 I think this is pretty obvious, right? If you don't want people to leave medicine, pay them well and not overwork them. The problem is no healthcare system wants to do that. Welcome back to the channel, everybody. For those of you who are new around here, my name is Michael, aka Dr. Cellini, and I'm a board certified diagnostic and interventional radiologist in New Jersey. Now, if you've been watching my channel for a little bit now, you have seen me post many videos about med students and physicians quitting medicine. And you may think this is just a subset of YouTubers trying to get views, comma, how, comma. However, it's actually a bigger problem than we may think. However, I said, comma, I'm dictating. In fact, one in five doctors say they will leave their current practice within the next two years. And one in three healthcare workers and doctors say they will reduce their work hours within the next 12 months. This is all according to a recent published survey, which of course I'll link down in the description. The recent survey was based off of 20,000 responders over 124 different institutions across the country. I'm just gonna go ahead and read some of this. The study found out that burnout, workload, fear of infection, anxiety or depression related to COVID-19 in the number of years in practice were associated with the intent to reduce work hours or leave. This is all again, according to a recent published study out of Mayo Clinic proceedings. And the study was not just shocking for everybody reading it. It was also shocking to the actual author of the paper. And she had this to say, while we anticipated that the stress of the pandemic would impact the people providing care, the extent of stress and the percentage of workers considering leaving is worrisome. Now that's actually coming from the author who wrote the actual paper. Crazy, right? And it wasn't just physicians who were experiencing the burnout. It was also noted that medical assistants, nursing assistants also experienced some of the highest degrees of COVID related stress and burnout. In fact, many healthcare organizations nationwide were having trouble filling medical assistant positions. Many hospitals and clinics are not fully staffed because of everything I just mentioned a minute ago. So you can imagine that this actually puts further strain, increased work and stress on the remaining healthcare workers. Now the author went on to talk about how in order to maintain access for patients and prevent the remaining clinicians from being overwhelmed, they need to nip it in the bud before it gets worse. And it's kind of leaning that way. So what exactly do we even do about all of this? But before we get into that, I wanted to touch on a few reasons why I personally think healthcare workers are leaving medicine. So let's touch on a few of those reasons. Number one, the elephant in the room. None other than what's causing this entire pandemic, the COVID virus. Now this is obviously a huge topic and a lot of people know about the increased demands placed on healthcare workers during the pandemic, lasting over the last three years now. I don't want to belabor this too much because I think everybody at this point who has been alive knows about the increased demands on these healthcare workers. However, that aside, there's been a massive swing in how people treat and think about healthcare workers during this time. If you remember towards the start of the pandemic, people used to cheer in the street in New York City. They would cheer at seven PM on the dot every single night, praise the healthcare workers like they were actual heroes. And as the pandemic went on, the pandemic became more politicized and thus healthcare workers were no longer heroes. And in fact, they were divided amongst each other and against the population. Healthcare workers like myself included risked our lives at the beginning of the pandemic because we actually had no idea what we were dealing ourself into. And I can't even describe how stressful and staring it was. Next, we developed a vaccine. We thought it was going to be our savior and in this pandemic and put it all behind us. However, it just became so overly politicized. It actually hurt and divided healthcare workers. Again, almost entirely related to politics, conspiracy theories and who knows what's being said on Facebook. And politics aside, working long hours and full PPE and walking into the unknown during this time is a stress that you can't really explain. You can only experience it. That's the only way I tend to describe it. What made it even worse during this time for healthcare workers is that the rest of the world was staying at home or working from home while we went in and battled it head on. A lot of the world worked from home and worked less where we had to work more harder, longer hours, understaffed and deal with something we were very unfamiliar with reading. So you can imagine the increased stress that put on all of healthcare workers. We had friends, patients, family members, colleagues fall ill, but we had no time to think about it or them. And furthermore, as you all know, we couldn't even visit them while they were sick. Now I don't want to get too far into this because I think at this point it's like beating a dead horse. But the pandemic has weighed on many people in healthcare probably more than they think. And the long-term effects of this stress has yet to be discovered. The second reason why I think doctors and other healthcare workers are leaving medicine is because of burnout, which is something any healthcare worker is familiar with. Now a lot of this may overlap with what I was just talking about. However, working longer hours and more shifts is definitely not sustainable and can quickly lead to burnout. Now I know what you are thinking, why is this radiologist talking about stress and burnout in the workplace when all he does is go into the hospital late and leave early, which isn't exactly true, by the way. However, radiology experiences a significant amount of burnout mostly due to the increased demands on imaging requirements per person, which means you have to read faster and more studies in a smaller amount of time, which is usually more than you can handle. You can imagine how that would lead to burnout. The next reason why I think healthcare workers are leaving medicine as a whole is because of the pay. I think especially during the pandemic we've seen many fields that can make more money than healthcare workers make, especially with not having to deal with all the stress that healthcare workers have to deal with. There are a lot of opportunities whether it be social media, other hobbies you may pick up that you found out about during the pandemic that could lead to more lucrative opportunities and less stress. Furthermore, the pay, especially during the pandemic did not really align with the amount of work we were putting in, especially including all the extra work, long hours, long shifts that we had to do in order to treat and take care of these extremely sick patients. The next reason why I think people are leaving healthcare is because there is lack of empathy. You're probably like, what do you mean? We have plenty of empathy towards our patients, but that's not what I'm talking about. The lack of empathy I'm talking about is from administration. I've