WebMD medical director: How practice leaders can thwart physician burnout

As FiercePracticeManagement reported previously, a 2012 survey published in the Archives of Internal Medicine found that nearly one in every two U.S. physicians has experienced at least one symptom of professional burnout, such as emotional exhaustion, low enthusiasm, cynicism, depression, suicidal tendencies, negative views on work-life balance and low professional esteem. And despite the growing industry attention toward this issue, a brand new study from Medscape reveals similarly discouraging news.

According to Medscape's second annual Physician Lifestyle Report, nearly 40 percent of respondents said they're burned out. Furthermore, those who feltthat way out also said they were less confident about their physical health than their less-stressed colleagues.

To discuss these findings and what they mean for physician practice leaders, FiercePracticeManagement spoke with Michael W. Smith, M.D., medical director and chief medical editor at WebMD (pictured left).

FiercePracticeManagement: What are the top mistakes doctors make when it comes to taking care of themselves?

Michael Smith: Certainly the first mistake would be not practicing what we preach, and, more importantly, putting ourselves second or probably third or fourth in priority. This definitely bears out in the Medscape survey, where those who were burned out were even less likely to take care of their own health, so it shows you the importance of that correlation there. Certainly doctors know the importance of exercise, healthy diet and keeping stress to a minimum, but the survey shows too few of us are doing those things.

But here's the question: Do doctors understand the role that job stress and being burned out has on their health? Maybe not--because we're so caught up in caring for our patients. Let's say we do understand, though. It's still likely that doctors in practice feel somewhat powerless to do anything about it because our first priority is the care of our patients, which leaves little time and really energy for other things.

FPM: What are some key misconceptions among practice leaders about how docs become burned out and how to address the problem proactively?

Smith: It's interesting to note that the top causes of burnout noted in the survey were too many bureaucratic tasks and spending too many hours at work. Those are not a big surprise and rightly should be big concerns. However, I would argue that one big cause that many doctors and org leaders forget about is the stress that doctors feel in not being able to care for their patients the way we'd like to. It's pretty clear that financial reward is not the primary reason for becoming a doctor. There are many other ways to make more money with a lot less job stress.

But we go into medicine because we want to take care of people, help them be healthier and live better. I'm talking about more than the stress of just having to justify a medical treatment to an insurance company. It really boils down to just how little time doctors have to spend with patients today and how we can make the impact on their lives that's needed in just the 10 or 15 minutes that we have with them. That's just very tough to do and we're left not providing the level of care that we want, that our patients need. And there's even extensive data showing that burned out physicians are not able to provide the level of care that they would like to. So it's really just acknowledgement of how serious a problem it really is.

FPM: So then, even if practice leaders can't eliminate all the red tape, what is their role in facilitating physician happiness and health?

Smith: It's really tough for administrators, managers, physician leaders, all of those groups to change healthcare. You know the problem is far bigger than they are.

However, those groups can actually put a focus on physician health in a way that really they only have the power to do. The topic of physician health is not one many people really think about much. The conversation is usually centered around the patients, but actually just talking about it will shed a necessary spotlight on the problem.

And certainly no one wants a burned out doctor taking care of them and administrators shouldn't want a physician burned out and stressed out because they're going to be less. So a way to make their doctors more productive is to improve their health. Administrators should do whatever they can to motivate doctors to take care of themselves, and just talking about it seriously will go a long way.

Even if you look at the survey, a favorite pastime of physicians in the Medscape survey was exercise. Actually doctors like exercise. It's just that we don't have the time to do it or there is something else standing in the way of being able to do that. But administrators can create that environment that encourages doctors to take care of themselves. Granted, it's not realistic to tell a doctor he can take an hour away from practice and go do whatever he wants, but we're literally talking about even 30 minutes. And yes time is money, but studies have shown that giving employees the time to take care of themselves improves productivity, and I would argue that that same holds true for physicians, if not more so, given that job stress is more for physicians than most Americans. I do absolutely believe that administrators can have a positive impact on their bottom line by just taking a few steps to let doctors take better care of themselves.

FPM: Any final advice for practice leaders?

Smith: Acknowledgement is key here, as is really just understanding and appreciating the importance of physician health in maintaining productivity and the integrity of care provided. Even the American Medical Association addresses the issue by noting that physicians have a responsibility to take care of their health and wellness.  But the profession—the practices, the employers--has that same obligation to take care of its doctors.

Really just acknowledgement, communication and taking very small steps to give doctors the resources—which for doctors are going to be mainly time--to take care of themselves, even if it's just 30 minutes, it's an absolute key. And I think if we don't, it's going to long-term do damage to the practice of medicine because that level of job stress is just not sustainable. We have to pay close attention to what we can do to get this problem in check.  - Deb (@PracticeMgtFollow us on FaceBook.

Editor's note: This interview has been edited for length and clarity.


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