why docs burn out? Paperwork

Scidaily: Why docs burn out:

when big business and gov't bureaucracy took over medicine, it stressed efficiency, but what really happened is it made docs into robots to follow the flow charts.

the art of medicine morphed into the business model, where continuity of care (of people you know) morphed into the McDonald's idea of efficiency (as if every doc was a clone and didn't matter if you knew him or her). Then the bean counters decided you needed to document everything: so you spent your time filling out blanks (often of things not important) instead of actually talking to patients.

And then, the electronic records struck:

"When the subsidies ran out and the promises turned into extra cost, less time with patients, time at home finishing EHR records, unreadable and meaningless cloned patient notes, HIPAA-restricted access to outside records, and government penalties for not 'mining' patient data that cost money to input, doctors became overworked robots." Alexander stressed that doctors need to spend less time on their EHRs. "EHRs are not going away, but they don't need to be the focus of the patient's visit," he said. "Doctors should oppose EHRs that occupy valuable doctor-patient time and which use billing diagnoses rather than patient assessments. EHRs need to be portable. Computerized notes should be templated for meaningful patient care notes."

the dirty little secret: A lot of time it is the art of medicine that works: the teenager who comes in for a cold, and she is pregnant but afraid to tell mom. The elderly mother comes in for stomach pain and the real problem is her druggie son is stealing her social security check, or the younger mom whose husband is beating her up when he is drunk. The man who is suicidal and alcoholic, dragged in by his girlfriend but won't tell you his real problem (his blood pressure medicine is causing impotence).

And then there is the Colombo scenerio: after you evaluated the problem and the patient was going out the door, he/she turns around and says: Just one more thing..."  and you find the real reason for their visit.