What is Burnout?
Burnout is a state of emotional, mental, and often physical exhaustion brought on by prolonged or repeated stress. Though it’s most often caused by problems at work, it can also appear in other areas of life, such as parenting, caretaking, or romantic relationships. (1)
We took an extensive look at physician burnout back in 2017, since that time there has been much said about the problem. According to a recent AMA interview with Tait Shanafelt, MD, chief wellness officer, Stanford Medicine, considerable progress has been made. Even so, Dr. Shanafelt emphasizes that there is still plenty of work to do and a long way to go. (2)
“If we could fix one thing under local control in the next three months, what would we change? And yes, someday we want AI-based listening to our visit that will key up the note and every order that needs to be done and we’ll walk out and it’ll all have been done magically or we want a new EHR, we want the system to build a new building for us so we have more space. Those things may come with time but they won’t benefit you tomorrow or next week. And there are so many things that can be changed in the local and practice environment and the way workflows, teamwork, other elements, to make it a better work environment in the near term. And I think it’s getting those things launched that also helps make people feel change is possible, ‘We’ve done one thing, let’s do the next,’ and it builds momentum.” (Bold and italics mine for emphasis)
— Tait Shanafelt, MD, Chief Wellness Officer, Stanford Medicine
If you have not listened to the AMA interview with Dr. Shanafelt, you’ll find a link at the end of this article in the resource section — it’s well worth your time.
What struck me, as I listened to the recording and read the transcript of the interview, was Dr. Shanafelt’s recommendation to fix what you can and not to wait for the next great technology to come along or some other outside solution to make everything better.
When I first entered healthcare in 1994 I was charged with helping physicians, practice leadership, and support staff with improving practice operations. My role centered around collaborating with physicians and practice leadership to make the patient experience as good as it could be. With a background in management/industrial engineering, I had the honor and privilege to facilitate a team approach to making workflow changes, reengineering processes, identifying, and implementing efficiency improvements, and rewriting local operating policy and procedures when needed. Our goal was to improve the patient’s experience, while simultaneously improving the work environment for the healthcare professionals delivering patient care.
After evaluating the practice’s existing workflow and processes, while working alongside a team of local experts, which always included a physician champion, we would intentionally limit the number of items on the improvement/change list to not more than three. Three opportunities for improvement that were within and under our control formed our target. With that short list of items before us, we would then prioritize the list so that the item at the top of the list would receive 100% of our energy and effort. Once the top priority was identified, we went about gaining physician support and staff buy-in, eventually making changes to workflow, processes, and/or local policies and procedures that would ultimately result in positive change.
As changes were implemented, we gathered feedback from patients to ensure our changes were indeed received favorably by those that mattered the most – the patients.
So, when I read and heard Dr. Shanafelt say, “there are so many things that can be changed in the local and practice environment and the way workflows, teamwork, other elements, to make it a better work environment in the near term”, I could not agree more.
Based on data published just this past April, physician burnout has escalated to critically high levels in the US — the statistics are alarming, as shown below. (3)
- 89% of physicians report experiencing some form of depression.
- 53% say their depression negatively impacts their interaction with patients.
- Of those who reported burnout, 47% said it’s had a severe impact on their life and 24% said it’s had a moderate impact.
- 13% have had suicidal thoughts but have not attempted it. 1% have attempted suicide.
- Over two-thirds of millennial, Gen X, and baby boomer physicians say their workplace burnout has had a negative effect on their home life.
- 35% said they’ve done nothing at work to try and alleviate their burnout.
- 79% said their burnout began before the pandemic.
- Happiness among physicians has dropped from 69% to 49% since the start of the pandemic.
What are Some Common Causes of Physician Burnout?
According to the Harvard Business Review article titled, “6 Causes of Burnout, and How to Avoid Them”, by Elizabeth Grace Saunders, here are six causes of burnout that may be impacting you, your co-workers, family members, or your friends. (5)
- Perceived Lack of Control
- Values Mismatch
There is nothing more rewarding than to fix something that has been broken, for what seems like forever, and to know that you and your colleagues made it happen. On the flipside, there is nothing more discouraging than to work in an environment that seems to be stuck where it is, without any real hope that things will get better.
The Effects of Physician Burnout
Research indicates the symptoms of physician burnout relate to increased rates of medical errors, malpractice, riskier prescribing patterns, and lower patient adherence. It affects physician well-being, organizational healthcare operations, and even patient safety. If left unaddressed physician burnout can have severe consequences for physicians both personally and professionally. (6)
Physician burnout is a serious problem that needs to be approached both openly and proactively. It is most often a system-wide problem and not just an individual one. While there may not be one definitive solution for all organizations, recognizing the issue is key. It starts with listening and understanding physician needs and priorities while providing support and addressing concerns to make the necessary improvements within a practice, organization, and healthcare system.
If your practice or organization is ready for change – positive change — I encourage you to explore 10 Steps to Maximizing Patient Loyalty and Effecting Positive Change within a Physician Group Practice.
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Jerry L. Stone