Why physicians are leaving medicine

Tirun Gopal, MD, a senior physician at Sutter Health in Allentown, Pa., joined Becker's to discuss burnout among physicians, countering misinformation and more throughout his more than 40 years of experience. 

Question: Only 57.5 percent of physicians said they would choose to become a physician again in a recent survey. What reform would you make to change their minds?

Dr. Tirun Gopal: It is easy to complain about one's career. After all, is there a career or profession which does not have challenges? Besides, the grass is always greener on the other side of the fence.  

There is so much concern about physician burnout and fatigue, loss of morale and empathy. The factors which contribute to these are the following:

1. A considerable part of the journey to become a physician is spent in medical school and training.

2. At the end of this journey, the student emerges as a physician with a formidable debt, the equivalent of a mortgage. It therefore becomes necessary to choose a specialty which is lucrative. This is to the detriment of healthcare in general because it diminishes the number of primary care physicians, especially in outlying areas.

3. Medicine is becoming increasingly complex, with increasing specialties and subspecialties; thus, the physician becomes increasingly an expert on a decreasing part of the patient's anatomy. The modern physician therefore is more likely to treat the condition and not the patient. 

4. With the abundance of information and disinformation on websites, the patient has a tendency these days to come into the visit armed with half-baked knowledge of their condition, creating a strain or barrier to the relationship. This affects both the physician and the patient adversely.

5. Now that artificial intelligence is gaining ground and making inroads into the medical field, lots of physicians are concerned that they would soon be replaced by the indefatigable AI, which has more empathy and is predicted to soon gain sentience. 

6. Having been in practice myself for the last 45 years, I must confess that I miss the trust I used to enjoy from my patients in the days of yore. I admit that I am resentful of the patient who challenges me with information that she gleaned from Dr. Google overnight and does not mind confronting me without any regard for the fact that I will always know more medicine than they ever will. At age 74, if there is something that would prompt me to give up medicine, it is this.

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