Lact - Palo Alto School Representative


Palo Alto School Representative

Center for training, intervention and research

Strategic systemic approach and hypnosis

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      Article from the doctor's daily newspaper on the professional exhaustion of a doctor - Testimony collected during a LACT workshop

       

      See the full article HERE

      burnout doctor blog Dr. X, a 54-year-old gynecologist and surgeon, who consults in offices and operates in clinics in the Paris region, gave an edifying testimony during a conference organized earlier this week in Paris by a firm specialized in the regulation of disorders and the prevention of psychosocial risks in the workplace.(1)

      (1) Cabinet LACT - The Labor Clinic



      Growing demands from "consumer" patients, charges, fees, rivalries, fed up...: this doctor "close to exhaustion" explained without bluntness the springs of his distress.

      Lack of recognition

      “I get frustrated with not doing exactly the things that I have some skill at. The women ask me as a gynecologist, but the day they have to have an operation, they go to the hospital across the street. I did not do 15 years of studies for that. I would like to have patients who do not spend their time canceling their appointments, nor asking me first and foremost how much I am taking in fees. The relationship with the patients becomes difficult, the link has deteriorated a lot in ten years. They consume us, they "objectify" us. I feel a feeling of lack of recognition, it's a pain. I have 8,000 euros in fixed monthly charges, and I sometimes have economic problems: in June, I'm going to make just 8,000 euros in fees, that is to say, I'm not going to earn anything. I have a feeling of insecurity.

      Competition

      My relationships with my colleagues at the clinic are weird. Everyone is on the lookout for work, we are all in the rivalry! In the midst of these colleagues, I feel alone, very isolated. Sometimes I go have a coffee with them, but when it comes to work, everything changes. When I get professional help from a colleague, I have to pay him back the amount of my excess fees, otherwise he won't help me. And if we're talking to patients, it's a 20% retrocession. We must be clear: the side everyone is beautiful, everyone is nice, it does not exist. You can hardly expect support from people who are in rivalry with you. You are always alone.

      Find the joy of exercise

      I could go to work in the hospital, I've done that before. We practice there as a team, we are salaried, and without worrying about money. The problem is that at the hospital, "we don't give a damn anymore". They tell you, "stop a bit, go slower, stay behind your computer, we'll call you in an hour when we're ready". I can't stand it, because I'm a hard worker. But if I can't find a better solution, I might go back.

      If things continue like this, I might burn out. I feel fed up and close to exhaustion. It may very well be that the next morning, I will not get up. I am worried, and I tell myself that we will have to find a solution fairly quickly. Luckily, I have lots of friends I talk to often. I am satisfied with their listening, but that does not solve the problem. The solution is up to me to find. My problem is how to make me feel a little less alone, and how to rediscover the pleasure of exercising as when I started. »

      HSR

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      Comments |

      52 comments

      06/19/2014 at 8:44 p.m.
      Occupation: Doctor
      “Dear colleagues, Nothing will change if we do not appropriate the tools of those who want to strangle us. We must invest in mastering our tools or we will be at the mercy of politicians and funders. We must now organize together an exit to a solvent sector 3. A confidential offer is currently circulating on the internet www.4aces.fr »
       
      06/19/2014 at 3:37 p.m.
      Occupation: Doctor
      "You have to do like the old recruits who entered the barracks for their military service: Enter your clinic or your hospital walking backwards, so you feel like you're coming out, it's much less traumatic! Joke to relax the atmosphere! »
      06/19/2014 at 11:28 a.m.
      Occupation: Doctor
      "Dear colleague, leave Paris, go to the overseas departments, we need a hard worker and medicine can still be practiced "the old way". The Sun is good for morale! The problems are not the same there, but life is more pleasant there and we need doctors who love their job! I live in French Guiana and there are hardly any female gynecologists in town! We need you... Courage! »

      06/19/2014 at 4:20 p.m.
      Occupation: Doctor
      “Dear colleague, I recognize myself through your testimony, watch out for your health first and thank you because thanks to you many colleagues react, but always in an isolated and disparate way: when is a general strike of doctors in France, look at the railway workers they don't bother, we are paid with a slingshot with schedules that are impossible to make us sick, charges that no other profession would tolerate without going down the street and what, still nothing!!! And no benefit in return. We are cash cows for everyone, we can work at will and we do it with a smile. That the one who lives well from his medicine = no tax, no carmf, no urssaf, no cabinet, no children to assume, no loan, no rotten schedules, and no stupid patients, no risk of complaint = that he testifies here. If not, let's think about working together to raise our issues loud and clear; it's high time no, what are we waiting for???all committed suicide??? Grit, Nerve »
       

