What's Ailing Our Doctors? - Today's physicians are burned out and battered by spreadsheets. We patients suffer too.

Today’s physicians are burned out and battered by spreadsheets. We patients suffer too. America's doctors are in crisis. Six in 10 physicians say they're burned out, with burnout rates for some specialties, such as primary care, reaching 70%. When polled by the American Medical Association, 40% of doctors said they were considering leaving their practices in the next two years. Another study, conducted by health-care industry publisher Elsevier, revealed concerns about mental health and burnout: 63% of med students in the United States reported that they had no intention of practicing clinical medicine after graduation and will instead work as lab researchers or academics. This is despite a predicted shortage of 124,000 physicians over the next 10 years.

- By Derek Burnett - illustration by Michael Waraska

When Viktoria Koskenoja was in college, she sat in the hospital at the bedside of her mother, who lay dying of leukemia, and studied for her medical school entrance exams. She was determined to one day speak the language of the doctors who swooped in and out of the room discussing the case. Later, in medical school and then in residency, Koskenoja found herself drawn to emergency medicine, with its unpredictability, its tapestry of characters, and its imperative to establish immediate trust with the constant stream of brand-new patients coming through the door. She had found her calling.

Her first position out of residency was her dream job, working in a Level 2 trauma center at a hospital in rural Michigan, where she'd grown up. And at first it truly was a dream. "Small community, really great group of physicians, really great group of nurses," she recalls. "It just felt like we had everything that keeps the hospital running."

But the facility had just been bought out by a private equity firm, and Dr. Koskenoja watched in real time as things began to change. "Cuts were made everywhere in every possible way," she says. Cuts that seemed harmful to patients, the very people they were there to help.

Doctors and nurses were let go or had their hours drastically reduced. "I'd walk into a room," Dr. Koskenoja recalls, "and see a patient with a blood pressure of 60/40," which is dangerously low. Before the buyout, "the nurses would have been all over that," she says. "But I would have to find a nurse, if I could, and try to get them to start fluids, or start them myself."