Physician Burnout

Physician (and Nurse) Burnout has been officially recognized for years and poses a significant existential threat to the safety of medical personnel and the treatment success of patients across the spectrum. Death by suicide in the medical profession has now reached approximately 400 annually just in the United States[1]. According to the Medscape Physician Lifestyle Report nearly “half of all physicians experience burnout with emergency care, critical care and family medicine experiencing the highest rates”.[2]

Burnout During COVID-19

The onset of COVID-19 has certainly exacerbated this phenomenon. However, burnout was quite real with 79% of physicians reporting burnout prior to the pandemic.[3] There are many contributing factors such as excessive paperwork and computer time associated with the practice, but there are many other drivers and influencing facets. The latter include perfectionism re: personality traits, excessive expectations, and fears including failure, loss of control and exposure. These last issues are associated with internal forces but there are many external pressures as well. In no particular order would be the long hours, demands of seeing more patients in a shorter amount of time, network frustrations, too many bureaucratic tasks, difficult/unrealistic patients and work-life balance.

There can be severe consequences associated with physician burnout: physical decline, relationship issues, addiction, anxiety, depression and the above referenced suicide. In addition, patient quality of care may be adversely affected including medical errors, prescription issuance and overall patient satisfaction.

The danger signs of physician burnout include negativity, exhaustion, illness and the development of poor habits.

Physician Burnout Intervention

There are a number of ways for medical personnel to combat burnout and they are similar to caregivers relief. For example, taking care of yourself being foremost - consider the final safety advice an airline stewardess gives regarding the use and implementation of the O2 masks if necessary “Be sure to place yours on first, then place one on your child, loved one or neighbor that needs assistance.” Proper nutrition and exercise also play a significant role in stemming the tide of burnout. Lastly, make time for yourself (here I recall a close friend calling me out in my role of cancer caregiver, to make sure that I was finding the time to walk, rest, & exercise by myself. She always maintained that I was more valuable as a caregiver when I could find the time to unwind.

According to the Agency for Healthcare Research and Quality (AHRQ), Dr. Mark Linzer developed a mini survey to allow physicians to check in on their stress and burnout levels. From his research, Dr. Linzer identified three interventions that could help to alleviate physician burnout:

Scheduling monthly provider meetings focused on work life issues or clinical topics after surveying staff members on which topics to address.
Enhancing 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.
Having medical assistants enter patient data into electronic health records, track forms, and send faxes to give doctors more face-to-face time with patients.[4]

The final advice we recommend in defeating burnout is to laugh. Find yourself a comedy on Netflix, take your shoes off, sit back and smile. Laughing may just be the greatest antidote to burnout.

So for your next appointment when your doctors are asking if you have fallen recently, or if there are any changes to your medication list, be sure to take a moment to ask your doctor how they are doing, when was the last time they laughed so hard their belly hurt, and what they are grateful for today. We are partners and in this together.

References [1] Andrew, L.A., (2018), Physician Suicide, Medscape, https://emedicine.medscape.com/article/806779-overview [2] Martin, K. L., (2020). Physician Lifestyle & Happiness Report 2020: The Generational Divide, Medscape https://www.medscape.com/slideshow/2020-lifestyle-happiness-6012424#1 [3] Kane, L., (2021). Death by 1000 Cuts': Medscape National Physician Burnout & Suicide Report 2021, Medscape. https://www.medscape.com/slideshow/2021-lifestyle-burnout-6013456#4 [4] Physician Burnout, (2017). https://www.ahrq.gov/prevention/clinician/ahrq-works/burnout/index.html