Unfortunately, there seems to be a growing list of factors contributing to physicians feeling burnt out and even devalued by society at large.

Physician burnout is real, and is happening in many specialties, including ophthalmology. In a 2022 survey of 13,000 physicians from various specialties, 40 percent of the ophthalmologists surveyed described themselves as burned out. The top two reasons given for this burnout were “too many bureacratic tasks such as charting and paperwork” and a “lack of respect from administrators/employers, colleagues and staff.”1

Then, as has been mentioned in this column before, we have the never-ending string of reimbursement cuts (5.4 percent this year). If money flows to what society values, then these cuts just compound this feeling that such a valuable procedure as cataract surgery means less and less to the powers that be, and that the physician isn’t respected. 

As if reimbursement cuts and the day in, day out hassle of administrators, payors and employers weren’t enough, there's an emerging threat that will only intensify as physicians sell their practices to become employees of larger entities, or simply sign on to be employees of health-care systems: restrictive covenants for physicians. Simply put, these physicians sign employment contracts that stipulate if they’re to leave the employ of the company, they’re unable to practice in the local area for several years. 

One such restrictive covenant situation is coming to a head in the Scranton/Wilkes-Barre, Pennsylvania area, in which a urologist is suing his former employer for what he alleges is illegal enforcement of a non-compete agreement.2 After resigning due to “restrictions on his ability to practice medicine,” the physician was informed the non-compete clause would go into effect and prevent him from practicing in a 20-mile radius for two years. 

As long as a physician isn’t overtly taking patient files out the door with him, it’s in the best interest of the community at large—especially with the impending provider shortage—to have as many physicians available as possible. The opposition to the restrictive covenants argue as much by noting that the community didn’t sign the non-compete, but is still hurt by it.

Fortunately, last year the Federal Trade Commission proposed a new rule that would prohibit companies from limiting doctors’ ability to work where they want after leaving an employer.3 (The one profession that’s successfully banned the practice of non-compete clauses in contracts is ... you guessed it: law.2 But then, of course it is).

Getting rid of these restrictive covenants for physicians may not just make economic sense (the FTC estimates it could increase workers’ earnings by $300 billion per year) but it might also go a long way toward physicians feeling that their skills are something that their local communities—and society at large—want and value.


— Walter Bethke
Editor in Chief


1. 2022 Physician burnout and depression report. https://www.medscape.com/slideshow/2022-lifestyle-burnout-6014664#4. Accessed February 20, 2023.

2. Urologist sues health system over noncompete clause. https://www.mdedge.com/internalmedicine/article/267861/business-medicine/urologist-sues-health-system-over-noncompete?ecd=WNL_EVE_240217_mdedge. Accessed February 20, 2024.

3. https://www.ftc.gov/news-events/news/press-releases/2023/01/ftc-proposes-rule-ban-noncompete-clauses-which-hurt-workers-harm-competition. Accessed February 19, 2024.