We Need to Keep Talking about Physician Burnout

Welcome to Editor's Corner. Here, the editors of Physicians Practice will share their thoughts on the happenings in healthcare and look at the industry from a broader viewpoint.

The idea that physicians are burned out isn't news, it's an accepted fact. What's happening now is researchers and other industry observers are trying to figure out why they're burned out. They're trying to find solutions.

The latest to try and do so are researchers from the Mayo Clinic, the famous nonprofit based in Minnesota. In conjunction with the AMA, the Mayo Clinic researchers surveyed more than 6,500 physicians to evaluate the various reasons for physician burnout, as well as the effects of digitizing medical practice. Needless to say, researchers found a direct link between burnout and usage of the EHR and computerized physician order entry (CPOE) systems.

"Electronic health records hold great promise for enhancing coordination of care and improving quality of care. In their current form and implementation, however, they have had a number of unintended negative consequences including reducing efficiency, increasing clerical burden, and increasing the risk of burnout for physicians," Tait Shanafelt, Mayo Clinic physician and lead author of the study, said in a statement.

The results varied by specialty, with family medicine physicians, urologists, otolaryngologists and neurologists being affected the most. Yet, it's clear from reading about the study that most physicians are feeling the crush of clerical burden related to EHR and CPOE systems.

 This is just the latest in a long line of research studies and surveys that have tried to uncover the "mystery" of burnout. Many already, like this one and this one, have already taken aim at EHRs. Other culprits have been healthcare reform, increasing numbers of patients, declining payer reimbursements, physician shortages, and even the opioid epidemic. There are a million reasons why and the truth is, everyone is probably burned out for a different set of circumstances.

At Physicians Practice, we've covered the subject quite a bit. We had burnout week earlier this month and it's something that comes up time and time again. Just last week, associate editor, Erica Sprey posted a Q&A with a burnout expert on why it's a practice's responsibility to reach out to physicians and address their concerns. If we're being honest, it's a subject we're probably not going to stop covering anytime soon. How could we not? This is the 8,000-pound gorilla in healthcare today.

Of course, it would be natural to wonder if we're playing the violin a bit too loudly. Some people I've talked to in medicine are less sympathetic to this problem. Or, as I've seen from commenters on this site, maybe we're offering quick fixes to a deeply rooted problem, giving physicians' false hope.

On both fronts, I don't want to hear it. Burnout is not a matter of whining loudly and it's too important a subject for people to cherry pick their own beliefs for the sake of self-promotion. We're going to keep publishing articles that offer explanations and cures, because the consequences are dire. We're not just talking about more people leaving a once-proud profession to do something else, although there is a physician shortage. We're talking about consequences that are permanent.

From an earlier article on burnout:

"If you think physician burnout is not a significant problem, consider these stats on physician depression and suicide in the United States from the American Foundation for Suicide Prevention:

• Three hundred to 400 physicians die by suicide annually in the U.S.

• Female physicians have a suicide rate equal to male physicians.

• The rate of depression for medical students is 15 percent to 30 percent higher than the general population.

• Depression is a major risk factor in physician suicide.

• Bipolar disorder and alcohol and substance abuse are also risk factors in physician suicide.

• Physicians have a higher suicide completion to attempt ratio."

With this in mind, let's keep looking for causes and solutions. Let's keep talking about burnout.