Many physicians under pressure to provide better outcomes faster and at lower costs, are getting burned out. Physician burnout is a significant health problem because it affects quality of care, results in high turnover rates and reduces productivity. More importantly, burnout can also destroy lives and increase the risk of suicide.
Unfortunately, physician burnout is widespread. In the Medscape National Physician Burnout, Depression & Suicide Report 2019, researchers surveyed 15,069 physicians practicing in more than 29 specialties about their degree of burnout, how they cope with it and if they had thoughts of suicide. Feelings of burnout were reported by 44% of respondents.
The Toll of Burnout
Left unaddressed, physician burnout can result in poor clinical care, increased mistakes, patient dissatisfaction, and dysfunctional interactions with patients, nurses, and other physicians. Physician burnout can even lead to doctors leaving the profession. For 1 in 10 of the Medscape respondents, they said their burnout was so severe that they were considering quitting medicine.
Burnout is expensive too. A June 2019 study published in the Annals of Internal Medicine found that physician burnout costs approximately $4.6 billion each year due to physician turnover and reduced clinical hours. This works out to about $7,600 per employed physician each year.
Perhaps worst of all, burnout can lead to depression and even suicide. Physicians in the United States have the highest suicide rate of any profession. In fact, the suicide rate among doctors is more than double that of the general population. Of the Medscape respondents, 14% said they have had thoughts of suicide but not attempted it; 1% said they have attempted suicide. Clearly, preventing and managing physician burnout is of the utmost importance.
Burnout is devastating and costly, but fortunately it is not an inevitable part of being a doctor. These are seven steps physicians can take to recognize, prevent and manage burnout before it ruins their careers.
1. Recognize the Symptoms of Burnout
Physician burnout can cause physical, emotional, and behavioral signs and symptoms. Recognizing these signs and symptoms in oneself or in others can prompt an individual or organization to address burnout. Physical signs of burnout include feeling tired often, fatigue, frequent headaches, back or muscle pain, change in sleep habits or loss of libido.
In addition to the physical effects of burnout, it impacts mental and emotional health as well. Emotional signs and symptoms of burnout to look for include self doubt or feelings of failure, detachment, loss of motivation, loneliness, increasing negative outlook, decreased job satisfaction or loss of interest in favored activities.
Finally, burnout symptoms can also involve the physician’s everyday behavior, including avoiding responsibilities, isolation, procrastination, use of food, drugs or alcohol as coping mechanisms, cynical or negative attitude, out-of-character aggression in driving or family, friend and co-worker interactions, and coming in to work late, leaving early or skipping work altogether.
2. Evaluate the Level of Burnout
The Maslach Burnout Inventory™ is a standardized assessment of physician burnout, in use since the 1970s. It uses three scales to evaluate physician burnout:
- Emotional exhaustion – Feeling drained at the end of the day and being unable to recover after time off; energy levels spiral downward.
- Depersonalization – Also known as compassion fatigue, depersonalization is characterized by a negative, callous, uncaring or detached attitude.
- Personal accomplishment – Measures feelings about the success and accomplishments of one’s work.
These scales offer a good starting point for assessing your own burnout. Many issues like burnout don’t present themselves obviously when you’re experiencing them, and the Maslach Inventory can help you make a more objective analysis of your own burnout.
3. Address the Cause of Burnout
Several factors contribute to physician burnout. The Agency for Healthcare Research and Quality (AHRQ) lists five causes of burnout:
- Time pressure
- Chaotic environment
- Low control over pace
- Electronic health records
- Family responsibilities
4. Shorten Hours or Change Work Settings
The Medscape survey asked what physicians did to alleviate burnout. Reducing work hours was the option for 31% of respondents, and 24% said they changed work settings. About 1 in 5 said they made changes to office workflow or staffing. Reducing work hours can leave physicians more time to spend with their families or engage in favorite activities. A change in work settings, such as switching from working as a clinician in an office to teaching or research, can provide a new outlook.
5. Practice Mindfulness
Research suggests that mindfulness may be helpful in reducing physician burnout. In one study, PCPs who underwent a short training in mindfulness enjoyed significant reductions in burnout, depression, stress and anxiety. The benefits continued throughout the nine-month trial.
6. Reduce Paperwork
The Medscape survey asked physicians about the factors that contribute most to burnout. An overwhelming 59% named bureaucratic tasks, such as paperwork, as the main source of their burnout. Spending too many hours working and increasing computerization/EHRs came in second and third at 34% and 32%, respectively. One family physician said, “All that paperwork sucks all of the enjoyment out of being a doctor.”
7. Consider a Partnership with a Management Company
Most physicians get into medicine because they want to help people, not because they want to spend their time worrying about billing or payer contracting. A management company can take over office and management tasks, which gives physicians more time to practice medicine and provide the best patient care possible. A management company can also provide more hints and tips for preventing and addressing physician burnout.
Recognizing the signs of physician burnout and addressing its underlying causes can help more physicians find satisfaction in their work, stay at their jobs longer, and provide exceptional care.