Physicians work hard every day to ensure their patients receive the best medical care. They put in long hours and hard work to stay up-to-date with available therapies and engaged in their patients’ care. As health care continues to advance, it also puts more pressure on physicians to provide better care, in less time, and for less money. These changing conditions are putting a strain on medical practice and leading to higher rates of physician burnout.
Getting Specific About Physician Burnout
Developments in medical research and advances in technology continue to improve health care and patient outcomes. With these rapidly changing treatment options and patient expectations, physicians are being challenged more than ever. These challenges along with other stressors can contribute to physician burnout. Physicians who experience burnout often show signs of emotional detachment and exhaustion, doubting their impact and quality of work, and cynicism.
While physician burnout does not impact every provider, it does affect a high percentage of physicians. Studies report 40-55% of surveyed physicians report symptoms of burnout. Burnout can impact physicians at different points in their career and can affect them to different degrees. For some, working in a stressful environment for many years can weigh them down and eventually cause symptoms of burnout. Others experience acute events at work or in their personal life that make them question their impact at work.
What Causes Physician Burnout
Increasing demands on health care facilities and providers put physicians at risk for burnout. Physician burnout can be complex and have a variety of causes. Some physicians feel burnout because the nature of their job is stressful. Patients come to them for help when they are feeling their worst. Providers are under a lot of pressure to ensure each patient an accurate diagnosis, appropriate medications and other therapies, and timely follow up. Errors in health care can directly impact a patient’s health, and in some cases can be the difference between life and death. The pressure physicians often put on themselves to be perfect can drive them to burnout.
On top of these daily stressors, hospitals and clinics are feeling the pressure of tight budgets and focus on patient satisfaction. Unfortunately, these demands are often creating stressful work conditions for providers. Higher workloads with less available time and lower reimbursements for services provided contribute to physician burnout. Burnout can also be caused by overwhelming amounts of charting and administrative work required for insurance companies and liability purposes; these tasks take away from their available time for patient care.
The Costs of Physician Burnout
Physician burnout does not only impact the mental and physical health of physicians. It can also greatly impact those close to them, and in some cases can affect the quality of the patient care they provide.
Doctors and Their Families
Physicians enter their careers with the understanding they will be expected to work some long hours and provide coverage for on-call times. Although families are often aware of these responsibilities, it can be stressful to work around the demanding schedule of a doctor. As this demanding schedule continues to weigh on physicians and signs of burnout begin, they often feel exhausted and emotionally drained. These feelings often follow them home and can isolate them from their families.
Patients
Surprisingly there has been research done that has shown burnout can actually have a negative impact on patient care. As burnout sets in, physicians find themselves easily distracted and detached when interacting with patients and their families. When their energy levels drop it can be harder to evaluate information and make good decisions; sometimes this results in significant errors. Patient satisfaction and quality of care can suffer, and expenses can rise when doctors cannot fully engage in their patients’ therapy due to burnout. Higher incidence of burnout can also lead to turnover, which prevents patients from establishing strong relationships with their health care providers.
Mental Health Problems
In addition to the costs to patients and physicians’ families, there has been a discouraging increase in mental health conditions reported by physicians over the years. In the MDVIP Physician Health Survey, physicians reported high rates of stress that impacted their health. A shocking 41% said they have contemplated leaving the field of medicine and 48% would not choose medicine if they were starting their career over again, all related to the stress of their job.
The Medscape National Physician Burnout & Depression Report released this year revealed 15% of physicians report being depressed, either clinically diagnosed (3%) or having feelings of being sad or down (12%). These mental health problems contribute to substance abuse among some physicians, and in severe cases, burnout and stress can contribute to physician suicide.
Managing Burnout
Many physicians may feel like burnout is inevitable and out of their control. Fortunately, there are things physicians can do to reduce their risk of burnout.
Practicing Self Care
Recognizing feelings of stress and taking a step-back can be an important practice for physicians. Without taking some time to take care of themselves, both physically and emotionally, physicians can easily lose their energy and motivation. Throughout the day, small breaks can help physicians overcome challenging encounters and stay engaged with their future patients. Finding time to exercise can help shake off the stress of the day and also build physical fitness which can contribute to better energy levels. Getting adequate sleep at night and taking time to eat healthy meals also improve energy levels.
Learn to Say No
Doctors are often some of the highest achieving individuals in the country. They are driven by a need to help others and trained to work extremely hard to accomplish their goals. This has led to advances in medical treatment, successes in patient care, and life-saving interventions for those who are suffering. Unfortunately, this drive to not only succeed, but to also never fail, can cause doctors to feel like they have to take on every challenge they are presented; this can lead directly to burnout. Recognizing when they have enough responsibilities and being able to say no to new opportunities can prevent physicians from becoming overwhelmed and feeling overworked.
Leaving Work at Work
Being able to walk away from the stress of each day in health care is an essential skill for avoiding burnout. Health care is a high stress environment, and physicians are presented with serious problems they need to solve every day. These problems can consume physicians’ thoughts until they are solved. However, leaving work at work and being able to disconnect from those stressors is extremely important to the mental health of these providers. It is important to make a deliberate effort to leave work at work and give your mind the opportunity to recharge before taking on the next day’s challenges.
Physician burnout is a problem that should be taken seriously by physicians and health care facilities as numbers of physicians who report symptoms of burnout rises. Burnout can impact the quality of patient care and can contribute to an already large problem with physician shortages. Taking steps to reduce stress levels and encourage self care can lead to better physician health and patient outcomes.
Resources:
- https://www.aafp.org/fpm/2015/0900/p42.html
- https://www.kevinmd.com/blog/2016/09/6-steps-overcoming-physician-burnout.html
- https://www.health.harvard.edu/blog/physician-burnout-can-affect-your-health-2018062214093
- https://www.mdmag.com/medical-news/beating-physician-burnout
- https://www.mdvip.com/about-mdvip/press-room/strained-healthcare-system-hurts-doctors-affects-patient-care
- https://www.nimh.nih.gov/health/statistics/major-depression.shtml
- https://www.ahrq.gov/professionals/clinicians-providers/ahrq-works/burnout/index.html
- https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235#25
- https://wire.ama-assn.org/life-career/physician-burnout-it-s-not-you-it-s-your-medical-specialty
