Welcome to this new website and blog for physicians in search of greater efficiency, meaning and joy in their work.  

Why now? I've observed a growing sense of discontent among the physicians I encounter, and within myself.  This cannot be good for patients. And it cannot be good for the physicians who care for them.  

This could be the best of times for medicine. We can do more for patients, with less risk, then we ever could before. We can communicate with colleagues and patients by call, text, email or even (!) in person. We have information resources at our fingertips. No more lingering doubts about the workup or long searches through outdated text books for treatment guidance. Why then do so many of us feel our days are being drained of meaning? 

I've spent much of the last five years trying to answer these questions, to discern how much of the problem is me as an individual, and how much is the system. I’ve concluded that while I have a lower tolerance for busy work than many, it is, in fact, mostly the environment—what is becoming a toxic brew of policy, technology and regulation--an environment that is sucking much of the oxygen out of practice.


Here is a quote from a colleague, who recently wrote: 

In no other industry would the highest paid, scarcest workers be assigned repetitive, largely worthless tasks that would not only take them away from critical work and leadership roles...but sour them upon even the true mission-driven aspects of their careers.

I work in one of the best practice models in the country, and yet I daily feel constrained by the additional roadblocks, burdens and electronic busy work that are added each year. We try to have the energy to both “be in compliance” and care for our patients. One day recently I was dispirited by all of the tasks I do that a junior high student could do: start the computer, sign in, navigate to the patient, navigate to the multiple screens that only I can am permitted to do, complete the billing invoice, do rote attestations….and from reading 10 page EHR notes from outside physicians that don't tell me the patient's story or the doctor's thinking.

And then I went to the hospital to admit one of my patients in transfer from a tertiary center after extensive surgery. We sat and talked about how he'd done, and how his wife, whom we had recently diagnosed with a malignancy, was doing. This was meaningful. This mattered. When I am on the brink of throwing in the towel, a patient pulls me back. 

I can't believe that EHR software developers, designers of Meaningful Use and other regulators, compliance officers, administrators, CMIOs and payers go to work every morning to ensnarl physicians in a thicket of mind-numbing tasks and frustrations that prevent us from meeting our best intentions for our patients. But that is the cumulative result of many well-intended policies and poorly designed technologies.

I do believe there is hope. That collectively we can find our way out of this tangle. Please join us in this search for joy and meaning in our work, and help us work together to create practice environments that bring out the professionalism in each of us.