Hard to find joy in medicine in wake of ongoing regulatory change

The ongoing onslaught of regulatory changes in the healthcare industry has left one doctor exhausted—and unsure whether he still loves the job.

Jordan Grumet, M.D., an internist practicing in Highland Park, Illinois, writes in a column for MedPage Today that he will stay in medicine because he enjoys caring for people, but the constant changes brought on by legislation like the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have left him with whiplash.

“What I do today is no longer practicing medicine. Instead it's like dancing the waltz, tango, and salsa simultaneously to a double-timed techno beat,” writes Grumet. “It's sloppy, rushed, unpleasant to look at, and often leaves my partner more confused and anxious than when we started.”

The sentiment is not uncommon, as MACRA’s new payment models leave many questions unanswered despite the law’s lofty goals. Some doctors have even proposed dropping out of Medicare entirely to cut back on stress. They argue that the Merit-Based Incentive Payment System (MIPS), the central feature of MACRA, seeks to “beat solo physicians into submission” and that the easiest way to reduce that stress is to eliminate the cause entirely.

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Burnout and stress is a common problem among doctors, so much so that most healthcare leaders (96%) surveyed say it’s a significant issue. Another survey of more than 1,600 neurologists found that 6 in 10 reported experiencing at least one symptom of burnout, like exhaustion, depersonalization or low personal accomplishment.

Raghav Govindarajan, M.D., a neurologist at University of Missouri Health Care, who was not involved with the survey, said in a second MedPage Today article that much of the exhaustion for neurologists doesn’t come from the job itself, but from “external factors like increased paperwork, insurance hassles, and ever-increasing regulation,” echoing Grumet’s concerns.

Stress and burnout can negatively impact a clinician’s performance, and possible strategies for combating that level of exhaustion include focusing on physician wellness and embracing team building.