Tincture of time

Abstract

In this article (part two of a two-article piece), I, Erin Nissen Castelloe, meditate on long-standing frustrations originating from my personal experiences in clinical medicine. My exit from clinical medicine can most succinctly be attributed to burnout, burnout triggered by inadequate time to address my patients' needs and complete the tasks mandated by the healthcare delivery system in which I worked. Self-and system-imposed pressures to meet my professional obligations led to chronic overwork, reduced personal time, sleep deprivation, exhaustion, and ultimately, recognition that my work situation was unsustainable. For more than ten years, I have questioned my decision to leave clinical medicine, hashing and rehashing the circumstances leading up to it. I am ready to let go of the questions that have haunted me, but I want to do so deliberately, considering them carefully before I release them. Therefore, with high hopesto understand my past, accept it, and move boldly into my future in medicine -I searched the literature, focusing on burnout in physicians and physicians-in-training; the role of time pressures in burnout; and the value of physicians spending adequate and high-quality time with patients. Conflict of interest: Erin Nissen Castelloe works as a paid pharmaceutical medicine consultant to several drug-development companies; she does not own or accept stock (or stock options) from any drug-development company for which she works.Acknowledgements: With humble thanks to the family, friends, and colleagues who reviewed drafts of this manuscript and the ideas therein.