longer the case. Aesthetics is an industry that desperately needs more passionate and skilled doctors, and training can be gained incrementally, by completing training courses relevant to the specific aesthetic areas you wish to work in.

For many transitioning physicians, the first step is taking an injecting training course: injectables such as Botox and dermal fillers constitute the bread and butter of many aesthetic professionals. These courses can be completed while you are still practising as a physician, so you can acquire a skill base while still earning.

Another essential element of transitioning to a career in aesthetics is building up your own clientele and professional networks: many doctors do this by taking a part-time role at an established clinic. The more proficient you are, the more loyal your client base will be, and the faster you can build a reputation and make a profit. The other option is to venture out on your own: open your own clinic or med spa, or add aesthetic services to your existing practice.

If you’re thinking about making the move to aesthetic medicine, watch this space. We’ll be posting tips for transitioning, insights into the industry, and the latest trends and developments in aesthetic technologies.

References

https://onlinelibrary.wiley.com/doi/full/10.1111/joim.12752
https://www.medscape.com/viewarticle/896257
https://www.theatlantic.com/health/archive/2018/05/the-burnout-crisis-in-health-care/559880/

https://globenewswire.com/news-release/2018/03/01/1402022/0/en/New-Statistics-Reveal-the-Shape-of-Plastic-Surgery.html
https://www.medscape.com/viewarticle/827680_1

Medical Turf Wars: Plastic Surgeons Clash With Other Doctors About Who Can Perform Liposuction And Tummy Tucks


https://www.mayoclinicproceedings.org/article/S0025-6196(17)30690-0/fulltext
https://www.ncbi.nlm.nih.gov/pubmed/26653297
https://www.businesswire.com/news/home/20171023006050/en/Global-26.5-Billion-Medical-Aesthetics-Market-2024
http://www.pnwaestheticsacademy.com/career-in-aesthetic-medicine/
https://www.schweigerderm.com/skin-care-articles/laser/10-best-lasers-for-the-face/

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