Physician burnout is reaching epidemic proportions says an Advisory Board article.
More than 50 percent of doctors now report having at least one symptom of burnout and it’s resulting in a negative effect on patient outcomes, patient satisfaction, and post-discharge delivery time.
"Physician burnout is everywhere," the article says. "From the lay press to health care news outlets, it’s making headlines. And there is a seemingly never-ending supply of sobering data points that underscore why this is such a large — and growing — issue for medical groups."
AMA/Mayo Clinic Survey
The article cites a survey, conducted in 2014 by the AMA and Mayo Clinic of 6,880 physicians, the purpose of which was to "evaluate the prevalence of burnout and physicians’ satisfaction with work-life balance compared to the general U.S. population relative to 2011 and 2014." The findings appear in Mayo Clinic Proceedings.
“In 2011, we conducted a national study measuring burnout and other dimensions of well-being in U.S. physicians as well as the general U.S. working population," the study authors wrote. "At the time of that study, approximately 45 percent of U.S. physicians met criteria for burnout."
A follow-up survey, conducted in 2014, found that more than 54 percent of physicians reported at least one sign of burnout, said an AMA article announcing the results.
Physicians also expressed having lower rates of satisfaction with work-life balance in 2014 compared to a similar sample of physicians in 2011, the article said.
"Burnout manifests as emotional exhaustion, loss of meaning in work, and feelings of ineffectiveness," said Tait Shanafelt, M.D., the study's lead author. "What we found is that more physicians in almost every specialty are feeling this way, and that’s not good for them, their families, the medical profession, or patients."
The study’s authors said that physician burnout is a systemic problem and that health care organizations bear responsibility for addressing the crisis.
The study also offered this snapshot of physician burnout statistics:
- Physician burnout is up ten percent over the last three years;
- Burnout rates are up across almost all specialties;
- Physicians report no overall increase in work hours;
- No increase in depression rates among physicians was observed.
Emergency Medicine Shows Highest Burnout Rate
Of all the specialties surveyed, emergency medicine ranked at the top. Urology, physical medicine and rehabilitation, family medicine, radiology, and orthopedic surgery rounded out the top five in that order.
“One factor that was a recent focus in a blog post from the New England Journal of Medicince (NEJM) — The Dark Side of Medicine — is the working conditions that involve aggressive and potentially dangerous patients and family members,” said Stephen Nichols, M.D., chief of clinical operations performance at Schumacher Clinical Partners. “Every physician I know can relate to this, regardless of their specialty. The ED tends to have some of the highest potential for such conflicts due to the greater number of initial encounters and the associated anxieties. However, many also occur on the floors and in the ICU, where things can build to a critical head.”
Dr. Nichols went on to say that a large number of these are naturally associated with psychiatric illness and substance abuse, which are typically under-resourced.
“I believe we will see more issues in hospital medicine and intensivist practices as those specialties grow in number, and are under the additional strain of that growth in their developing areas,” he said. “Some of this is also due to the de-coupling of the primary physician-patient relationship, which is a trend in other areas of our modern lives. But another piece of it is that the decoupling results in more and bigger blind spots when dealing with the psychodynamics of patients and their families. We are simple not aware of such issues before they erupt.”
Addressing Physician Burnout
The study recommended following as ways to address the problem:
- Research must provide “evidence-based interventions” addressing burnout, including improving efficiency;
- Factors in the practice or work environment have to change;
- Offering self-help solutions is no longer sufficient.
Other recommendations included improving the efficiency of the practice environment, reducing the administrative burden, and providing physicians with greater flexibility and control over their work.
“I absolutely agree that large scale change in our working conditions, based on experience and evidence, will provide the best solution for the long run,” Dr. Nichols said. “In the meantime, it is important that each of us also find our best ways to cope and manage with the pressures we face on a daily basis.”
Physician Burnout Resources
The following resources, from the NEJM, SCP, and the AMA, provide information about the dangers of physician burnout and how to avoid it: