A growing crisis in the 21st century is physician burnout. According to research, 1 in every 3 physicians are burnt out at any one time. It is natural that this high-risk specialty leads to high stress; however, being able to "recharge" after shifts and on weekends is vital to maintaining mental health and career satisfaction.
Doctors who are unable to do this suffer from burnout, meaning they are physically, emotionally, and spiritually exhausted.
Long hours and extra shifts, not to mention the pace of work, lead to intense physical exhaustion. Emotional burnout means that doctors are less able to:
- engage with patients
- build relationships with them
- show them compassion in their conditions.
A common symptom of burnout is spiritual exhaustion, which is when doctors begin to question their calling as practitioners of medicine and carers for communities. When spiritually exhausted, doctors question the meaning in the sacrifice of their time every day to this profession.
Doctors in burnout often distance themselves from their patients, making their interactions less personal. Also, burnt out doctors may be insecure and may have imposter syndrome; they can lack pride in their accomplishments and feel listless.
Effects of Physician Burnout on Healthcare Ecosystem
Burnt out doctors have negative effects on the rest of the healthcare ecosystem as well. Less engagement with both patients and colleagues, such as other doctors, nurses, or hospital staff, is characteristic of burnout. This leads to a less effective healthcare community.
For example, doctors who are burnt out make twice as many errors as doctors who are not burnt out. They are also more likely to refer patients to other doctors, increasing the already high cost of healthcare. This leads to less overall patient satisfaction.
Physician burnout also causes a high rate of turnover. A study showed that 1 doctor in 50 prepared to abandon their medical careers in the upcoming two years, while 1 in 5 planned to decrease working time in the next year. Burnout can also lead to substance abuse and even suicide.
This burnout epidemic is occurring at the same time as the need for physicians skyrockets. As baby boomers reach old age, doctors are disproportionately leaving their jobs. According to the American Medical Colleges, we may be short 100,000 physicians by 2030.
Causes of Physician Burnout
One of the most common causes of burnout are unfavorable leaders. A study from 2015 shows that doctors who felt positively about their supervisors were less often burnt out.
Furthermore, with the advent of EMRs and EHRs (electronic medical records and electronic health records, respectively) and greater "bureaucratization" of healthcare, the two hours spent on filling out forms to one hour with patients has led to increased burnout. The EHR systems means doctors have to fill out forms, check lists of boxes, indicating demographics, noting progress, problems, and medication, and more. Ultimately, it is helpful to the care process but extremely time-consuming for doctors.
Chaotic, fast-paced work environments and lack of control in inherently high-risk situations contributes to physician burnout. Stress can also come from the individual demands of the doctor's specific specialty. Some specialties, such as emergency medicine, are more chaotic and fast-paced than others. Other specialties, such as surgery, contain higher risks of diagnostic or procedural errors, which can lead to higher stress.
Burnout can be influenced by trying to balance work with personal life. Long hours often negatively affect relationships and quality time spent with others outside of work. Worst of all, physician burnout is a taboo subject within the medical field, as many doctors feel the need to portray the image of perfection fostered since medical school.
In a recent study, physicians from specialties all across the board rated their burnout on a scale from one to seven. All but one specialty averaged four or higher. The most affected specialty is emergency medicine, with over 60% expressing feelings of burnout, up from 30% in 2013.
How to Reduce Physician Burnout
- Scribes or physician assistants could fill out EHRs instead of doctors; however, they should be highly trained to streamline the process and not add weight to the already top-heavy system.
- Transitioning the purpose of these excessive records from billing to patient care could help streamline the process and lead to decreased burnout.
- Hospitals and administrations should also strive to increase work-life balance with the promotion of flexible schedules.
- Staff surveys can be used to gauge satisfaction with administration efforts.
- However, perhaps the solution can be simple; one hospital in Minneapolis found the creation of a "recharging" space to be an effective barrier to burnout. This room was located away from the busy parts of the hospital, and featured a sound machine, cozy seating, and low lighting. It could be used for quiet reflection or naps. Doctors noted that it made them feel that the hospital valued them and their mental health.
- On an individual level, doctors should focus on distinctly separating work and life. Some things that could alleviate stress during time off are doing hobbies they love, exercising, spending time with loved ones, and talking to psychologists if necessary. Physicians who aren't burned out are more likely to be in excellent health and not overweight or obese. Furthermore, Unmarried physicians were more likely to be burnt out, as well. Vacation is important, too. In a recent study, of the physicians who reported they weren't experiencing burnout, 70% took over two weeks of vacation annually. Physicians indicating burnout were less likely to take the same amount of vacation.