PMR is the least happy specialty

[clubdeac]

A new medscape article focusing on physician burnout showed that PMR physicians were the least happy at work of 29 specialties and had the 3rd highest burnout rate. Apparently more than 15,000 physicians were surveyed. First I’d like to know more about the practice specifics of the PMR physicians that responded. Second, is the AAPMR/ABPMR aware of this and if so what are they doing about it? Personally I couldn’t agree more with the results. I just sent an email to the board and academy and strongly encourage others to do the same. Our field is obviously in need of some serious help.

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[Bostonspine]

I personally wonder how that breaks down inpatient vs outpatient...

 

[cluelessme7]

If that is the medscape survey you are referring to, its 15k physicians across all specialties, from which PM&R representation is 2%. I'm skeptical of making the generalization off such a low n. I have yet to actually meet a truly burnt out PM&R attending, both inpatient or outpatient.

 

[j4pac]

I can see it. ER and PM&R are both regarded as “good lifestyle” specialties. I think that tends to draw a particular crowd...people who want to make good money while not working as hard. But you’re still a physician...the hours can be long and stressful and most PM&R physicians are not driving round in Lamborghinis. Throw in a more stressful than average patient population and wahlah, you have burnout and low job satisfaction.

I suspect that if that same group was transported into a different specialty, the result wouldn’t be any different.

 

[sloh]

I can see it. ER and PM&R are both regarded as “good lifestyle” specialties. I think that tends to draw a particular crowd...people who want to make good money while not working as hard. But you’re still a physician...the hours can be long and stressful and most PM&R physicians are not driving round in Lamborghinis. Throw in a more stressful than average patient population and wahlah, you have burnout and low job satisfaction.

I suspect that if that same group was transported into a different specialty, the result wouldn’t be any different.

Agreed. Happiness = reality - expectations. Selection bias with these surveys.

 

[clubdeac]

If that is the medscape survey you are referring to, its 15k physicians across all specialties, from which PM&R representation is 2%. I'm skeptical of making the generalization off such a low n. I have yet to actually meet a truly burnt out PM&R attending, both inpatient or outpatient.

Well now you’ve met one been practicing 10 years. Maybe got 5 more years in me if things don’t change

 

[Chelsea FC]

Well now you’ve met one been practicing 10 years. Maybe got 5 more years in me if things don’t change

Can you please voice why you are unhappy in your field ?

 

[PMR2008]

A few thoughts. I am not surprised about the survey at all. A little background about myself. The company I started with in 2012 grew from 3 physicists to about 130+ in 6 years. I have been involved with every step of the growth and since I am part of the admin and med affairs I have had a chance to directly talk to 300-400 doctors over the years. Many I have meet in person as well. Half of them ended up joining our group.
All the docs I talked to had symptoms of burn out and were unhappy with their current situation. Very few were unhappy because of the choice of specialty or the part of the country they were working in. The primary reasons I have seen are below
1) Inpatient/Acute Rehab - sicker patients, increased regulations, low pay, lack of control, lack of admin support, call, long hours, working on weekends/call
2) Outpatient pain - regulations, type of patients, long hours, lack of partnership potential, reduction in reimbursement
3) Academic - low pay, hierarchy, long hours, lack of control
4) VA - low pay, bureaucracy

It can be hard for my practice to recruit sports med or VA physiatrists(except those looking for a pay raise or hate the bureaucracy). Primarily because they have low burnout.

 

[clubdeac]

Can you please voice why you are unhappy in your field ?

burdensome administrative tasks, onerous EHRs, mountainous paperwork, endless insurance headaches, falling reimbursement, NP encroachment etc,

 

[cluelessme7]

I guess the question then becomes, how does one combat this? A lot of the issues discussed above are apparent throughout most if not all fields in medicine, especially ones that deal with emergent/acute issues necessitating active overnight coverage. The burn out rates across the board will be sky rocketing in the coming years.

 

[Chelsea FC]

burdensome administrative tasks, onerous EHRs, mountainous paperwork, endless insurance headaches, falling reimbursement, NP encroachment etc,

Im a medical student so I have no idea about this stuff but when i search around the different speciality sub-forums most of these problems you listed are also issues other fields are complaining about so the question is are any of these specific to PM&R specifically ?? What about the field makes theses issues more profound ? As someone interested in the field I would love to hear your opinion.

