We are witnessing the slow death of American medical ideology

From The New York Times (accessible text):

Doctors have long diagnosed many of our sickest patients with “demoralization syndrome,” a condition commonly associated with terminal illness that’s characterized by a sense of helplessness and loss of purpose. American physicians are now increasingly suffering from a similar condition, except our demoralization is not a reaction to a medical condition, but rather to the diseased systems for which we work.

The United States is the only large high-income nation that doesn’t provide universal health care‌ to its citizens. Instead, it maintains a lucrative system of for-profit medicine. For decades, ‌at least tens of thousands of preventable deaths have occurred each year because health care here is so expensive.

During the Covid-19 pandemic, the consequences of this policy choice have intensified. One study estimates at least 338,000 Covid deaths in the United States could have been prevented by universal health care. In the wake of this generational catastrophe, many health care workers have been left shaken.

“For me, doctoring in a broken place required a sustaining belief that the place would become less broken as a result of my efforts,” wrote Dr. Rachael Bedard about her decision to quit her job at New York City’s Rikers Island prison complex during the pandemic. “I couldn’t sustain that belief any longer.”‌

Thousands of U.S. doctors‌‌, not just at jails but also at wealthy hospitals, now appear to feel similarly. One report estimated that in 2021 alone, about 117,000 physicians left the work force, while fewer than 40,000 joined it. This has worsened a chronic physician shortage, leaving many hospitals and clinics struggling. And the situation is set to get worse. One in five doctors says he or she plans to leave practice in the coming years‌.

To try to explain ‌‌this phenomenon, many people have leaned on a term ‌‌from pop psychology for the consequences of overwork: burnout. Nearly two-thirds of physicians report they are experiencing its symptoms.

But the burnout rhetoric misses the larger issue in this case:What’s burning out health care workers is less the grueling conditions we practice under, ‌and more our dwindling faith in the systems for which we work. What has been identified as occupational burnout is a symptom of a deeper ‌collapse. We are witnessing the slow death of American medical ideology.

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