“We Dont Talk About Bruno” *: Is Providers’ Wellbeing Profaned by the Healthcare System?

The COVID pandemic opened eyes to the vital need for an excellent health care system, however, speaking about medical system deficits continues to carry a lot of challenges.

In the virtual space where some people with no education can deceive the general population with false information and get paid!
Medical providers are trying hard to stand their ground and protect their patients as well as half-lives spent between books and learning.

The dark prophecy is that the next pandemic in this world could be the burnout of the medical providers and people will start to choose many specialties and stay away from medicine, which will eventually lead to healthcare disasters.

Yes, “We Don t Talk About Bruno” * in medicine, maybe because we don’t have time,´-or-for the same reasons appeared in the Encanto movie.
Let’s think about the coming points, I am not saying they are facts, nor fiction, just raising a simple question which one of them is your workplace "Bruno"?


1- The Relative Value Units (RVUs) Dilemmas:
Many people choose medicine as it should be the further field from trading and money language they hate.
Unfortunately, with the ignominious system, insurance companies mysterious details, and Relative Value Units (RVUs), providers are asked to do the business that they never wanted´-or-chose.
In many hospitals, outstanding medical brains are burned out because of this trick of the trade.

2- Defensive Medicine:
Providers are getting less and less authority, and documentation is the standard for good care. So instead of spending most of the time with patients, providers are in---dir---ectly forced to spend most of their time typing and filing documents.
Common good feedback from trainees:” This mentor always has my back”.
It doesn’t only mean that a mentor supports and teaches them.
It also means that the mentor provides the confidence to stand their ground in many cases. The mentor is empathic, cares more about patients excellent care and knows that in good, promised healthcare system, preventive care comes first.



3- Lack of Resources:
Many healthcare companies providers suffer to complete tasks excellently due to a lack of resources. Poverty and economic problems can be the reason in some places. New foundations, healthcare disparities, health insurance companies restrictions are other reasons.
Working with no transparency can lead to providers burnout by the inability to ask for resources they need to complete their intended excellent patients care.


4- Drowned Academic Jobs:
Many providers in academic jobs are moving towards research, with less and less time to teach clinically. Many academic places are using residents to work hard and work their way, paying less attention to their education. This is one of the consequences of the RVUs system and other “Bruno” points. Teaching activities are time-consuming which can be difficult to fulfill if you are a full-time provider in many places around the world.


5- Racism:
I worked in multiple hospitals around the world, I still remember two racist statements I heard, one of them was overseas in my accidental homeland when a strict Muslim refused me as a doctor as I don’t wear Hijab: “We are in a Muslim country, and you are not qualified with no Hijab”. The other one was in the United States my homeland by choice more than ten years ago when a professor assumed that because of my last name “Muhammad”, I don’t believe in women s rights….

The ironic thing was that I could stand my ground overseas and the person who refused the doctor as she has no Hijab was transferred to the hospital dean and came back to apologize. However, in the United States, it was assumed that the professor didn’t mean it.

Racism nowadays is smarter, occult, and hidden in the nonverbals as well as the obstacles people put in your way when you prove successful in it.

Isn’t the time to have an anti-racism department in every university?

6- Favoritism:
In some companies, you can’t mentor your friends, and this is wise. Not only because you can’t help as supposed to, but also as favoritism might lead to unfair job opportunities.
Years ago my friend quit her job when I asked her why her reply was heartbreaking: “ I worked so hard on this project till I saw it going to be the baby of a person who I covered, he is a friend of the boss, it is very hard to see your years of hard work going to trash”.
Favoritism is the logical daughter of the broken healthcare system and it is very hard to be controlled without more efforts to reform the system.

7- Women’s Rights’ Fight:
While work equality is one of the hot subjects around the world, we still see the consequences of pregnancy, having children, and raising them in a good way on how many companies perceive female providers.
My friend overseas was sent a long letter as she brought her son with her to work one time - before the pandemic- while her husband was praised for it “a wonderful dad”.
It is unbelievable to accept that any woman can be a great medical provider while she is guilty about her motherhood responsibilities.


8-The Missing " Why":
Many people in leadership positions and authorities need to use the secret word " why", they need to talk about "Bruno". And to be fair all of us have some authority at different levels, we need to ask why, we need to speak up and before making assumptions, ask why…
When a provider is burned out, ask why?
When a provider is refusing a task, ask why?
When a provider is leaving a job, ask why?

Making assumptions can lead not only to another healthcare pandemic but can also support a maladaptive system that needs to be reformed in many countries around the world. Yes, this is another universal problem.


Going back to Bruno in the Encanto movie who carries the wisdom and the solution and talking to him solve things out, and after you read the above, which one of the above points is your workplace "Bruno"?

Should you talk about “Bruno”?


To be continued...


*"We Don t Talk About Bruno" is a song from Disney s 2021 animated feature film Encanto.

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