Commiserating after another 26-hour call shift, a fellow resident and I realize that both of us have independently arrived at this depressing calculus: yes, getting COVID could mean life-threatening illness, but at least we’d get two weeks off.

“Oh no, not another rant about physician burnout.”

But hear me out, this is not another call for systemic change. This is an indictment of ourselves, the frogs who have been selected for their extraordinary tolerance for pressure and heat, and now find themselves slowly being boiled to death.

The typical 23-odd years that lead up to medical school admission in Canada is a gauntlet of challenging boxes to tick. You don’t have to be whip-smart, just abnormally perseverant and goal-directed. The process selects for and engenders an extraordinary work ethic, which seems reasonable. Who wants a lazy doctor? 

The problems with this manifest once these people enter a healthcare system constrained by scarcity: not enough funding for primary care, for nursing staff, for OR time, for community allied health. Good workhorses that we are, when the system squeezes us with additional demands, we shoulder the burden and say “I will work harder!” Until we break a leg and get sent to the glue factory. RIP Boxer; his family will get a medal. 

Case in point, nary a peep was heard from the resident doctors at one of the main teaching hospitals of my university when it adopted an EHR that shifted the burden of order entry from unit clerks to physicians. Unit clerks are people whose full-time job was to help physicians deal with administrative paperwork, but now, with electronic order entry the responsibility of physicians, unit clerks spend most of their days on Insta. Meanwhile, the residents who didn’t have any spare time to begin with (or any realistic union protection of work hours) have to take time from patient care to wrestle with a user interface more complicated than that required to fly a rocket to space.

An oft-repeated maxim from the engineering world says that the best engineer is a lazy engineer, because a lazy engineer is more likely to create tools for minimizing effort and maximizing gain. I think medicine should drop the self-destructive obsession with hard work and focus on improving our tools so we can work smarter. The EHR, the thing that we spend the majority of our day sitting in front of, is the obvious place to start.

Otherwise, the pot will keep boiling until we croak.