      06/19/2014 at 09:03
      Occupation: Doctor
      "Dear colleague, we cannot blame the patients for asking for the amount of the consultation fees because in Paris it is a total drift and the patients no longer follow, even the overruns of fees in the clinic, for a hysteroscopy-ressection of endometrium, we can reach 400 to 600 euros of excess by combining radio assessment, consultation opinion, excess anesthetist, surgery, control consultations... Not all have mutual insurance which compensates, the choice of the hospital to side becomes frequent. It is urgent to agree to be taken care of, you can call a dedicated line AAPML Association professional assistance to liberal doctors: 0826 004 580. You will also find on burnout test scales: Maslach test and confirm that yes, you show all the signs of burnout and read what Eric Galam, specialist in the matter, says. Kind regards. Gynecologist Paris »

      06/19/2014 at 10:43 a.m.
      Occupation: Doctor
      “Dear Confrere, it is a little easy to denounce the fees again without relating the total cost to that of other comparable Western countries. One cannot want to consume from the doctor, pay €27 and be compensated for €2,700,000 in the event of a complication: all the reinsurers will say so. A generalist is paid like a hairdresser for men: 23 €. At the public hospital, this low value of the act intrinsically widens the deficit, in addition to the low productivity: we all pay, again, for this nonsense. And if this gynecological surgery is done with a robot at €1,500,000 paid for by the MIGAC over-deficit envelopes, €1,400 of pliers must be added to an intervention still paid the same price by the CCAM. »
       

      On 06/19/2014 at 06:49
      Occupation: Doctor
      “Dear colleague, there are Regions and Paris is not France; you will find more brotherhood and you will be welcomed into associations which are very brotherly, there is no lack of work and you can make yourself respected with decent fees. Try the experiment before it is too late, if I may allow ! »

      06/19/2014 at 10:12 a.m.
      Occupation: Doctor
      “And the much lower cost of living in the provinces makes it possible to live better without forcing excess fees to afford the life you think you deserve in Paris. »

      On 06/19/2014 at 00:58
      Occupation: Doctor
      "Dear Sister, accept these 2 pieces of advice from a psychiatrist: - in such circumstances, get help through support from a professional, with in particular a good assessment of the level of mood depression, even if the support from loved ones keeps its place - do not minimize the consequences and sequelae if one truly achieves burn-out The fact remains that everyone is "free" from their voluntary servitude..."
      06/18/2014 at 11:50 p.m.
      “Burn out is here, you have to know how to stop before it's too late. Even a civil servant there is no escaping it, that is why at 58 I am retiring. »

      06/18/2014 at 11:43 p.m.
      Occupation: Doctor
      " So what ?! The QDM is satisfied with its small opinion poll. »

      On 06/18/2014 at 11:13 p.m.
      Occupation: Doctor
      « "The relationship with the patient is difficult .... sometimes; a certain stupid requirement in front of a pro: it is difficult to support it and then everything becomes heavy! I decided to lower my income and my number of patients to preserve my quality of life, mine! Because everyone has their own and we are very different! Then complain about paying too many charges: you have to do your accounts or be close to your accountant to find the right balance between gain and expenses and therefore taxes + charges and net income. Patients are killing us, medicine is great! For 30 years I have been working on it: what progress! Let's regain courage and confidence in ourselves to stand up to Difficult patients and not let them destroy our vocation!”

      06/18/2014 at 10:39 p.m.
      Occupation: Doctor
      “It is unfortunately the observation that I do it myself. We are no longer entitled to any recognition. The patients are aggressive, unstable, without any respect. We are crushed with social charges, treated as haves. I borrowed to be able to pay my taxes. The tax burden is confiscatory. I'm working to bail out a failed state. Burnout awaits us all. At 60, I only have a small pension left to survive Povre France »
      On 06/18/2014 at 11:05 p.m.
      Occupation: Doctor
      "I think we are all 'Burn out', some 'crack' others survive! It is difficult to be a caregiver and to admit this weakness! We are not united and everyone suffers in their corner! There is no difference between the "Burn out" of the employee, the liberal, the general practitioner, the specialist... Doctors all suffer from a devaluation of their profession and the image they have by themselves. »

