A recent publication in publication Mayo Clinical Proceedings (2015;90(12):1600-1613) concluded that in the United States, physicians are worse off than they were just three years ago. The work-life balance has suffered and more than 50% of physicians report professional burnout. This is in contrast to the high degree of professional satisfaction reported with their career choice.
Burnout is a term that reflects emotional exhaustion, a loss of meaning in work, feelings of ineffectiveness and a tendency to view people as objects rather than as human beings. This has profound implications in healthcare and is likely one of the largest causes of high rates of physician turnover. The problem is pervasive and getting worse. The inventors of the Maslach Burnout Inventory (MBI) describe burnout as “…an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.”
Researchers noted a 10% increase in burnout prevalence over the last 3 years despite no increase in the number of hours worked, no change in career satisfaction or symptoms of depression. And before you say that this is probably just a human condition of living in the United States, the trend among the general US working population does not follow suit.
What are the possible solutions to this problem? Here are a few suggestions:
1. Increase Efficiency: this does not mean pushing more patients through the office at a faster rate but rather helping organize, calibrate and fine-tune workflows to empower physicians to be more effective in the time they have during an encounter.
2. Promote Work-Life balance: end the ridiculous long shifts of residents and encourage physicians to optimize their career with their families. Create an environment that nurtures community, flexibility and control that will yield more meaning in the care of patients. Establish programs that provide healthy outlets for physicians in the workplace such as exercise facilities and farmer’s markets. Permit physicians to exert control over their work hours whenever possible.
3. Encourage Self-Reflection: give physicians time and space to examine their own wellness as well as personal and professional values. Teach strategies for conflict resolution and stress reduction. Skills for resilience in challenging situations can be taught and learned. Workshops and group discussions can help doctors know they are not alone in their feelings and give them a sounding board for their symptoms.
4. Leverage Technology: utilization of tools such as telemedicine can allow physicians to schedule treatment time without a physical presence. This provides flexibility and a refreshing newness to the work.
5. Focus on the Value: physicians should be permitted to shift their focus to the aspects of health care they find most valuable. For some, this is research. For others, teaching. Finding a good career fit may not be the same thing they thought it was in medical school.
Physician burnout can lead to rising costs, reduced quality of patient care and even medical errors. Doctors who are stretched to the limit are unable to provide necessary empathy to their patients. If you are a physician who is experiencing burnout or an administrator who recognizes the symptoms in your employees, examine whether or not your health system is overworking the providers or simply failing to provide needed support. Changes can lead to improvements in all aspects of the care spectrum, for patients and for the organization as a whole.
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