For those of us who are consumers of healthcare (which is pretty much everybody), we go to a doctor or hospital expecting to be attended to by caring staff who are satisfied with their work and dedicated to the medical field, right? Boy, are we ever wrong.
I’ve recently been studying research on burnout among medical professionals and what I’ve found is truly troubling. Faced with diminished compensation, consolidation of practices (ACOs) and constantly-shifting insurance structures, physicians are questioning their choice of careers. Nurses are working 12-hour, or even double, shifts. Every day, medical staff care for patients who are sick, ungrateful and often depressed. No wonder they’re burned out! And the problem is not just here in America--it’s global. A random sampling of studies reveals the same phenomenon in Canada, South Africa, Finland, Taiwan, the UK, Holland, Spain and Latin America.
Not only is medical burnout a problem, it’s getting worse
Burnout can occur in any occupation but happens most often in the “caring” professions: medicine, nursing, social work, counseling and teaching. A national survey published in theArchives of Internal Medicine in 2012 reported that U.S. physicians suffer more burnout than any other American workers. In this year’s Medscape Physician Lifestyle Report, 46 percent of all physicians responded that they had burnout, a substantial increase since 2013 in which burnout was reported in slightly less than 40 percent of respondents. Aneditorial published in the Journal of General Internal Medicinereported burnout rates ranging from 30-65 percent across specialties, with the highest rates incurred by physicians at the front line of care, such as emergency medicine, critical care and primary care. (The lowest happiness scores belonged to radiologists.)
Of even more concern, among internists and family physicians who responded to the Medscape survey, burnout rates rose from 43 percent to 50 percent in just two years, and these two specialties were most likely to say they would not choose their own specialty again. Interestingly, the least burned-out (happiest?) physicians were dermatologists, ophthalmologists and pathologists.
What begins as a calling often becomes an anchor dragging people down
It was only 20-odd years ago that “burnout” was added to the medical lexicon. Originally, the term meant the cessation of operation of a jet or rocket engine. It was applied to humans in the mid-1970s by Herbert J. Freudenberger, a German-born American psychologist.
Patient.com defines burnout is "an experience of physical, emotional and mental exhaustion, caused by long-term involvement in situations that are emotionally demanding.” Signs of burnout include decreased enthusiasm for work, growing cynicism and a low sense of personal accomplishment. As the name implies, explains an article inThe Atlantic, individuals suffering from burnout feel as though a fire that once burned inside them has dwindled, and perhaps has even been entirely extinguished. They describe a sense of having "run out of fuel" and feel as though they "have nothing left."
Why should rates of burnout be higher among physicians? For one thing, they tend to work longer hours than other workers, on average about 10 more hours per week. Moreover, striking an appropriate work-life balance appears to be a bigger challenge for physicians, in part because they often tend to keep work and personal life more separated than other workers, reports The Atlantic.
Burnout in the healthcare field is something we need to pay attention to, and fast
As the U.S. population ages, the number of physicians will need to increase. When burnout causes physicians to reduce their practice or leave medicine altogether, patient access to healthcare is diminished. Also, burnt-out physicians are likely to be less productive, make more mistakes and generally deliver a lower quality of care than their more satisfied, fully engaged colleagues.
Added to this, as insurance companies increasingly tell doctors how much time they can spend with each patient and what they will and will not get paid for, those who saw medicine as a calling are shifting to treat it like a job, having to obey rules set forth by others.
The solution, though, does not lie in incentivizing physicians with higher pay or restructuring their hours to minimize fatigue. It lies in discovering, or rediscovering, earnest professional fulfillment. Physicians need to recall that they are summoned to something older, larger and nobler than themselves. They must be reminded, not just in words but in real, concrete ways, that a career in medicine represents one of life's greatest opportunities to become fully human through service to others. If we are genuinely concerned about healthcare workers’ burnout, we need to focus on promoting what is best in them: compassion, skill, and above all, wisdom.
Why is this important? Because in the end, the elimination of burnout will mean better care for patients.
Andrea J. Simon, Ph.D., is a former marketing, branding and culture change senior vice president at Hurley Medical Center in Flint, Michigan. She also is president and CEO of Simon Associates Management Consultants.