Can Being A Faculty Member Be Fun?
By
Leonard Zwelling
https://www.nejm.org/doi/full/10.1056/NEJMms2311042
In this excellent article in The New England Journal of Medicine printed on March 7, national correspondent Lisa Rosenbaum discusses the concept of “moral injury.” It is essentially when doing your job runs up against your values. It applies to physicians when the systems in which they are working prevent them from doing what they believe will deliver the best medical care. She writes moral injury is when “the system prevents” physicians “from meeting the patients’ needs.”
I agree with Dr. Rosenbaum and believe it is harder than ever for doctors to do what they think is best for their patients and still fulfill the administrative commitments asked of them by the corporatized system in which medicine is practiced.
I was taught a long time ago what fun is. Fun is “pleasure, engagement, and meaning.” I am going to argue that what lies between current faculty attitudes (i.e., burnout) and the goals of the administration to increase revenues through more rapid patient throughput, is that the faculty are not having fun because of the moral injury they face every day.
A doctor knows when a patient needs more of his or her time and must be allowed to deliver that care even if it does not meet the administrative needs of clinic leadership, i.e., see another patient every 15 minutes.
A scientist knows what to spend time on like performing experiments, reviewing data, and teaching students. Investigators do not need scores of computer-based courses in lab safety and sexual harassment to do their jobs. Those courses are only CYA for administration in case something goes wrong they have someone else to blame.
Clinical investigators understand the regulatory requirements of performing human subjects research and do not need more bureaucratic hurdles to leap over. Believe me, I get this one as I was once the one setting up the bureaucratic hurdles trying to keep the institution in line with federal code. That part wasn’t always fun.
In the end, I think the thing that would go the farthest to tamping down burnout as well as decreasing moral injury would be if the performance of the faculty’s jobs was fun.
That doesn’t mean every minute has to be filled with joy, but an effort on the part of the leadership to lessen administrative tasks and recognize the tremendous burden Epic puts on clinicians (often at home after dinner) might go a long way toward increasing doctor satisfaction which would in turn increase patient satisfaction. It would also decrease the incidence of “non-professionalism” which often stems from frazzled days and long nights.
The leadership of any business organization, academic medical or not, has to own the well-being of the staff most aligned with the business model. At MD Anderson, that would be the faculty and clinical and research support staff.
Right now, for faculty, that is simply not the case as I see it, but I could be wrong. If I have it wrong and your job is fun and not laden with moral injury, please correct me on the comments page or via email (leonard.zwelling@gmail.com).
But if I’m right, then let your department chiefs and division heads know that it’s not working for you right now and that it is their responsibility and that of the leadership to make work fun again.
Work doesn’t have to be a four-letter word. At times in my life, it has been. At other times it was pure joy. Most of that was up to me, but not always. The system could get me down. It is one of the jobs of leadership to facilitate joy in the workplace and not just for themselves by making doing of the work as easy as possible and as much fun as possible.
