Physician burnout: A major public health issue

May 14, 2018

CONTRIBUTOR

Laura Drucker 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.

 
 

Burned Edges Frame

Physician burnout at a glance

image-large-ei-phys-burnout-chart-1
In 2018, 42% of physicians reported feeling burned out (a state of physical, emotional or mental exhaustion)
image-large-ei-phys-burnout-chart-2
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%
image-large-ei-phys-burnout-chart-3
Reported rates of burnout by age

Causes of physician burnout

Leading drivers of the burnout epidemic include:
image-large-icon-two-color-clip-board


Excessive workloads


image-large-icon-two-color-chart-up

Increased performance measurements
image-large-icon-two-settings-gears

Inefficient work processes

image-large-icon-two-color-ipad-health
Clerical burdens, particularly the implementation of electronic health records
image-large-icon-two-color-home

Work-home conflicts

image-large-icon-two-color-MUTE
Lack of input or control in work lives, organizational  support structures, and leadership culture

Why physician burnout is a problem


image-large-icon-three-color-ribbon
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

image-large-icon-three-color-coins
Healthcare costs
image-large-icon-physician-red
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?
image-large-ei-phys-burnout-chart-4
Actionable steps to address physician burnout:
image-large-icon-two-color-checkmark
Routinely assess and monitor dimensions of wellbeing and engagement as part of larger institutional performance metrics
image-large-icon-two-color-checkmark
Improve efficiency of practice environment and processes
image-large-icon-two-color-checkmark
Identify, reduce, and delegate clerical work
image-large-icon-two-color-checkmark
Re-evaluate cost cutting measures that increase the burden on physicians by reducing documentation support
image-large-icon-two-color-checkmark
Employ proven models of process improvement (example: Six Sigma) with specific intent to improve work flow for physicians
image-large-icon-two-color-checkmark
Make targeted efforts to improve physicians’ work-life balance through increased flexibility and enhanced work-life integration
image-large-icon-two-color-checkmark
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