No easy answers to physician burnout

Physician burnout
Physician burnout is a growing problem with no easy answers.

Some 900,000 practicing physicians, along with millions of other healthcare workers, are caught in a complicated healthcare web that leads to an epidemic of burnout in the medical field.

“We believe that to alleviate the stress and burnout in the medical professions, we must pay attention to system factors that lead to what we call the ‘occupational health crisis in medicine,'” write two doctors in an opinion piece on STAT. Steven A. Adelman, M.D., director of Physician Health Services Inc., a nonprofit corporation founded by the Massachusetts Medical Society, and Harris A. Berman, M.D., dean of Tufts University School of Medicine, recently surveyed 425 physicians, healthcare leaders and executives about eight possible ways to transform healthcare.

Top on that list was an overhaul of the cumbersome, time-consuming electronic health record (EHR) systems that impact the well-being of doctors and the vitality of medical practice, they write.

Physician burnout is typically recognized as emotional, physical and mental exhaustion brought on by prolonged stress. It’s a problem in dire need of a solution, as an estimated 350 to 400 doctors kill themselves each year.

EHR has contributed to widespread doc burnout

The problem of physician burnout has certainly been magnified by the EHR and goes directly to the fact doctors cannot spend the time they want with patients, according to a NEJM Catalyst article.

Michael Schneck, M.D., a professor at Loyola University Chicago Stritch School of Medicine, told the publication that changes are needed to create a better experience for physicians and patients. “We take people who are highly trained, highly educated individuals selected because of their motivations in terms of humanism and their ability to learn copious amounts of material, and we turn them into highly educated factory workers,” Schneck told NEJM Catalyst. “We ask them: ‘How many patients have you seen?’ ‘How many procedures have you done?’ ‘How have you met quality metrics?’”

Physician burnout is only getting worse. Fifty-four percent of physicians reported at least one symptom of burnout in a 2015 study—and that was up from 45.5% in 2011. Physicians’ happiness in terms of work-life balance also went down, from 48.5% in 2011 to just shy of 41%. Equally troubling, half of physician respondents said they felt emotionally exhausted and that the work they do is less meaningful.

Why doctors experience burnout

Change has been the norm in healthcare over the last few years, and doctors have experienced that change most acutely. To wit, the 2015 study highlighted that physicians feel like they are part of a “fixing-people production line.”

One reason for physician burnout is the “myth of invulnerability” that doctors promote. This myth-building typically starts during medical school.

While no specialty is left untouched by burnout, critical care professionals have some of the highest rates of burnout in the healthcare industry. A study that captured data spanning the past 10 years revealed that up to 45% of critical care physicians experience severe burnout; at 71%, this figure was even higher for those in pediatric critical care.

5 ways to prevent burnout 

Still, healthcare organizations can help alleviate stress and burnout among physicians by undertaking some of these initiatives:

Encourage doctors to embrace outside interests. For example, Paul Parker, M.D., a Georgia pediatric surgeon, plays bluegrass music in a band with other physicians as a way to reduce stress. He also plays his banjo and guitar in his office in between surgical cases.

Focus on physician wellness. Children’s Healthcare of Atlanta has organized such a program to support its physicians’ physical and mental well-being. Key elements of the program include communication, physical activity, learning, nutrition and stress management. Yoga and meditation can also help with wellness.

Help doctors be more efficient. Make sure your doctors focus on care of patients—not on administrative tasks. And as Adelman and Berman suggest, developing a more physician-friendly EHR can help.

Support physicians in saying “no.” Encourage your doctors to decline committee assignments or even patient demands when they already have too many commitments.

Redesign the practice. One idea is to outsource burdensome tasks such as compliance and waste management. Alternatively, practice could choose to bring in a trainer with this type of expertise to educate practice employees.