From The New England Journal of Medicine: “The social determinants of health — and physicians’ sense of powerlessness in the face of them — seem crucially missing from the discussion of burnout. This kind of burnout is the feeling you get when you’re trying to rescue the drowning people but they keep coming. And you’re torn between competing exigencies: the proximal needs of the people drowning, and the distal need for naming, fighting, and demanding accountability for the upstream forces that are causing harm. Medical students are trained to think from a vantage point of individual agency, and we become stuck there: ‘What can I do?’ begins as an earnest, ambitious question, but it so often spoils to a cynical one. If medical schools and residency programs are serious about burnout, they have to teach us about collective action — teach us to ask, ‘What can we do?’ To fight burnout, we should never worry alone about the social determinants of health that patients face. To fight burnout, organize.”
