Doximity interviews Dr. Sandeep Jauhar

Sandeep Jauhar, MD, PhD, captured the nation's attention this summer with his book Doctored about rising career disillusionment among physicians. In this Doximity exclusive interview, Dr. Jauhar talks about his unique career path and the process of becoming a physician author with Alex Blau, MD - Doximity's Medical Director and a former journalist.

Alex Blau, MD: Dr. Jauhar, Doctored is your second book after first publishing in 2009 about your residency training. What initially drove you to start writing about your experiences in medicine?

Sandeep Jauhar, MD, PhD: I’ve always enjoyed writing, and writing has helped me process and make sense of the many profound, touching, infuriating, and puzzling experiences that I (and all of us) have as doctors. I started writing in medical school. I got an opportunity in 1998 to write about my medical residency in The New York Times, which has resulted in a long and productive relationship. I published my first book, Intern, in 2008, based on copious notes I took nearly 10 years prior (when I had no idea I’d ever write a book). Over time, writing has become a bigger part of my professional life, though I still consider myself first and foremost a practicing clinician.

"I've deliberately kept my practice relatively small so that I can take care of my patients the way I want." Tweet this »

AB: If you could snap your fingers and change one thing about healthcare in the US, what would it be?

SJ: Increased pay to primary care physicians, so they don’t have to run on a demoralizing treadmill everyday, seeing patients every 10-15 minutes. Besides being the right thing to do for a segment of our profession that, in my view, is underpaid and under-appreciated, I believe increasing "cognitive care" reimbursement will have the added benefit of reducing unnecessary consultations and tests (or rather, tests and consultations that are necessitated by the lack of time doctors have to devote to their patients).

I wrote a piece in the New York Times recently in which I note that physician incomes make up only 10-20% of healthcare costs. However, our decisions (whether to hospitalize a patient, order that MRI, etc) determine close to 80% of healthcare spending. Take doctors off the office treadmill — the biggest driver of that treadmill is decreasing reimbursements — and you will likely see healthcare savings.

AB: Do you see any hopeful signs on the horizon for physicians in their working lives? What can we do as healthcare professionals to drive positive change?

SJ: I do. Some of this hope stems simply from a greater recognition among doctors of the burnout problem. About a third of physicians will experience burnout at some point in their professional lives. Sometimes the lowest point is also the tipping point. I think we’re at that point today. Perhaps the most important message of my book is that unhappy doctors make for unhappy patients. If doctors don’t find ways to take care of themselves and find ways to adapt to the maelstrom of changes afoot in American medicine, there is little hope for our patients.

AB: You talk in your book about feeling overwhelmed—how do you balance a busy career as a cardiologist with your writing and media work?

SJ: I’ve deliberately kept my practice relatively small so I can take care of my patients in the way that I want, the way I was trained, and the way I expected I would when I entered medicine. It’s not perfect, but it’s a lot better than when I was running on my own daily treadmill. The writing thing is sort of cyclical. When a book is published, there is a lot of media coverage and as an author I have to make myself available for interviews and so on. But then I go back to being my relatively anonymous and normal self.

AB: Who are other physicians who have inspired you or who you see as mentors?

SJ: Abe Verghese, Oliver Sacks, and Elisabeth Rosenthal are three physician writers who immediately come to mind. One of my favorite books about medicine is A Fortunate Man, by John Berger, about an English country doctor named John Sassall. Sassall’s affecting story and photographs have been a great inspiration to me and many physician readers (even though he suffered from depression and eventually took his own life).

"Keep a journal. Write a little bit everyday. Find threads in the material. And feel free to email me." Tweet this »

AB: What advice would you offer to physicians looking to publish about their experiences and perspective on medicine?

SJ: Keep a journal. Write a little bit everyday. Find threads in the material. And feel free to email me. I’m happy to read and suggest venues for publication. Most major newspapers like The New York Times and the Washington Post are interested in medical narratives. JAMA and Annals of Internal Medicine also have widely read columns by physicians.

For more information on Dr. Jauhar's writing, please visit his website at www.sandeepjauhar.com. Have a physician leader to recommend for a future Doximity interview? Email with your suggestions.