Physician burnout: A major public health issue

CONTRIBUTOR

Laura Mueller

Essential Insights contributor, healthcare writer

Physician burnout poses a major threat to health systems and public health overall, calling for an ever-growing need to better define—and solve—the problems that lead to such widespread rates of stress and exhaustion among healthcare providers.

The triple aim of healthcare, as defined by the Institute for Healthcare Improvement, is to optimize patient care and satisfaction, increase positive health outcomes, and reduce per capita healthcare costs. Physician burnout, however, has been associated with the antithesis of all three aims: reduced quality of care, worse overall health outcomes, and increased costs.

Some doctors are now calling for the triple aim to evolve into the quadruple aim, with physician satisfaction and mental health being a critical factor for achieving success in all other major objectives. Figuring out how to better prevent and address physician burnout is a problem best tackled from the top down, and it all begins with a better understanding of the scope of the issue and its effects on the larger system.

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Physician burnout at a glance

In 2018, 42% of physicians reported feeling burned out (a state of physical, emotional or mental exhaustion)

Compared to other professions, the likelihood of a physician experiencing burnout is 37.9% compared to 27.8% and the likelihood of a physician experiencing dissatisfaction with their work-life balance is 40.2%, compared to 23.2%

Reported rates of burnout by age

Causes of physician burnout

Leading drivers of the burnout epidemic include:

Excessive workloads

Increased performance measurements

Inefficient work processes

Clerical burdens, particularly the implementation of electronic health records

Work-home conflicts

Lack of input or control in work lives, organizational support structures, and leadership culture

Why physician burnout is a problem

Quality of patient care

Physician burnout is associated with lower satisfaction among patients

image-large-icon-physicians-red-and-grey

nearly 1/3 of doctors reporting depression say they are less engaged with patients; and

29%

say they are less friendly with patients

image-large-icon-three-color-woman-smiling

Overall health outcomes

Increased emotional exhaustion and depersonalization are associated with:

Lower rates of clinician-rated patient safety
Higher standardized mortality ratios
Longer lengths of stay

Healthcare costs

doctors who experienced burnout were more than 2x as likely to leave

$15.5 - 55.5 M
the cost to the institution over a two year period for physician burnout and turnover

How healthcare leaders can address burnout in the workforce

Just how common are “burnout” programs in the healthcare space?

Actionable steps to address physician burnout:

Routinely assess and monitor dimensions of wellbeing and engagement as part of larger institutional performance metrics

Improve efficiency of practice environment and processes

Identify, reduce, and delegate clerical work

Re-evaluate cost cutting measures that increase the burden on physicians by reducing documentation support

Employ proven models of process improvement (example: Six Sigma) with specific intent to improve work flow for physicians

Make targeted efforts to improve physicians’ work-life balance through increased flexibility and enhanced work-life integration

Invest in workplace programs that offer support to physicians experiencing burnout

Stay tuned to cardinalhealth.com/essentialinsights as we look more at this and other topics to help your organization thrive in the challenging, dynamic world of healthcare.

Sources:
https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235#1 • https://www.medscape.com/features/slideshow/ lifestyle/2017/overview#page=6 • https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1351351 • https://link.springer.com/content/ pdf/10.1007%2Fs11606-017-4011-4.pdf • https://onlinelibrary.wiley.com/doi/abs/10.1111/joim.12752 • https://journals.lww.com/hcmrjournal/pages/ articleviewer.aspx?year=2008&issue=01000&article=00005&type=abstract • https://www.ncbi.nlm.nih.gov/pubmed/19934755 • https://www.ncbi.nlm. nih.gov/pubmed/21890381 • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302790/ • https://www.ncbi.nlm.nih.gov/pubmed/11874308 • http://www. mayoclinicproceedings.org/article/S0025-6196(17)30690-0/fulltext • http://www.mayoclinicproceedings.org/article/S0025-6196(16)00101-4/abstract • https://wire.ama-assn.org/life-career/stanford-physician-burnout-costs-least-775-million-year • http://wellmd.stanford.edu/content/dam/sm/wellmd/ documents/2017-ACPH-Hamidi.pdf • https://www.ncbi.nlm.nih.gov/pubmed/24148815 • https://www.rand.org/pubs/research_reports/RR439.html • http://www.mayoclinicproceedings.org/article/S0025-6196(15)00071-3/abstract • https://internalmedicinefaculty.wustl.edu/wp-content/ uploads/2017/04/2017-JAMA-Shanafelt-editorial-physician-burnout.pdf