By Johnathon Ross, M.D., M.P.H.
JAMA Network Open, Comment, Jan. 4, 2025
A recent editorial in the Journal of the American Medical Association decries the fact that caregiver burnout seems to arising from systemic causes:
āThe crisis of physician burnout has serious implications for every aspect of health care delivery. That physicians who work the hardest to meet vulnerable patientsā needs are more susceptible to experiencing burnout highlights the need for systemic reforms that allow physicians to connect with meaningful work in ways that support rather than exhaust them.ā
Yes, it is paradoxical that physicians and other caregivers are burning out from their most meaningful roles. There is an even greater paradox that stares caregivers in the face every day. That paradox is how the wealthiest nation in the world can spend nearly twice as much per capita on health care as any other rich nation and still have the worst health outcomes. (See the OECD reports and the Mirror, Mirror reports from the Commonwealth Fund.)
U.S. caregivers see the enormous waste and profiteering, and the neglect of our most vulnerable fellow citizens by our sickness care non-system. It is dominated by PHARMA, the insurance industry, the device makers, and hospital systems that put profits and greed before patients in need. How are we as physicians supposed to respond to such a cruel and unjust system that leaves nearly 30 million with no coverage, and nearly half of us self-rationing our own care due to unaffordable co-payments and deductibles that are supposed to control costs by putting āskin in the game,ā but have clearly failed to control costs or improve care. We see who is getting skinned and it is not a game.
Those of us at Physicians for a National Health Program believe that an improved, expanded Medicare for all can achieve this goal. We already have the best caregivers, the best facilities, and the best research, and already spend enough money to create the best health system in the world. Those who are benefitting from the current failing sickness care non-system are wealthy, powerful enemies of this type of change. They will not go away without a struggle.
What we lack is the political will to kick these moneychangers out of the Temple of Medicine. We have the power to bring about the needed change. The cure for our health care blues is for caregivers to become activists who seek the system change that will allow us to focus on the care of our patients. Caregivers are the DNA. Without us they cannot create the next generation of caregivers. Without caregivers there is no system. We have the power. We must organize the struggle.
āPower concedes nothing without a demand. It never did and it never will. If there is no struggle, there is no progress.ā – Frederick Douglass
Dr. Johnathon Ross is a past president of Physicians for a National Health Program.