      On 06/19/2014 at 06:27
      Occupation: Doctor
      “I agree with this vision of things but I want to insist on all these consultations where we choke not to say to such and such a patient “you make me dear!”. And it grinds and it grinds and it throws its doubts at you what we did to the neighbor and not to them and why this and why that: yesterday one pumped me on the ITT: they purposely put me 2 j so that I don't receive compensation! There, the Physio with whom I had organized warns me that she has canceled her appointment!!! We also owe taxes: we pay the unemployed and immigration; but we don't deserve it! Being told the emergency doctor did it on purpose!!! What a mentality: it is what kills us; you have to guard against it, protect yourself; neither the Physiotherapist nor myself will have an appointment possible for this person if they call back! And hop the principle of the snowball begins: these people who do not trust their doctor who treats them (self denying) demolish us! So of course if the CPAM forgets (it does it on purpose ???) to pay us (I am a regulator), if a Personal pb falls on it, all that with the Carmf Urssaf levies and taxes which, them, do not forget you: THIS IS TOO MUCH! »

      06/18/2014 at 10:22 p.m.
      Occupation: Doctor
      “We are probably experiencing an evolution of liberal practice. A "modernization" of this type of exercise for everyone liberal with the resulting concentrations. This is the meaning of the story. We can fight it with awareness like a Don Quixote or we can surf with the breaking wave and take advantage of the opportunities offered to us, such as offering what salaried systems cannot, such as quality, listening, etc. »
      06/18/2014 at 10:49 p.m.
      Occupation: Doctor
      "What optimism..."

      06/18/2014 at 10:19 p.m.
      Occupation: Doctor
      “Dear colleague, you are dangerously mistaken: you are already burnt out! Dear colleagues who reacted before me: are you already brainless or what? Not a diagnosis! just schoolyard comments. Gnagnagna! It's like me ! It is well done ! Stop in occupational disease. Take advice from the UFML if you are harassed by your administration. Courage. It takes time to rebuild yourself. »

      On 06/18/2014 at 10:59 p.m.
      Occupation: Doctor
      "Urologist 70 km from Paris, I confirm this feeling: we have become service providers satisfied with the demands of patients and constantly criticized by our directors who take us for capricious kids when we ask them to bring our tools up to modern standards. of work. The margin is shrinking, the charges are constantly increasing, and our packages have not been re-evaluated for 20 years. The worst is to come when patients won't even have to advance their consultation: all we have to do is leave our only employer: social security I hope we all have the courage to do it, so will be reborn the corporatism of doctors all united to treat with dignity the people who need it. »

      06/18/2014 at 10:07 p.m.
      Occupation: Doctor
      “In France, there are two medicines, that of Paris, that of the provinces. Exercising the same specialty, I am also exposed to brown out, but here, no one steals work, there are too many, never seen an example of a dichotomy in 30 years. A colleague who helps another? It's free. A piece of advice, dear colleague, leave Paris, you will earn a better living and you will forget a large part of your worries which have nothing to do with burnout, but rather with depression. »

      On 06/18/2014 at 11:03 p.m.
      Occupation: Doctor
      “It's funny this idea that the provincial colleagues have of the practice in the Paris region. A provincial surgeon to whom my mother was taking me began to complain to me with all his heart, imagining that I was being verbally or even physically attacked every four mornings. Well no, in my working-class suburb, people are very nice for the most part; and the others have an interest in becoming one if they want to have a doctor, because here we have enough work to be able to afford to fire the rare bad guys (I've done it a few times). As for relations between colleagues, they are very cordial when they are not friendly. »

      06/18/2014 at 10:58 p.m.
      Occupation: Doctor
      “Your conception of Parisian medicine is quite caricatural. Personally, I practiced general medicine in the provinces (countryside) and in the suburbs of Paris, well, I prefer the suburbs, the people (and colleagues) are much nicer there; and when I get home, I'm calm, I don't risk having to do "consultations" in the street or at the supermarket. Anonymity has its advantages. As for the amount of work...we have quite enough here; patients who move in find it very difficult to find a treating doctor. The only point where I agree with you is on the cost of living. But here we have Paris and all its culture within reach of public transport, it's fabulous. »

      06/18/2014 at 10:07 p.m.
      Occupation: Doctor
      “I am 45 years old, and exactly the same feeling. I did visceral surgery in a PSPH establishment which closed, and found myself with the choice between the public hospital and the private clinic. I have chosen loneliness and burdens, but I know that I will not last until retirement, if there is one..."

