Doing things that make the least sense for the patient and the physician because some insurance administrator or government agency will only pay the bill if it is done a certain arbitrary way. In other words, we hate B. S.

They say that compassion fatigue is contributing to burnout, and compassion fatigue is defined as, “indifference to charitable appeals on behalf of those who are suffering, experienced as a result of the frequency or number of such appeals.”

But the Oxford dictionary is wrong. 

It’s not the number of the charitable appeals that are the problem. 

It’s the inability to alleviate that suffering because of infuriating insurance restrictions and constrictions.

Anger is a natural response to a perceived feeling of powerlessness in the face of injustice.  And these insurance edicts make everyone angry.

But that anger has no outlet in medicine, so compassionate physicians compartmentalize and push it away, put our heads down and do the next thing and the next thing and the next thing because we so desperately want the best for our patients.

But here’s the thing about anger.  It’s energy that needs to get out; it’s there to be the fire for change.  When the change doesn’t come, it burns away at the soul and changes the physician.  She burns out. Until she does something different.

I was lucky enough to spend some time last week visiting a couple of direct primary care practices here in Virginia (thank you Edson Family Practice and Kaya Health!), and there were three things I noticed immediately--

The first was that the work of the doctors matched the patient needs, NOT the insurance needs. The palpable frustration from doing unnecessary tasks was completely absent, and it felt like a breath of fresh air.

The second was that the doctors were cheerful and talkative.  They weren’t cramming all these silly insurance hoops into the day, so they had the time to attend to what really matters—the patients, the staff, and perhaps most importantly—themselves. Never once did they look at their watches. Time was abundant.

And the third was that the staff were positive, energetic, and happy to accommodate the needs of the patients—because they had the time and flexibility to do so.  A patient could come in and drop off a urine, get diagnosed with a UTI, and get treatment in a matter of minutes. When patients are getting the care they need, it makes life better for everyone—staff included.

So, while doctors hate doing things that make no sense, the joy we feel in doing the right things in the right way at the right time is priceless.

I am looking forward to being free of insurance restrictions, so we can all experience the freedom and lightness of medicine that truly alleviates suffering. Thank you for helping to revolutionize medicine, so we can all heal!