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Physician Burnout: What Is It, What Causes It, and How Do We Cure It

 

At one point in every professional’s career, they will encounter some form of burnout. But in the case of medical practitioners, burnout takes a whole new meaning. Physician burnout is not an individual problem; the American Medical Association (AMA) calls it an epidemic, even before the COVID-19 outbreak.

For decades, doctors in all settings in the US have been burned out because of multiple causes. And it will take a number of comprehensive steps to help medical professionals recover from burnout and create a more supportive and caring atmosphere for the next generation of American doctors.

Defining Physician Burnout

Physician Burnout is a long-term stress reaction characterized by negative feelings toward the profession and the people involved, including patients and their families. A doctor who is burnt out feels emotionally exhausted and no longer finds their work meaningful. The negative emotions extend to themselves, as well; they feel ineffective, frustrated, and not able to provide the best patient care. They also tend to see patients, students, and colleagues as objects, not human beings.

This isn’t mere fatigue. It is classified by the World Health Organization as an occupational phenomenon that needs to be addressed and prevented.

Based on the WHO’s classification, there are three major symptoms associated with burnout.

  1. Exhaustion – Doctors feel dog-tired, not just physically, but also emotionally and mentally. Their energy is almost always depleted.
  2. Cynicism – Doctors feel an increased mental distance from their job. They feel cynical and tend to lose their ability to care, empathize, and connect with patients.
  3. Reduced Efficacy – The negative feelings get in the way of their job, and consequently, they do not perform at their best. 

It’s important to note that physician burnout won’t be cured by simply taking a break or taking time off from hospital duties. The causes of burnout are deeply ingrained in the current healthcare system, which makes them hard to solve and escape.

Physical Symptoms

Burnout often concerns the emotional and mental well-being, but it also manifests through physical symptoms. Physicians often feel the following:

  • Headaches
  • Impaired memory
  • Insomnia
  • Shorter attention span


Burnout in Different Practices

According to the Medscape National Physician Burnout and Suicide Report 2020, about 42 percent of physicians report that they are burned out.

Specialities that are the most burnt out are:

  1. Urology (54 percent)
  2. Neurology (50 percent)
  3. Nephrology (49 percent)
  4. Diabetes and Endocrinology, Family Medicine, Radiology, Obstetrician-Gynecology, Rheumatology (46 percent)
  5. Infectious Diseases (45 percent)


Why Do We Need to Address It?

Burnout affects almost every aspect of a doctor’s life, including their career satisfaction, personal relationships, and the patient care they provide. As with any profession, burnout is simply unhealthy for the worker and would doubtless affect the work they provide. And in the case of doctors’ work, lives are at stake.

Some studies show that burnout can lead to medical errors. A study led by researchers at the Stanford University School of Medicine surveyed over 6,000 physicians in active practice across the USA. About 55 percent reported symptoms of burnout, while 10 percent reported that they made at least one major medical error during the prior three months.

They found out that doctors with burnout have more than twice the odds of self-reported medical error, after they have adjusted other variables, such as work hours, work unit safety training, and fatigue. The study also revealed that the medical error rate tripled—even in units that were marked as extremely safe—if the doctors working in that unit experienced high levels of burnout.


Causes of Physician Burnout

Several factors cause physician burnout, and the common denominator among them is an inefficient healthcare system that demands a staggering workload but provides little reward.

According to the Medscape study, physicians cited the following as the top contributors to their burnout:

  1. Too many bureaucratic tasks (such as paperwork and charting) – 55 percent
  2. Long, overwhelming work hours – 33 percent
  3. Lack of respect from administrators, colleagues, and staff – 32 percent
  4. Increasing computerization of their practice – 30 percent
  5. Insufficient compensation and reimbursement – 29 percent


The Texas Heart Institute Journal study entitled Physician Burnout: Causes, Consequences, and Cures also 
offered similar reasons behind the burnout epidemic.

  • Loss of Autonomy – The researchers claim that the profession has lost much of its human context. It has been overridden by rigid policies of medical reimbursement and hospital regulations, whereas in the past, doctors have a greater autonomy to see and treat their patients.
  • Too Many Rules – The current medical environment is overrun with rules from the government, hospitals, and insurance companies, which limit the time a physician spends with their patients.
  • Asymmetric Rewards – Doctors embrace a mindset of service that doesn’t ask much for return. A certain asymmetry (where good work is rewarded poorly, but mistakes are punished strongly) takes a toll on the medical professionals.


Is There a Cure for the Burnout Epidemic?

Despite the grim situation, medical institutions are actively taking steps to solve and prevent burnout. After all, reducing burnout not only improves the quality of life of doctors, but it also improves patient outcomes and increases the efficiency of the organization.

Spearheading the movement is the AMA, which recommends a seven-step action plan. The plan includes conducting wellness surveys, initiate interventions, and continual polishing of said interventions. The Texas Heart Institute Journal study also stresses the need to invest in better, more efficient electronic health records systems (including revenue cycle management services and electronic patient records) to make administrative tasks easier for physicians.

If physician burnout is a deeply rooted issue in the medical field, and because the causes are flaws in the system, only systemic remedies would work. Once these comprehensive corrective steps are taken, people can expect healthier doctors and by extension, a higher chance of better patient outcomes.

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