contd from 3.15.21 The rate of 'Burn-out', dissatisfaction, and unhappiness among residents has grown despite improvement in salary, working hours and having to take calls from home. This is amazing to someone like me who trained in the 'good old days when terms like 'burn-out' had not been invented. Why the general unhappiness? Good question. In my view the reforms made in training were not thought out well. Medicine was and is still a tough avocation ( I am avoiding the word profession ). Change for the sake of change or 'progress' never ends well. Changes ought to be well thought out, debated, analyzed for consequences and then implemented slowly and cautiously. For example in the surgical field tendency to force an active surgeon to retire because studies show a decline in dexterity with age is frankly stupid. A general observation cannot be applied en mass. To do so sidelines and destroys the carrier of an older person. with his or her forced 'retirement' is lost years of accumulated wisdom and experience which is irreplaceable. Most surgeons know when it is time to stop. If, in a few cases this does not happen they can be gently talked into it by reasoning and persuasion. Dr. Michael De Bakey, the famous heart surgeon operated well into his late seventies.
Knowledge has grown and no one person can know everything in their field. But taking away routine things from a physician like treating an infection or prescribing an antibiotic and giving it to a 'specialist' e.g. infectious disease specialist or pharmacist is downright dumb. A physician will seek help when he or she knows that they need it, and if God forbid they don't there is plenty of oversight now that they can be made aware of that they do in nearly all cases. Making such a rule for a 'study' or a committee' thinks so is both demeaning and insulting. (cntd tomorrow)