worked in many different hospital systems. Some of them are very good and some of them don't really care about healthcare workers and a lot of those bad ones only care about one thing and that's the bottom line. The healthcare workers are not really a top priority. A quick disclaimer here, I love the current organization I work with so this does not include you. Like I said, not all hospitals act this way but there are definitely some that do. This has always been the case for as long as I have been in medicine. However, I think the pandemic really highlighted this issue and not only did it further highlight this issue, it actually created a larger divide between healthcare workers and administration which ultimately just led to more burnout. I think we saw many reports during the pandemic where hospitals were pushing their employees to work harder and longer hours all while being short staffed, also without PPE but that's neither here nor there. And while those healthcare workers were working extra time they weren't really being compensated for it. The hazard pay wasn't there, the overtime wasn't there. We just kind of did it because that's what we do as healthcare workers. We work and we take care of patients but when you're not compensated well for what you put in eventually you burn out. The next reason why I think people are leaving healthcare is because reimbursements continue to go down. Now I know you already talked about pay but I just wanted to touch on reimbursements as well because a lot of you all probably don't know how physicians get paid. Reimbursement rates are basically rates for certain procedures or surgeries or clinic visits, et cetera. That Medicare, Medicaid and insurance companies pay physicians or other providers. Every procedure, surgery, office visit, complaint, et cetera has a certain code and each code builds a certain amount and obviously the amount that the code is billed for depends on how complicated the procedure is, how complicated the surgery is, how long the visit is, whole bunch of other factors are going to it that we're not going to get into today. Now year over year, a lot of specialties experience decreased reimbursement rates which means they have to continue to work harder and harder as the reimbursement rates for those procedures or surgeries or whatever go down which means you have to work harder, harder, longer hours automate the same pay as the reimbursements go down and as you can see, just to maintain your current salary having to work harder, harder, longer hours can obviously facilitate and hasten burnout. Now I'll give you a quick radiology example because that's pretty much all I know. So say I'm a neuro radiologist that gets paid $20 for every MRI brain that I read. I may read say 20 brain MRIs in a certain shift for the sake of this example and I would make $400 off of those 20 brain MRIs. Say next year the insurance companies, the government, they meet and decide to reimburse $18 for every MRI brain because it's not that complicated after all in their eyes. So now you can see that I have to read more in order to reach $400 per day. In fact, I would have to read at 22.2 MRI brains every day in order to make $400 which means I would either have to read faster or stay longer at work. And you can see year after year after year, this could most certainly lead to burnout because you'll have to read faster, you'll have to read more studies all to maintain your current salary. Burnout is bound to happen and that's why it's so prevalent in the field of radiology. And finally, the last reason why I think physicians especially are leaving medicine is because let's not forget those criminals who are charging so much for medical school. Student debt is becoming out of control at this point. Some schools are charging $100,000 per year which is absolutely insanity. In fact, the average physician debt graduating medical school is around 200 to $250,000 which is about accurate for me. The increasing rates of student loan debt, further increase of working hours and longer days to help pay off that large student debt burden which leads to burnout. And when you pile on the student loan debt on top of decreased reimbursement rates for physicians, burnout is right around the corner. Now I just wanted to touch on a few of these reasons why I think physicians are leaving medicine and I could go on further and further with many more examples but we'll stop right there and continue on what the heck we're going to do to fix this problem. Now this is quite a loaded question. So how exactly do we prevent healthcare workers and physicians from quitting medicine altogether? Well, we could just fix everything I just talked about but that would probably be too easy. So let's get into a little discussion about how we're going to fix this mass exodus in medicine. Now this is coming from the authors here of this paper that we talked about earlier and they say that we should make the employees feel valued. Everybody wants to feel valued after all. They say feeling valued by one's organization reduces the rest of healthcare workers intending to cut back their hours or leave altogether. The author offers suggestions to the employers that they should consider lessening the workload on physicians and staff as well as well as reducing hours worked. So I think this is pretty obvious, right? If you don't want people to leave medicine just pay them well and tell them to work less. I mean that seems pretty obvious but the problem is no healthcare system wants to do that. The author also states that some ways an organization can help healthcare professionals feel valued is that they can have transparent communication, offer support for children and or rapid training to support deployment to unfamiliar units which I think is a good idea. I can't tell you how many of my friends were deployed to other units that they had no business being in but that's what you had to do when you're understaffed in a pandemic. And then they also offered some suggestions on how they can fight burnout for the healthcare workers. You can focus on providing adequate PPE obviously you can create supportive environments how enlightening you can ensure access to services for mental health which I totally agree with. You can reduce workload via better teamwork that's kind of hard to develop but still agree here. You can even apply a systems approach to interventions and that improving organization culture and practice efficiency. I just love this. This is like such a corporate answer. I just love these type answers. Now aside from all this corporate jargon here the real way to prevent burnout and mass exodus of physicians and healthcare workers is to pay them well and not overwork them. It's really that simple. It's a simple equation that for some reason just isn't accepted. Now at the end here I'll leave you with a quote from the article. Healthcare workers ultimately want to help patients and their ability to adequately do so is taking its toll. Healthcare workers aren't exiting the field because they can't handle their jobs they're quitting because they can't handle being unable to do their jobs which I think is a fantastic quote. I should put that on a T-shirt. So do me a favor, like this video, subscribe to my channel for more content like this. And as always, I'll see you all on the next video. Bye.