For centuries doctors have been held up as heroes who heal disease, alleviate pain, and save lives, and traditionally they have been paid handsomely to do so. Even if salary is not a motivating factor, it’s not surprising that so many idealistic young people want to give back to humanity in such a grand and noble way. However, this idealism tends to waver somewhat for many prospective physicians as they move through the grind of medical school and the manic demands of residency. And those who survive these obstacles have a new set of challenges in the real world. Here are 5 key challenges for a doctor serving humanity that can make helping patients difficult for millions of doctors.
1. Bureaucratic (and otherwise flawed) healthcare systems.
Although healthcare system frustrations probably plague most countries that actually have a system in place, one that is taking center stage right now is the relatively new Affordable Care Act (ACA) in the United States. There are numerous inevitable problems as doctors and their staff struggle to adapt, and to sort out the uncertainties regarding the ways the new law will affect the quality of patient care. Physicians are also rightfully concerned about how the ACA will impact their practices, economically and otherwise. (Some have stated in no uncertain terms that the Act will be a disaster for doctors and patients alike.) Although the key purpose behind the ACA is supposedly to benefit patients, the reality is that dealing with new government mandates, struggling with new technologies, and learning to navigate new payment mazes can detract from this core mission.
The ACA is not the only source of physicians’ frustrations with bureaucracies. Other programs, such as pharmacy benefit plans, can also cause frustration, as one physician documented early in 2014. And beyond the borders of the U.S., healthcare system glitches remain an obstacle to the delivery of health care to those who most need it. Even in countries where affordability and patient access aren’t the top issues, there are many frustrations for doctors and patients. For instance, the much-lauded UK system “[lags] notably on health outcomes,” according to a 2014 update from The Commonwealth Fund.
2. Lack of time for patients.
In many cases this challenge is related to the problem of bureaucracies and other healthcare system challenges, but it is also part of a larger picture that encompasses a range of factors, including regulatory issues, society’s expectations of medicine, and the frantic pace of modern life. Government regulations, private-pay requirements, and the day-to-day hassles of running a business often force physicians to spend less time with patients. The stakes are so high – with their very careers on the line – that today’s doctors can’t afford not to jump through every hoop that is put in their path.
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3. Political, social, or economic barriers to serving those most in need.
In the under-developed world, problems stem from other issues that are beyond doctors’ control: geopolitical events, economic and social problems, and even natural disasters. In many cases it’s the total lack of healthcare infrastructure that is the problem. In some countries, wars, government corruption and the high patient-to-physician ratio make the goal of “serving humanity” seem almost idealistic. Doctors and other healthcare workers and volunteers who hope to make life easier for people in the troubled spots of the world face many challenges and dangers.
4. Incurable diseases, the re-emergence of older deadly diseases, and the emergence of “superbugs” for which medical science has little remedy.
Doctors have probably always felt helpless and frustrated in the face of incurable diseases. Doctors and other healthcare workers now have to deal with the strains of superbugs that are emerging. These include increasingly antibiotic resistant bacteria (thanks in large part to overuse and misuse of antibiotics throughout the food chain), and new strains of viruses that keep medical researchers and healthcare workers on their toes. Hospitals are breeding grounds for many of these bugs. Despite their best efforts, it sometimes seems that doctors are losing the war against these microscopic enemies that are claiming millions of lives all over the world.
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5. Stress, burnout, and lack of work-life balance.
These may seem like personal problems at first glance, but they can seriously affect a doctor’s performance. Notwithstanding the perks that come with any position of authority and respect, being a physician has always been a stressful occupation. After all, doctors hold people’s lives in their hands. Today’s doctors, however, face a confluence of factors – including those listed above – that make their jobs particularly stressful. Perhaps the worst news in this regard is that physicians have a higher than average suicide rate, more than likely due to untreated depression. In the U.S., the suicide rate among female doctors is 2.3 times the national average, and the suicide rate of male doctors is 1.4 times higher. For several reasons, doctors also have a higher than average rate of alcoholism and drug abuse.
Many doctors work 80 hours or more weekly, and relatively little of that time is spent actually interacting with patients. Doctors and their staff spend so much time complying with new regulations, adapting to new technology, and addressing economics of maintaining a practice, it’s no wonder burnout remains a constant threat. “The unavoidable fact is that unhappy physicians make for a poorer healthcare system,” wrote the authors of a December 2013 article on the Medical Economics web site. Though this article primarily focused on U.S. doctors, burnout and frustration are also a problem with overworked, underpaid doctors all over the world, perhaps especially in countries with bureaucratic healthcare systems.
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The above isn’t intended to discourage any enthusiastic, qualified candidate from becoming a doctor. To the contrary: the world will continue to need good doctors. Doctors make positive contributions, so the desire to serve humanity is both praiseworthy and reasonable. The key for a prospective doctor is to manage his or her expectations, by acknowledging the challenges associated with the profession. Facing up to these realities can help doctors live up to the ideals that drove them to medicine in the first place.