Diagnosis: Physician Burnout
In recent decades, physicians’ care for their patients has become more challenging because of increased workload, increased administrative responsibilities, and decreased autonomy.[i] No matter what changes in the healthcare industry – regulations, expectations, legislation, reimbursements, etc. – it seems medical providers are never able to keep up. This is why the concept of physician burnout has remained a trending topic for quite a while.
Some argue that burnout comes solely from the unrealistic requirements the industry imposes on medical providers. Others argue that burnout can be ameliorated or even prevented if the proper technology and resources are fully implemented and leveraged. Regardless of which side of the argument one supports, the reality is that our medical providers have been feeling the pressure for many years. An essay published in JAMA in 2005 found that male doctors killed themselves at a rate 70 percent higher than males in other professions and female doctors killed themselves at a rate between 250 and 400 percent higher than females in other professions.[ii]
Many studies have shown a positive correlation between burnout and depression in many occupational groups. In fact, individuals with a high degree of burnout are also likely to fulfill the diagnostic criteria of major depression.[iii] Although many changes have to be made to eradicate physician burnout, our hope with this blog is to provide scientific insight into the causes and symptoms of burnout and attempt to recommend feasible tactics to improve physician satisfaction.
What is physician burnout?
Most studies examining the causes and relationships of physician burnout use the Maslach and Jackson’s definition, which characterizes burnout by emotional exhaustion, depersonalization, and reduced personal accomplishment.[iv] While the field of medicine is naturally very stressful, more pressure has been incrementally added to physicians’ workload as the healthcare industry becomes increasingly stricter with regulations.
What are the symptoms of burnout?
Although the physical symptoms of burnout are very similar to those of depression, the two conditions are not necessarily redundant. This is why it is crucial to identify the source of the symptoms to properly diagnose the issue and quickly implement solutions.
Being a physician requires a great level of interaction with patients. These not only require physicians to express empathetic concern while remaining professional but also sometimes force physicians to fake positive emotions to obtain desirable responses from patients.[v] Feeling abnormal degrees of emotional depletion after a day with regular patient traffic might be an indication of burnout.[vi]
As emotional resources become depleted, physicians become empathize with their patients. This leads to cynical attitudes and detached feelings toward patients.[vii] While most people who choose medicine as their profession have a desire to care for others and improve the lives of many, depersonalization makes doctors indifferent toward those under their leadership and care.
Reduced personal accomplishment
One of the worst symptoms of physician burnout is the unhappiness that arises from simply being burned-out. Being emotionally depleted and losing interest in practicing lead to high levels of both personal and professional dissatisfaction.[viii]
As the burnout worsens, the sense of low self-efficacy becomes more intense and physicians’ thoughts towards themselves get progressively more negative.[ix]
What can I do to prevent/fight burnout?
While physician burnout is not a condition as simple to diagnose and treat as the common cold, there are a few steps that can help alleviate the symptoms and create a more efficient work environment.
Empower and engage your patients.
Much of the clerical burden associated with government regulations is rooted in the data entry required with every patient seen. Consider acquiring a patient portal that integrates well with your EHR system to allow patients to remain knowledgeable about their care. With this, patients can be encouraged to input their own information whenever possible and make their own appointments and find answers to their questions without needing to call your practice.
Optimize your work team.
As the healthcare industry changes what is expected of all medical professionals, organizational charts at all practices must be modified accordingly. Medical schools tend to fail to prepare doctors for the administrative, managerial, and technological roles they will need to fulfill at a small practice. Even if you are a master of many trades, you should realistically stick to your core competencies. Hiring a Practice Manager or an EHR specialist will likely be a great investment to maximize the usability of technology and simplify your life.
Fully implement and leverage the right technologies.
The current healthcare conundrum is that EHRs were created with the intention to simplify physician’s workload yet they seem to be the root of many of the problems related to physician burnout. While it is true that there is more to do now because of EHRs, most of the issues that arise from an EHR are truly caused when practices fail to optimize their system.[x] Customizing your system and all its features to cater to the specific needs of your practice will go a long way. Greenway clients, for example, have professional services for ongoing training available to help make their technology work for them.
Anyone suffering any sort of mental health issue is hesitant to seek help just out of fear of being stigmatized. This fear is amplified for physicians because they deem it unreasonable and even embarrassing for an authority figure to be mentally unstable in any way for any reason. Seeking either psychological or psychiatric help can not only make the situation better: it can also save lives. Look for intervention programs for physician burnout.
Physicians already face tough occupational stressors. Long working hours and sleep deprivation become part of their routine as early as college. Upon graduation, add the demands of high degrees of professionalism with and responsibility for patients, daily conflicts between ethical values and economic targets, as well as the risk of medical errors and malpractice suits.[xii] Any degree of burnout has the ability to become extremely destructive to any physician. Everything physicians are required and expected to do exhausts them emotionally in some way, but all the resources and tools available today can help them reclaim their sense of autonomy. Proactively protecting your practice and yourself against burnout will optimize efficiency and provide a better sense of personal accomplishment.
[i] Wurm, W., Vogel, K., Holl, A., Ebner, C., Bayer, D., Mörkl, S., . . . Hofmann, P. (2016, March 01). Depression-Burnout Overlap in Physicians. PLOS ONE, 11(3), 1-15. doi:10.1371/journal.pone.0149913
[iv] Lee, R. T., Lovell, B. L., & Brotheridge, C. M. (2010, September 15). Tenderness and Steadiness: Relating Job and Interpersonal Demands and Resources With Burnout and Physical Symptoms of Stress in Canadian Physicians. Journal of Applied Social Psychology, 40(9), 2319-2342. doi:10.1111/j.1559-1816.2010.00658.x