By Rick Sheff, MD, chief medical officer, The Greeley Company
Physician burnout is an epidemic, and like most epidemics, there isn’t one simple solution. Hospitals, healthcare systems, and physician groups must invest in addressing burnout in order to sustain high-quality patient care. The imperatives to succeed in today’s healthcare industry are to improve quality and reduce costs, and these goals can’t be achieved if physicians and clinicians are burning out at staggering rates.
A recent report in Medscape found that 44% of physicians reported at least one symptom of burnout in 2019. The proportion of physicians screening positive for depression continued to rise to almost 42%, and the rate of suicide and depression in doctors is more than twice the general population. This equates to more than one medical school graduating class a year dying from suicide, a grim reminder of one of the most devastating impacts of burnout. There is a return on investment for addressing physician burnout, and it’s also the right thing to do.
There are several leading drivers of physician burnout, and often physicians struggle with a combination of stressors. First, there is emotional exhaustion and the inability to recover when away from work. This is a prevalent issue for physicians whose decisions can significantly impact a patient’s life. This can often lead to depersonalization, when physicians are unable to connect with their patients and develop a negative or cynical attitude. Additionally, the added stress and unaccounted time required to integrate the electronic health record (EHR) with patient care pulls physicians and clinicians away from the gratification of direct patient interaction.
The EHR also adds many hours of unaccounted for and uncompensated work after hours, putting added strain on work-home balance. Physicians feel their work with patients is being reduced to a set of metrics, usually metrics they feel don’t reflect the quality and value of their work. A study by the Rhode Island Department of Health reported that 70% of physicians using EHRs measured one symptom of IT-related stress, and of that group, less than 30% reported that EHRs improve job satisfaction. When physicians experience a reduced sense of personal accomplishment, an overall dissatisfaction with their job sets in.
Ultimately, burnout is a symptom of a broken healthcare system.
We are in the midst of a revolution in public accountability for quality and value in healthcare, and while the pressure to perform on metrics isn’t going away anytime soon, physician leadership can adapt to better serve the needs of physicians. We need a new kind of physician leader who can provide “translational leadership” or leading in a manner that helps connect the passion physicians have for providing patient care to achieving target performance.
To meaningfully impact physician burnout, establishing institutional awareness and commitment to moving the needle on the epidemic are key. When physicians burnout, the health system suffers from increased turnover rates, decreased productivity, and often decreased patient satisfaction. By cultivating institutional leadership recognition that there is an ROI for reducing physician burnout/distress, a commitment to measuring and improving physician well-being can be achieved.
Often, physician burnout is linked to high-conflict and low-trust environments. If applicable to your organization, undertaking a process to address and heal these issues can minimize the adverse effects of physician burnout. When developing an action plan to address conflict and low trust, it’s important that leaders specifically name and acknowledge the past tensions, develop a shared vision for a preferred future, and establish ground rules for how they will conduct themselves going forward. By doing a substantive piece of work together while demonstrating adherence to the ground rules, physicians and management leaders can slowly rebuild a modicum of trust and integration. Repeating this cycle will reap positive benefits in the long-term satisfaction and improved performance of your physicians.
There is an overwhelming need to enhance integration and connectedness among physicians. All too often finding a shared purpose, or why is difficult because of a history of conflict and low levels of trust, especially between physicians and hospitals/healthcare systems.
Healthcare success is three-fold: we must find a way to achieve physician success/satisfaction, hospital/healthcare system success, and good patient care at the same time. Overvaluing any one of these to the neglect of the others will result in failure of our entire healthcare system. To make healthcare available to those in need in the future, it is our duty to find a solution to keeping our medical providers engaged and satisfied so they can provide high quality patient care.