 

[sloh]

I guess the question then becomes, how does one combat this? A lot of the issues discussed above are apparent throughout most if not all fields in medicine, especially ones that deal with emergent/acute issues necessitating active overnight coverage. The burn out rates across the board will be sky rocketing in the coming years.

There are certain routes in PM&R that are more promising. 2 that come to mind are SAR contracting group (NHR, US Physiatry, IRC) or outpatient MSK with a health system under salary compensation model as opposed to RVU's (with a reasonable patient volume).

 

[Eurycea]

burdensome administrative tasks, onerous EHRs, mountainous paperwork, endless insurance headaches, falling reimbursement, NP encroachment etc,

How big of a concern is NP encroachment for PM&R?

 

[clubdeac]

How big of a concern is NP encroachment for PM&R?

I know of several CRNAs across the nation doing stim, RFA and vplasty. It’s insane...here’s one example. He even refers to himself as doctor. How this is legal I don’t know

 

[HaveAnOsteoblast]

I can see it. ER and PM&R are both regarded as “good lifestyle” specialties. I think that tends to draw a particular crowd...people who want to make good money while not working as hard. But you’re still a physician...the hours can be long and stressful and most PM&R physicians are not driving round in Lamborghinis. Throw in a more stressful than average patient population and wahlah, you have burnout and low job satisfaction.

I suspect that if that same group was transported into a different specialty, the result wouldn’t be any different.

Voila...

 

[RangerBob]

Medicine can be miserable. I’d literally go crazy if I had to do derm. When I rotated through rads, 3-4hrs in that reading room wore me out more than 14+ in the ICU. I counted down the hours till lunch everyday.

If you go into PM&R for the lifestyle, you will burn out/become unhappy, just like any specialty. So many people now go into the field thinking the grass will be greener, but it’s the same as everyone else’s lawn.

I don’t see anything intrinsic to the field that would make it less desireable than others. Too much paperwork?! Try FM or peds! No respect? See the last answer. Midlevel encroachment? See above! Low pay? Lousy EMR? I’m sounding like a broken record here.

The difference is no one went into FM/Peds/IM hoping to dodge most of medicine, get a good salary, with good hours, and less stress. And then find out many PM&R jobs don’t offer all of that.

A good read for all of us (including myself, as I’ve been complaining a bit more about my job lately):

Stop Whining About Job Satisfaction | The White Coat Investor - Investing & Personal Finance for Doctors

 

[ED50]

Medicine can be miserable. I’d literally go crazy if I had to do derm. When I rotated through rads, 3-4hrs in that reading room wore me out more than 14+ in the ICU. I counted down the hours till lunch everyday.

If you go into PM&R for the lifestyle, you will burn out/become unhappy, just like any specialty. So many people now go into the field thinking the grass will be greener, but it’s the same as everyone else’s lawn.

I don’t see anything intrinsic to the field that would make it less desireable than others. Too much paperwork?! Try FM or peds! No respect? See the last answer. Midlevel encroachment? See above! Low pay? Lousy EMR? I’m sounding like a broken record here.

The difference is no one went into FM/Peds/IM hoping to dodge most of medicine, get a good salary, with good hours, and less stress. And then find out many PM&R jobs don’t offer all of that.

A good read for all of us (including myself, as I’ve been complaining a bit more about my job lately):

Stop Whining About Job Satisfaction | The White Coat Investor - Investing & Personal Finance for Doctors

This is a great read, thanks for sharing!

 

[Mad Jack]

I know of several CRNAs across the nation doing stim, RFA and vplasty. It’s insane...here’s one example. He even refers to himself as doctor. How this is legal I don’t know

He says he is board certified in anesthesiology which is horribly, terribly, awfully incorrect and misleading

 

[Osminog]

He says he is board certified in anesthesiology which is horribly, terribly, awfully incorrect and misleading

And fraudulent.

 

[SSdoc33]

He says he is board certified in anesthesiology which is horribly, terribly, awfully incorrect and misleading

The website is purposely ambiguous. The page itself is dedicated to this huckster, and there is a separate heading stating "Board Certified For Anesthesiology" which describes what an anesthesiologist does. It is meant to trick the less knowledgeable.