Guest Post by Peter Valenzuela, MD
I’ve been a practicing family physician for almost two decades. In the past that would be considered “mid-career” for a doctor. But today, it’s quite a feat. Recent statistics show that over half of the one million active physicians in the U.S. show signs of burnout. Many are opting to leave the profession.
When I began practice, I was the medical director of a rural clinic in West Texas, performing the full scope of family medicine that included: ambulatory clinic, inpatient care, emergency room, nursing home and even home visits. I delivered babies, performed caesarean sections, endoscopies and assisted on various other surgeries. I followed my patients and their families throughout the continuum of care. Back then, I worked endless hours, but always loved what I did. That was a time before electronic health records and other programs and regulations that have increased what physicians do today. I’m not trying to argue against these measures, but they have taken a toll on the joy of practicing medicine.
I’ve always had a sense of humor about health care. It began when my peers named me class comedian in medical school (medical schools frown on the term “class clown” for physicians). As I’ve transitioned from full-time clinical care to more administrative responsibilities, it’s been eye-opening to see how organizations make decisions — and how little docs have to do with those decisions. Research shows that only 16 percent of health care organizations consider the impact of strategic decisions on the resilience and well-being of those affected. That’s where the idea for Doc-Related was born. I love to draw and I wanted to apply humor to raise awareness about organizational disconnects.
Doc-Related has been called the “Dilbert for healthcare”, which is quite a compliment! It was partially inspired by the works of some extraordinary individuals who’ve taken unusual approaches to raising awareness about the challenges with our health care system. Dr. Zubin Damania (ZDoggMD), also known as the “Weird Al of health care”, creates funny-yet-sobering music videos. GomerBlog, known as “The Onion for health care professionals”, is a satirical medical news website.
Doc-Related’s characters are amalgamations of people I’ve met and worked with over the last two decades. They are multi-generational and multi-cultural with diverse personalities and interests.
Ideas for the comic come from several sources. The first is what I call the “alphabet soup” of health care. We’re living in the age of acronyms: CG-CAHPS, HEDIS, MACRA, MIPS, P4P and RAF to name a few. Trying to navigate through these waters can be burdensome and confusing. Another source for ideas are the countless committees and meetings I attend just to keep up with the strategies and initiatives needed to survive in the industry. A third source is having conversations with physicians and hearing their frustrations about what is being done to them instead of with them. Finally, I get lots of ideas when I’m seeing patients and charting in the electronic health record. Common themes include compliance, communication, electronic health records, patient satisfaction, process improvement, provider satisfaction, quality and risk management.
I’ve had the fortune… or maybe misfortune… to experience both sides of the table—as a family physician who continues to practice on a part-time basis and as an executive with oversight of large multi-specialty groups. Blogs and bookshelves are overflowing with how difficult the system is for patients seeking care. My goal is to show how difficult it is for those seeking to provide the care.
Dr. Peter Valenzuela is a nationally recognized cartoonist, educator and physician leader. Peter has been profiled in journals ranging from Healthcare Design Magazine to Medical Economics to Physician Leadership Journal. He’s also been featured on Docs Outside the Box, Outcomes Rocket and The Happy Doc podcasts.
His humorous, creative leadership style has led to him twice being recognized by the Medical Group Management Association and American College of Medical Practice Executives (MGMA-ACMPE) with the Harwick Innovation Award and Physician Executive of the Year Award for meeting the challenges of health care head-on and exhibiting leadership deemed outstanding to achieve exceptional medical group performance.
Peter attended medical school at UT Southwestern in Dallas and completed his family medicine residency at John Peter Smith Hospital in Fort Worth, Texas. He earned a master in business administration from Auburn University in Auburn, Alabama. In addition, Dr. Valenzuela holds a greenbelt certificate for six sigma in healthcare from Villanova University and a healthcare innovation and entrepreneurship certificate from Duke University. He is also an alumnus of the exponential medicine program through Singularity University. Dr. Valenzuela currently works as the chief medical officer of a large multi-specialty medical group in Northern California.
 Physician Burnout: A Leading Indicator of Health System Performance. Mayo Clin Proc. November 2017;92(11):1608-1611.Mayo Foundation for Medical Education and Research
 Human Experience at the Forefront: Elevating Resilience, Well-being, and Joy in Healthcare. Experience Innovation Network. 2016.