The consequences of burning out — a phenomenon that rises linearly as a doctor matures, until it finally dies down at about 60 — can be hard to measure. Some solutions to fixing burnout are therefore pragmatic. They involve lessening burdens: removing paperwork that does not positively affect patient care, lightening bureaucracies and dissolving the form-filling, diagnosis-coding, button-pushing culture of modern medicine. We survived, I think, by deepening our commitments to research. We tried to increase our mastery within peculiar medical niches. And powerful, autonomous interests kept us going.

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