Tag: Internal Medicine


It happened again.  I was talking to a particularly sick patient recently who related another bad experience with a specialist.

“He came in and started spouting that he was busy saving someone’s life in the ER, and then he didn’t listen to what I had to say,” she told me.  ”I know that he’s a good doctor and all, but he was a real jerk!”

This was a specialist that I hold in particular high esteem for his medical skill, so I was a little surprised and told her so.

“I think he holds himself in pretty high esteem, if you ask me,” she replied, still angry.

“Yes,” I agreed, “he probably does.  It’s kind of hard to find a doctor who doesn’t.”

She laughed and we went on to figure out her plan.

This encounter made me wonder: was this behavior typical of this physician (something I’ve never heard about from him), or was there something else going on?  I thought about the recent study which showed doctors are significantly more likely than people of other professions to suffer from burn-out.

Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both).

This is consistent with other data I’ve seen indicating higher rates of depression, alcoholism, and suicide for physicians compared to the general public.  On first glance it would seem that physicians would have lower rates of problems associated with self-esteem, as the medical profession is still held in high esteem by the public, is full of opportunities to “do good” for others, and (in my experience) is one in which people are quick to express their appreciation for simply doing the job as it should be done.  Yet this study not only showed burn-out, but a feeling of self-doubt few would associate with my profession.

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“I can’t sleep, doc.”


“Yeah. And it ain’t like I ain’t sleepy, either. I just be sitting there. Just up and bored.”

“Tell me about your evenings.”

“I get in bed at like eleven. I turn on my television and just watch some TV. You know, Leno and the news.”


“My old lady falls asleep and then I just sit there. Wide awake.  After while, I shut off my television and just lay there.”


“I know . . . .  I ain’t supposed to watch TV in bed, but I’m telling you, doc, it ain’t that.”

“That television can be harder on you than you think. Has it always been hard for you to sleep?”

“No, ma’am. I used to sleep fine. And as for that TV? Naw, it ain’t that. I been sleeping with my TV for years.”Continue reading…