Wellness. When applied to health care workers and more specifically, the need for physicians to strike a better life balance, I am so very sick of hearing this term. It has become so empty and so meaningless. I admit, I even recoil a little at just hearing the word now.
I had a similar experience earlier in my life while working as a domestic violence advocate. The word then was "support" and all the good intent in the world could not restore meaning to the word. I remember one particular discussion with my boss about a statewide advocacy group offering their "support" to local shelter programs during a massive snowstorm. We were outwardly laughing about how absurd this was because the real, tangible sorts of "support" our programs desperately needed - like help shoveling out the snow drifts covering driveways and sidewalks - was not what they meant and never would be. The small things that could have had a big impact and would have meant the world to us, were never going to come.
Years removed from that situation, I cannot help but realize I've found myself back in a similar, if not even more abusive relationship with my employer. Granted, I'm a resident physician and anyone whose ever watched a medical drama on TV is surely aware that residency is a tradition of brutally long hours at emotionally and mentally exhausting labor intended to push competent physicians out at the end. But even if I can forgive the personal process I'm living through, I cannot be blind to what I'm witnessing all around me.
A few weeks ago, I was at a meeting that brought together doctors, physician's assistants, and nurse practitioners who work at the various county health department-run clinics. These meetings happen on a routine basis to give pertinent updates to all of us under one roof. This particular meeting had a different spin than normal, however, as the latter portion of the morning was to be dedicated to the topic of: Wellness.
What ultimately ensued has stuck with me for nearly three weeks now and the more I think about it, the more indignant I feel. This room packed with various highly educated and competent individuals who were dedicating their careers to care for the most underserved in our community, was at a boiling point. It was clear that the System were are all forced to operate within was wearing us ragged and tearing us apart.
Our concerns were voiced to one another. Nearly everyone in agreement, all expressing similar frustrations and angst at our inability to achieve improvement in conditions. We were asked to write out our greatest complaints and suggestions on giant post-it notes hung on the wall. To discuss in open forum thereafter so we could feel heard. The only problem was - the ones who most needed to hear these concerns, were all conspicuously absent.
Despite the reoccurring thoughts about that day I've had over the past few weeks, I had not felt the need to document the experience until now. But now, every experience that re-emphasizes those complaints rings in my head like a warning siren telling me we all need to flee and save ourselves while we still can. While we may still have some ability to save the parts of our humanity and drive to do this work that remain intact.
My best friend contacted me this afternoon to tell me he received a phone call on his way into clinic, a mere two minutes late based on our given start time, to find out where he was an if he was coming in today. My friend is incredibly reliable and timely, particularly for a doctor. So today was an anomaly, to be sure. But the troublesome part is that rather than be met with a question about if he was okay or if anything was wrong given the tardiness is incredibly out of character for him, he was instead met with an accusation. A hard working resident physician, who plays by their rules, always goes the extra mile and accommodates without complaint was not given the benefit of the doubt. Instead, he was treated as troublesome. In this environment where there is always more work to be done than time to do it, there are never any thank yous or recognition for a job well done. There are only shaming lists of ridiculous metrics that mean nothing to my patients and nothing to true quality of care, but seemingly show something about how we're doing to other bureaucrats behind a desk somewhere.
Physicians who are able to live in ways that embody wellness, do not work in these systems. They do not cowtow to meaningless mandates and metrics that do nothing to help our patients. They have found a better way that cuts out the layers of administration and insurance that separate doctor from patient. They refuel their desire to be the physicians they wants to be by taking great care of patients and developing personal relationships where everyone can feel that they truly matter as an individual.
This is what direct primary care is all about. When people tell me that they don't think it is possible in this community or that it is just some far fetched idea that will never work, I often remind myself just how untenable our current system is. Public or private, the setting truly doesn't matter when the drivers are all the same. But to eliminate the unnecessary layers and find the holy grail of incredibly satisfied and well cared for patients with incredibly happy doctors, all for a substantially lower cost? Proletariat Health will be about getting back to what matters. That's the real revolution.
