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Why Do Physicians Stay in Toxic Work Environments?

— Reclaim your power at work

MedpageToday
A photo of a male physician checking his watch.

This post originally appeared on

For the most highly educated and specialized professional on the healthcare totem pole, physicians put up with a ridiculous amount of nonsense in the workplace.

You are pressured to see high volumes of patients in a rapid-fire fashion (15 minutes per visit) even when it interferes with the quality of care.

You are expected to complete mundane and excessive administrative tasks and generally are not directly compensated for this time.

You are given very little flexibility from your employers when it comes to rearranging your schedule and taking personal time off.

For the average physician, the working conditions are intolerable at best and inhumane at worst.

So the question is, why is this poor treatment tolerated?

I think part of the answer has to do with learned helplessness. In case you don't remember your Psych 101 class, let me give you a little refresher.

In 1965, psychologist Martin Seligman, PhD, was doing research on classical conditioning and discovered a phenomenon called learned helplessness.

In the experiment, he administered electric shocks to a dog stuck in a crate. There was no way for the dog to escape the crate or escape the shocks. The dog just had to endure shock after shock.

Then they put the dog into a larger crate where half was electrified and half was not. The dog now had an escape route. It could easily jump over a small fence into the non-electrified area and avoid the pain of the shock.

But when the researchers administered the shock, the dog just laid down, accepting its fate. They named this condition "learned helplessness," or not attempting to remove yourself from a negative situation because your past experience has shown you that you are helpless.

I believe medical training teaches physicians that they are helpless. Throughout medical school and residency, you are administered shock after shock of painful experiences.

Work a 24-hour shift and complete 6 hours of documentation afterward. Shock.

Stand for 10 hours holding a retractor in or without taking a water or bathroom break. Shock.

Be shamed for taking a sick day. After all, you are either in the hospital (working) or you are in the hospital (because you are so sick). Shock.

You are led to believe that this is just the price of admission to becoming a doctor. If you really want to become a physician you must find a way to endure these painful situations. You just have to put your head down and power through your training. There is no way out but through.

But once you graduate residency and are out in the world working as a board-certified physician, you take that sense of learned helplessness with you: when you are told you have to see 22 patients in one morning, when you are expected to check your inbox even on your off days, when you are asked to cater to patient satisfaction metrics.

Many physicians just lay down and accept their fate (albeit begrudgingly).

You tolerate being overworked and underappreciated because your past has taught you that you are helpless.

But you are not helpless, and if you want the healthcare system to change and your quality of life to improve, you must start to reclaim your power.

So if you are burned out in the medical field and feeling helpless and powerless to change anything, I want to challenge you.

What is one small way you can reclaim your power at work?

  • It could be saying no to squeezing in a patient who called for a last-minute sick visit when your schedule is already booked.
  • It could be negotiating getting paid for your administrative tasks.
  • It could be setting a boundary for not checking your inbox on your off days and asking your employer to hire someone to cover this.

Until you start to reclaim your power and advocate for yourself, you will remain stuck in the electrified crate that is our current healthcare system receiving shock after shock of painful experiences.

Chelsea Turgeon, MD, is a former OB/GYN resident and can be reached at .

This post appeared on .