Physicians can save themselves from burnout

I had always dreamed of becoming a doctor. But once I started practicing, my life evolved into a living hell.

I worked 16-hour days, saw 25 patients for rushed 10-minute appointments, never took lunch breaks, and spent most weekends catching up on paperwork. I put on 30 pounds and felt lousy.

Late one night after coming home utterly exhausted, again, my wife looked me in the eye and delivered an ultimatum. "You deserve a life. We need you," she said, urging me to change how I practiced medicine. So I did. 

Now, my life could not be better. These days, I get plenty of sleep and exercise and eat well. And most importantly, I can spend quality time with both my family and my patients.

What changed? I switched to a membership-based model where patients pay an annual fee for more personalized, preventive care. As a result, I have reduced the size of my practice and no longer stress about having to make ends meet. Other primary care physicians can save their careers, their health, and literally even their lives by following suit.

I'm hardly the only doctor who has faced such challenges. Physicians suffer from burnout at about twice the rate of the general public. In fact, a staggering 78 percent of today's physicians report feelings of burnout.

This stress endangers physicians' health and livelihoods. Three in four doctors at volume-based practices don't have good eating or sleeping habits, according to a recent study conducted by Ipsos and MDVIP, the network of doctors I'm affiliated with. Over 40 percent of physicians on today's practice "treadmill" contemplate leaving medicine altogether. And tragically, burnout can exacerbate depression -- about one doctor takes his own life each day in the United States.

Burnout isn't just dangerous for doctors, but for patients, too. Burned-out physicians are twice as likely to make medical errors. Merely working late into the night can increase physicians' chances of making a fatal mistake by 300 percent. Medical errors cause up to 250,000 deaths a year.

Physicians who switch to retainer-based practices can lead significantly healthier lives.

For instance, over half of MDVIP physicians get at least seven hours of sleep each night; only 29 percent of doctors in volume-based practices do the same. Fifty-nine percent of MDVIP physicians eat a well-balanced diet; only 36 percent of volume-based doctors do. And 50 percent of MDVIP physicians exercise regularly, compared to 39 percent of volume-based doctors.

Making the switch can improve patients' health, too. When doctors feel pressed for time, they can't give each patient the attention he or she deserves. Over 50 percent of doctors in volume-based practices reported that they often find themselves "writing prescriptions or referring patients to specialists due to time constraints."

Having a smaller patient panel allows doctors more time to assess patients and help them make better lifestyle choices. While a typical primary care doctor may have to see 25 or more patients a day, physicians who practice in a model like mine might see 10.

This extra time has made me a better doctor. For instance, I now have the time to really work one-on-one with patients on making lasting lifestyle changes that can alter the course of their health. Whether it's a nutrition, exercise or weight loss program we're working on, my patients and I are able to check in with each other weekly, and I'm tracking improvements in their HbA1C, body fat mass levels and inflammatory markers.

My wife was right. I deserve a life-and so does every doctor struggling with burnout.

David Maleh, MD, is an MDVIP-affiliated internal medicine physician in Wilmington, Delaware.