Causes and solutions for physician burnout

Healthcare providers are reaching their breaking point, if they haven’t already.

From my perspective, physician burnout can be described as reaching the point where work stressors cause an individual so much distress that he or she leaves the practice of medicine either by switching careers or by committing suicide.

Often times, the reasons why physicians are burned out may be unknown. Those feelings of burnout or the underlying cause of them may be related to past trauma or an issue that has nothing to do with the practice of medicine.

Alternatively, the why may be directly related to either the practice of medicine or the business of medicine. For example, previously, I wrote an article for the Nevada State Board of Medical Examiners about battlefield medicine and the impact to first responders and physicians. Responding to a mass casualty such as the Oklahoma City bombing, the 2017 Las Vegas shooting or a school shooting carries residual trauma.

Physicians are human beings. If they do not address the underlying issues of trauma, these men and women may also develop post-traumatic stress disorder (PTSD). Given the rise in the number of mass shootings, terror attacks, and hate crimes, the medical community must address burnout.

In order to provide suggestions for mitigating physician burnout and physician suicide, it is necessary to understand what it is and the underlying causes. One issue is that physician burnout has varying definitions.

A recent study published in the American Medical Association’s journal JAMA illustrate why it’s burnout is such a difficult problem to address. Authors gathered 182 reports involving nearly 110,000 physicians from 45 countries. They concluded:

“In this systematic review, there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality. These findings preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians.”

The business of medicine appears to have more of an impact on physician burnout than the actual practice of medicine, according to a recent study published in the Journal of Internal Medicine. Researchers identified five causes for burnout:

• Excessive workload, including EHRs and pre-authorizations;

• Work inefficiency and lack of work support;

• Work-life balance;

• Loss of autonomy and control; and

• Loss of meaning from work.

Fortunately, some of these stressors can be addressed. For example, physicians can:

• Hire additional clerical staff and make a concerted effort to retain good staff;

• Try different software programs and EHRs to find the one best suited for their practice; and

• Keep mental, physical, and emotional health in check by exercising, practicing yoga, eating well, sleeping, and seeing a therapist.

Although some of these suggestions may appear to be more time-consuming, they actually make physicians more efficient and productive. By delegating tasks and hiring staff, physicians can reduce their stress while spending more time focused on patient care.

The U.S. healthcare system is at a tipping point. It needs to take action to address burnout. There is no other alternative. If not us, then who? If not now, then when? After all, what will the healthcare system be if physicians and other medical professionals are not there to treat those who are sick or injured?

Rachel V. Rose, JD, MBA, advises clients on compliance and transactions in healthcare, cybersecurity, corporate and securities law, while representing plaintiffs in False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at Baylor College of Medicine in Houston. Rachel can be reached through her website, www.rvrose.com.