      06/18/2014 at 10:02 p.m.
      “The environment in which our colleague lives seems very hostile… There are many regions of France where a gynecological surgeon can find a facility where she will have as much work as she wishes, and no rivalry with colleagues who are happy to be able to share the work. It will have much lighter loads, no transport time and therefore more life time. »

      06/18/2014 at 10:02 p.m.
      Occupation: Student
      “Hello, if this colleague could find her place, and her “comfort” of existing, .. I would strongly advise her. This colleague who spent his life helped patients and colleagues in this type of situation, but not only: I cannot quote him I suppose, but at least suggest: his works: from the law of the strongest to the law of just among others. He practices in Toulouse and leads conferences. »

      06/18/2014 at 9:55 p.m.
      Occupation: Doctor
      "Here we are!! Indeed ... it is time to revolt! »
      06/18/2014 at 9:53 p.m.
      Occupation: Doctor
      “Public or private system: Application of “30% due on order” and cancellations at the last moment by patients will decrease by 70%. But Marisol announces in a media stunt: Generalized Third Party Payer! We are at the "Bon Marché".. De Profundis... »

      06/18/2014 at 9:32 p.m.
      Occupation: Doctor
      “Hey, we dare to talk about money, it's new! Until now it was taboo among the post-sixty-eighters.

      06/19/2014 at 06:31
      Occupation: Doctor
      "Hi hi times are changing ....... the cursor is moving...... we are no longer going to work with our horse-drawn carriage, we no longer have a landline, we sleep with our i pad, we take our plane tickets on the internet, we follow our training at a distance and we dare to say that we earn ..... little!!!!! When others complain about paying too much tax!!! The world is crazy ! »
      06/18/2014 at 9:21 p.m.
      Profession: Doctor “Doctors have historically made the bed of this sad situation, always wanting to be “the cute ones”, the well-meaning ones, the blessed yes yes etc. I have always been flabbergasted by their resignation to all the frustrations that have been inflicted on us over the past decades. Maybe they thought that the patients, the CPAM and the politicians and everyone... were care bears! Now you have to become an adult!! A tired 61-year-old obstetrician”

      06/18/2014 at 8:51 p.m.
      Occupation: Pharmacy
      "I am a pharmacist, just like you, I know these rivalries...we say my dear colleague or sister...Thinking...if you could "burst" a real world of hypocrisy...As for patients who take us for wealthy people when for several years we have been taxed from all sides... If I had to do it again, I would become a civil servant....”

      On 06/19/2014 at 07:19
      Occupation: Pharmacy
      “You always have the option of becoming an assistant and doing your 35 hours! It's up to you! A pharmacist "

      06/18/2014 at 9:59 p.m.
      Occupation: Physiotherapist
      “You have to see what you allow yourself to sell, if not that you generate your cases. Hearing the time of his retirement is preferable. »

      06/18/2014 at 8:48 p.m.
      Occupation: Doctor
      “What does the CGT think of the testimony of this liberal surgeon? »
      06/18/2014 at 10:01 p.m.
      Occupation: Doctor
      “Well, is she going off the rails? (yes, I know, it's easy, but it feels good) Signed: A shrink who rearranged his work time (and fees) so he wouldn't end up on the other side of the desk”

      06/18/2014 at 8:46 p.m.
      Occupation: Doctor
      “20% retrocession to refer a patient? Is it legal? »

      06/18/2014 at 8:45 p.m.
      Occupation: Doctor
      “Good evening, indeed, the networks exist and the black too... Without confraternity... Pierre operated on Jacques' patient after having dressed up and didn't tell Jacques! No respect no solidarity... We saw it for endorsement 8! Think of the taxis and the cgt of the SNCF! A chir idf »

      06/18/2014 at 8:43 p.m.
      Occupation: Doctor
      “I totally recognize myself in this testimony I am a general practitioner in a group practice in town”
      06/18/2014 at 8:43 p.m.
      Occupation: Doctor
      “I completely agree with our colleague's opinion concerning this risk of Burn Out, I am approaching the age of fifty and I feel exactly the same difficulties. Even my secretary is exhausted by calls from people who take us for service providers... You actually have to sort it out if you don't want to dive into problems, it's the best solution I have found for some time... Do not bother with these patients who "consume surgery" as they go shopping at the supermarkets "because they are entitled to it!!! " I remind you that within the framework of the Medical contract, you are not required to take care of a patient you do not want... On the other hand, systematically send a re-addressing letter to avoid problems. We do a great job, don't leave it to politicians or fake patients!!! »

