Month: April 2014

The Imposter Syndrome Part I: Once Thought Rare, Now Known to be Common Among Physicians

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The Imposter Syndrome

You didn’t learn about it in medical school and you probably rarely talk about it. But you need to be aware of a syndrome that’s all too common among physicians all over the world. It strikes regardless of specialty, income, or years in practice. Although there is no definitive data, it’s believed to have reached epidemic proportions.

What am I talking about? It’s the Impostor Syndrome! If you have Imposter Syndrome (IS), you may fear that it’s only a matter of time that you’ll be “found out” as a fraud. Despite abundant external evidence of success and accomplishment, you regularly find it difficult to believe that you are, indeed, a success. You may attribute your accomplishments to luck or chance, not believing that you actually have the intelligence, fortitude, and skills required to get to your current place in your career. You likely also have an inflated sense of the success and aptitude of others.

When the Imposter Syndrome Strikes

Whatever your professional status, you can still get IS. Listen to what Dr. Margaret Chan, Director of the World Health Organization, says about herself: “There are an awful lot of people out there who think I’m an expert. How do these people believe all this about me? I’m so much aware of all the things I don’t know.”

The emotional drain of IS is significant. It erodes your sense of confidence, and contributes to the emotional exhaustion and lack of sense of accomplishment emblematic of physician burnout.

The syndrome does not only strike physicians but is particularly common among this group. Why?

1)      There are simply too many technological advances to keep up with. No matter your specialty, the body of knowledge is growing rapidly.

2)      Medical training emphasizes perfection. You’re taught early on that you should know the answer to everything related to our field, and, if you’re not perfect, you’re a failure.

3)      Physicians tend to be their own harshest critic, focusing much more on negative qualities than their strengths.

So, how do you make the diagnosis of IS in physicians? The criteria include all of A, B, and C:

A. The patient must be a physician.

B.  On at least a weekly basis, the patient believes they will be “found out” as a fraud.

C.  The patient believes that all other physicians in their specialty know more than they do.

Do you or someone you love suffer from Imposter Syndrome? If so, you can take comfort knowing that it affects almost all physicians. Once a diagnosis is made, knowing how to manage the syndrome is key. Stay tuned for Part II to find out more about treatment of this common disorder.

4000 Clicks: The EMR Really Is Dragging You Down

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We all know the advent of the electronic medical record (EMR) is slowing us down. While it’s leading to better care (although the jury is still out on this,) it’s adding one more headache to your over-extended days. The jury is in, however, finding that the EMR is worsening physicians’ quality of life and contributing to physician burnout, something we are in the midst of an epidemic of. A recent study in the American Journal of Emergency Medicine supports what other studies have found: physicians spend a greater percentage of time on documentation than they do on direct patient care.

From 6 mouse clicks to order an aspirin to 227
for a discharge summary after an ER visit for abdominal pain, this study found that physicians spent 44% of their time on data entry and only 28% on direct care.  This is 1.5 times as much time on documentation as on patient care.  A scary figure, yet pretty validating for physicians who find themselves overwhelmed.

Why is this important for you to know? Because you are not alone! Many physicians feel like there is something wrong with them personally for not being able to keep up with documentation, that sense of always running behind. As time pressures increase, physicians are more and more isolated from one another, so there’s less and less opportunity to, shall we say, “compare notes.” In addition, it’s always better to have validation that a problem you’re experiencing is real and external, not in your head or due to a state of deficiency on your part.

We can’t change the fact that the EMR is here to stay. Once you know what you’re up against, though, you’re less likely to let it weigh you down psychologically. It’s a small thing but, with physician burnout so rampant, EVERY small amount of weight you can shed contributes to your ability to survive.