Burnout was first described as a psychological syndrome in 1996 by Christina Maslach, Ph.D. in the Maslach Burnout Inventory (MBI) Manuel. A condition that affects physicians in all specialties and practice settings, it’s defined in the International Classification of Diseases (ICD-11) as an occupational phenomenon resulting from chronic workplace stress levels that have not been successfully managed.
As the World Health Organization (WHO) notes, physician burnout is characterized by three dimensions:
- Emotional exhaustion, leading to easily becoming irritable or downhearted
- Replacement of usual empathy with cynicism, negativity and feeling emotionally numb, which is called depersonalization
- A low sense of professional satisfaction effectiveness
Dangers Due to Physician Burnout
Physician burnout also can result in a lack of empathy for patients and increased medical errors. According to the Agency for Healthcare Research and Quality (AHRQ), doctors experiencing burnout are more likely to leave practice, which reduces patients’ access to and continuity of care. The existence of depersonalization in doctors often leads to poor interactions with patients, because burned-out physicians suffer from impaired attention, memory and executive function.
Healthcare costs are impacted by burnout in direct ways, such as turnover, early retirement and less than full-time work. Indirectly, physician burnout affects costs through poor quality of care, unnecessary testing and referrals, increased malpractice risk and possibly higher hospital admissions and readmissions. Overall, the problem costs the healthcare industry approximately $4.6 billion annually and about $7600 per employed physician each year.
Recent research in the form of two surveys conducted by Medscape indicate just how critical physician burnout is. The ‘Death by 1000 Cuts’: Medscape National Physician Burnout & Suicide Report 2021 found that:
- Sixty-nine percent of doctors said they were somewhat or very happy in 2020 before the pandemic started, a figure that fell to 49 percent during the pandemic.
- Critical care physicians had the highest rates of burnout (51 percent) among all specialties, followed by rheumatology and infectious diseases.
- The three most common contributing factors to burnout that physicians cited were too many bureaucratic tasks (58 percent), spending too many hours at work (37 percent) and lack of response from leaders or colleagues (37 percent).
- Over 70 percent of respondents who reported burnout consider it serious enough to have at least a moderate impact on their lives.
- Roughly 13 percent of respondents have had thoughts of suicide but have not attempted it.
Another survey, this one of more than 7,500 doctors globally, almost 5,000 of which practice in the United States, asked physicians about the effect the COVID-19 pandemic had on them. The survey results showed that:
- Almost two-thirds (64 percent) of the U.S. physicians surveyed said the pandemic had intensified their sense of burnout.
- Approximately 25 percent answered, “retiring earlier than previously planned,” and 12 percent answered, “a career change away from medicine.”
- When asked about the ways they’re coping with the stress of the pandemic, 29 percent of U.S. doctors said they were eating more, 19 percent said they were drinking more alcohol and two percent said they were taking more prescription stimulants and medications.
Causes of Burnout
Although not all doctors experience the same burnout symptoms, typical signs of burnout consist of poor quality of work and increased medical errors; patient safety issues; lower patient satisfaction; lack of physician engagement; and poor retention rate and early retirement. The marked increase in reported physician burnout over the past few years is directly attributable to loss of control over work, increased performance measurement, the increasing complexity of medical care, the implementation of electronic health records (EHRs) and profound inefficiencies in the practice environment. The American Medical Association notes that physician burnout is often associated with increasing administrative responsibility due to regulatory pressures and evolving payment and care-delivery models, which can lead to a reduction in the amount of time physicians spend delivering direct patient care.
The utilization of electronic health offers multiple benefits, including increased patient safety and enhanced coordination of care, but this technology also has radically altered and disrupted established workflows and patient interactions. Electronic health record technology is frequently cited cause of burnout due to its lack of interoperability, poor user interface and interference with face-to-face patient care.
Industry Recommendations for Physician Burnout Intervention
Various healthcare industry associations have recommended a variety of interventions to help address and reduce burnout levels in physicians. AHRQ suggests that physicians and the health systems, healthcare leaders and organizations who employ them:
- Schedule monthly provider meetings focused on work life issues or clinical topics after surveying staff members on which topics to address.
- Enhance team functioning through diabetes and depression screening quality improvement projects to engage office staff, enhance teamwork and reduce the pressure on physicians to be responsible for all aspects of care.
- Have medical assistants enter patient data into electronic health records, track forms, and send faxes to give doctors more face-to-face time with patients.
- Create standing order sets.
- Provide responsive information technology support.
- Reduce required activities.
- Provide time in the workday and workflow to complete required documentation tasks and enter data into the electronic health record.
- Offer flexible or part-time work schedules.
- Have leaders model and support work-home balance.
- Hire floating clinicians to cover unexpected leave.
- Build teams in the work environment that address work flow and quality measures.
- Ensure values align between clinicians and leaders.
Similarly, a report by the National Academy of Medicine (NAM) identified the following six goals to lay the foundation for system level changes to reduce physician burnout and improve well-being:
- Invest in research.
- Create positive work environments.
- Reduce administrative burdens.
- Create positive learning environments.
- Enable technology solutions.
- Provide support to clinicians and learners.
Digital Technology Solutions to Help Doctors Avoid Burnout
Although not all technology helps to alleviate burnout for physicians, well-designed solutions reduce some pressure on doctors. For example, digital technology, such as automated patient outreach, HIPAA-compliant two-way texting, EHRs and tools for chronic disease care, enables these clinicians to easily access patient information, enhance clinical decision-making, prescribe medication(s) with mitigated risk of adverse drug reactions, order and review tests and imaging, send and receive physician referrals and more.
More recently, telehealth has been utilized to help many physicians see more patients without the risk of contracting COVID-19. Providers can conduct a virtual visit from nearly anywhere they have an internet connection, helping them improve patient access and outcomes. Telehealth also reduces unnecessary emergency department visits by allowing for better support of chronic care patients.
Healthcare technology can even assist physicians and other providers with vaccine management. Using automated patient outreach, they can prioritize and organize which patients should receive a vaccine, track vaccine distribution and receipt status and maintain privacy and security while integrating with vaccine registries. This technology also allows providers to reduce burdensome administrative outreach and scheduling tasks.
At Providertech, our HIPAA-compliant CareMessenger platform lets you check in on patients to ensure they aren’t experiencing any unexpected side effects from vaccines, offering them peace of mind and better-quality care. It also offers actionable, real-time data and insights through integration with most EHRs.
Check out our recent blog: A Step-by-Step Guide to Launching Telehealth at Your Practice.