As hospitals address physician burnout by appointing chief wellness officers for their employees and medical schools revise curriculums, healthcare is neglecting one clear solution — physicians seeing more healthy patients, a physician argues in The Washington Post.
Five insights from the op-ed, written by Ravi Parikh, MD, a fellow in hematology and oncology at the University of Pennsylvania in Philadelphia:
1. Dr. Parikh describes a day at the clinic where he had several challenging appointments for patients with deteriorating conditions, saying how he dreaded telling them bad news. But between these appointments, Dr. Parikh saw a patient who had surgery about a year ago to remove a lung tumor and was looking healthy.
Dr. Parikh gave the patient a clean bill of health, asking him to come in for a checkup in three months. The patient questioned why he needed to return if his condition looked good, especially since the visits reminded him that he once had cancer.
2. "I told [the patient] that, while I sympathized, most patients in remission should see their oncologist periodically after finishing therapy to monitor their cancer and address possible side effects. He agreed and scheduled an appointment," Dr. Parikh writes.
"What I did not say — or even consciously realize at the time — was that I needed to see him as much as he needed to see me."
3. But healthy patients are often pushed out of medical appointments, Dr. Parikh says, fueled by the 20 million newly insured patients with more access to healthcare after the ACA passed.
Additionally, recent articles in major consumer and academic venues argue against patients having an annual physical, saying healthy patients may not benefit from these visits.
4. "But as one who treats people on the verge of life and death every day, I am starting to recognize the emotional toll," Dr. Parikh writes. "Between the gut-wrenching conversations about mortality and managing life-threatening complications of a treatment that my team prescribed, a full day of clinic can leave me drained, guilty or, even worse, depressed."
Dr. Parikh says even on his toughest days at work, he does not think seeing a healthy patient wastes clinic time. "On the contrary, when I saw that my patient who had survived lung cancer was on the schedule, I felt relieved," he says. "These are the patients who prevent me from burning out."
5. Even for patients with conditions less critical than cancer, having well visits can be important to their health, Dr. Parikh says. Physicians can discuss topics such as smoking cessation, exercise counseling and mental health, which are often ignored during sick visits.
"As more physicians become burned out and apprehensive about practicing medicine, we must realize that there are limits to what chief wellness officers, counseling and pep talks can accomplish," Dr. Parikh writes. "Only systems-level changes in how doctors treat and see patients will curb the rise in physician burnout. Perhaps healthy patient visits can be therapeutic for everyone."