      06/18/2014 at 8:29 p.m.
      Occupation: Doctor
      “Patients, if you knew... They and those for whom they vote are the main culprits for this degradation. The GPs who envy you are in the same boat; having to continue to pedal endlessly like Sysiphe so as not to fall. More pleasure in treating because the engine of your activity are the charges to be covered and which run after you...infernal cycle, until you fall. Personally: I fell ill but indirectly, perhaps by psycho-somatism, for a reason that had no connection, but who knows; then a respite of several months of convalescence and salaried employment until retirement in occupational medicine. And there I can tell you how much salaried activity is relaxed under hourly constraints in the country of 35 hours and RTT and paid holidays. Headed by an employer, of course, but what has become of ¨liberal¨ medicine today, if not a new form of slavery? »
      06/18/2014 at 7:43 p.m.
      Occupation: Doctor
      ““54” years old; this is the exact age when a surgeon at the Antony-Massy clinic had a cardiac arrest at 6 p.m. after having operated "non-stop" standing since 8 a.m. Alas, resuscitated by colleagues, he will survive 4 months with right hemiplegia before dying. Many people knew him, he advised one of my sons not to have surgery. What to think? fortunately the son listened to him! »
      06/18/2014 at 7:40 p.m.
      Occupation: Doctor
      "I'm surprised that there isn't an outburst of reactions, finally someone among us has dared to tell the reality of things, but no, we're on our surgeon's pedestal (I'm sure other specialties are concerned) and all is well in our world of rivalry, jealousy, espionage, little "innocuous" phrases about colleagues etc... Everyone will understand. Let's wake up, brothers and sisters, let's stop the massacre, let's stand together, let's help each other. Look at the result: we are no longer recognized, we are stressed, we are afraid of the next questioning (beware of the lack of information...). »
       
      06/18/2014 at 7:33 p.m.
      Occupation: Doctor
      "I completely agree with you. I will therefore try, I say try because the charges are nevertheless to be paid, to switch part of my activity as an employee, and to raise more and more in liberal. When we also see the prospects for the amount of our future pensions, the choice is quickly made. The CARMF and the URSSAF have things to do. »

      06/18/2014 at 7:32 p.m.
      Occupation: Doctor
      “Dear Sister; ask yourself the question of going to settle and live in the provinces in a favorable place in terms of demography, where patients are waiting for you impatiently and a pretty region... »

      06/18/2014 at 10:53 p.m.
      Occupation: Doctor
      “The province is not a panacea. »

      06/18/2014 at 6:48 p.m.
      Profession: Auxiliary Physician
      ""The pb is that in the hospital we don't give a damn anymore". Don't come back to the hospital, you would be surprised and perhaps disappointed to have to work at a pace that has changed a lot compared to a few years ago..."

      06/18/2014 at 9:09 p.m.
      Occupation: Student
      "The fact is that between two operations we are always obliged to wait an hour, that is to say not to rush the ash who cleans the room, the nurses in the operating theater who are very nice but who don't rush either and you also have to wait for the patient (taken away late by the stretcher-bearers but also wait for the anesthetist) etc... But this is also true in service where the temptation to delegate everything to interns is great and indeed to have the impression of doing less...”

      06/18/2014 at 9:46 p.m.
      Occupation: Doctor
      “Administration when you hold us in the yoke of unions! Profitability with respect to skills = 0...”

      06/18/2014 at 9:06 p.m.
      "Me too, it makes me 'almost' smile, this kind of sibiline little phrase... I could tell my story which does not happen in private, but in the hospital, and the burn-out, the harassment, threats, it's not coming, it's already done! Following the desire to continue to practice ethical medicine as I learned and for which I signed up at the start of my career, in the face of the T2A and HPST disaster (and soon probably the next Touraine law!)! !! If the QDM wants to devote an article to me, there is no objection, I could testify as Dr Y ... A PH, who dreams of being a liberal, currently in great pain, following the refusal to do "rapport" medicine at a discount. »
       
      06/18/2014 at 4:23 p.m.
      Occupation: Doctor
      ""The joys of the profession" as they say "all beautiful all pretty". Can't wait for the "MEN TO COME BACK!" »

      06/18/2014 at 9:52 p.m.
      Occupation: Doctor
      "I don't understand the relationship between the deteriorating conditions of private surgery and the return of 'MEN'. Can you expand your thinking? »

      06/18/2014 at 9:17 p.m.
      Occupation: Doctor
      “The men can come back, but when they burn out, you won't hear them, they will kill themselves directly. Peace to them. »

      06/18/2014 at 8:19 p.m.
      Occupation: Doctor
      « ???? »

      A team of more than
      50 trainers in France
      and abroad

      of our students satisfied with
      their training year at LACT *

      International partnerships

      The quality certification was issued under
      the following category of actions: Training action

      A team of more than
      50 trainers in France
      and abroad

      of our students satisfied with
      their training year at LACT *

      International partnerships

      The quality certification was issued under
      the following category of actions: Training action

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