I noticed Dr. H. Steven Moffic, MD had written another article in Psychiatric Times asking whether it’s time for psychiatrists to consider going on strike. Often the issue triggering discussions about this is the rising prevalence of physician burnout. I’ve already given my personal opinion about physicians going on strike and the short answer is “no.”
One of my colleagues, Dr. Michael Flaum, MD, recently delivered a Grand Rounds presentation about physician burnout. The title is “Everyone Wins—The Link Between Real Patient-Centered Care and Clinician Well-Being.”
Fortunately, I and other are able to hear the substance of his talk on the forum Rounding@Iowa. During these recorded presentations (for which CME can be obtained), Dr. Gerry Clancy, MD interviews clinicians on topics that are of special interest to medical professionals, but which can be educational for general listeners as well.
I remember meeting Dr. Flaum when I was a medical student. At the time, he was very involved in schizophrenia research. He’s been a very busy clinician ever since. As he says, while he may be Professor Emeritus now, he’s definitely not “retired.” He’s still very active clinically.
Dr. Flaum identifies both systems challenges and physician characteristics as important in the physician burnout issue. Interestingly, he bluntly calls the systems challenges as virtually unchangeable and focuses on bolstering the physician response to the system as the main controllable factor. His main tool is Motivational Interviewing, which is more of an interview style than a separate kind of psychotherapy.
I think the kind of approach that Dr. Flaum recommends, which you can hear about in the Rounding@Iowa presentation, is what most psychiatrists would prefer rather than going on strike. See what you think.
Go Retire Psychiatrist 
I attended a very good conference on moral injury today that was presented by a psychiatry colleague. She did an excellent job of tracing the history all the way back to Achilles in the Iliad and then discussed factors in the present that lead to moral injury of physicians and other healthcare workers. The strike issue came up and the practical aspect is that caring for patients, especially those in the hospital is not really optional – even though their suboptimal care for profit is a major source of moral injury.
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