Do you ever wake up and feel like you absolutely do not want to get out of bed and face your job? Does your job make you feel like you can’t succeed, no matter how hard you try? These symptoms of job burnout are never pleasant and might lead you to quit your job or leave your profession altogether. Unfortunately, the current medical climate has caused many doctors to suffer from burnout. It’s bad news for doctors, and it’s bad news for patients. Because doctor burnout can impact your health and your healthcare.
It’s official. Doctors burnout is widespread.
Burned out doctors lose satisfaction with their work and feel like they are not as effective in their jobs as they would like. Unfortunately, this problem is widespread among doctors with almost 50% of doctors reporting feelings of burnout. And the percent of doctors reporting burnout increased 4% in two years.
Why? Doctors feel burned out by the rapidly changing healthcare environment. Today doctors face increased stress due to measurement and accountability related to quality, errors, inequities, and soaring costs. Add to this the widespread use of frustrating Electronic Health Records (EHRs) and it’s no surprise doctors are unhappy and burned out.
Crisis in Health Care report.
The 2018 report “Crisis in Health Care: A Call to Action on Physician Burnout” by the Massachusetts Medical Society, Massachusetts Health and Hospital Association, Harvard T.H. Chan School of Public Health, and Harvard Global Health Institute describes common causes of burnout:
- Frustrating EHRs interfaces that have made it difficult to engage with patients, thereby undermining patient encounters for both doctors and patients.
- Long work days have become even longer as doctors struggle to keep up with a soaring burden of administrative tasks.
- Feeling that patient care can be negatively impacted by the demands of documentation or quality measures.
Additionally, the report states that many doctors feel the daily demands of their profession are at odds with their professional commitment to healing and providing care. Doctors struggle with their inability to meet their patients’ needs, due to conditions beyond their control. Examples include patient poverty, lack of insurance authorization, and unreasonably short appointment times.
For more information on doctor burnout read my previous blog post which details the findings of a 2016 survey of doctors by The Physicians Foundation.
What kind of impact does doctor burnout have?
Experts agree – doctor burnout is a public health crisis.
Clearly, a primary impact of burnout is on doctors’ mental health. However, it’s obvious that a healthcare system can’t operate at the highest levels of quality performance when the doctors working in are not well. Therefore, the big, and scary impact of doctor burnout is the impact it has on the health and well-being of patients.
Burnout causes doctors to quit or reduce their hours.
When people are very stressed by work, it’s natural for them to seek ways to reduce their stress. And doctors are no different. Burnout causes doctors to reduce their hours or leave the profession altogether. Research found that every 1 point increase in burnout (on a scale of 7) is associated with a 30-40% increase in the chance a doctor will reduce their work hours in the next 2 years. Furthermore, the US Department of Health and Human Services predicts a shortage of up to 90,000 doctors by the year 2025. And one of the main causes of this shortage will be doctors leaving the profession due to burnout. It’s already hard to find a doctor taking new patients in some areas of the country. Imagine how hard it will be to get appointments when there is a shortage of doctors!
Burnout negatively impacts care.
Patients do not like it when their doctors express symptoms of burnout. Not surprisingly, research in primary care settings shows a significant correlation between reduced patient satisfaction and doctor burnout. Furthermore, evidence suggests that burnout is associated with increasing medical errors.
How your doctor interacts with you can impact your health.
Research shows that what doctors say, and how they say it, can impact patient outcomes. A recent study found that itchiness from a skin test improved more quickly when patients heard encouraging words from their doctors. In a similar study, researchers assessed whether the perceived warmth and competency of a doctor impacts patient health. The study found that a placebo cream reduced allergic reactions only when the doctor projected warmth and competence. When the doctor said the same message, but acted colder and less competent, the placebo cream had no effect.
This research suggests that when doctors don’t connect with their patients in a warm, encouraging manner, they may put the chances of successful treatment at risk. Doctor-patient rapport has important effects on a patient’s physical health.
Can burned out doctors provide warm, encouraging encounters? Probably not as easily as doctors who do not feel burnout.
How can doctor burnout be reduced?
The “Crisis in Health Care” report outlines 3 steps that could reduce doctor burnout:
- Support proactive mental health treatment and support for doctors experiencing burnout and related challenges.
- Improve EHR standards with strong focus on usability and open Application Programming Interfaces (known as APIs, these are 3rd party Apps for EHRs that can improve the interface and experience).
- Appoint executive-level chief wellness officers at every major health care organization.
For detailed information on each of these recommendations, read the report here.
What can patients and families do about doctor burnout?
Understanding the stresses your doctors face can improve your interactions with a burned-out doctor. Treat your doctor the same way you want others to treat you and cut them a little slack. For example, don’t be angry if your doctor is running late. Instead, understand that it is likely because he/she is busy with another patient. Personally, I appreciate how my primary care doctor gives me as much time as I need during my appointments. Therefore, I am never upset that she is running late while she is helping other patients. That being said, if you frequently suffer through long waits in the waiting room and then feel rushed during your own appointments, it might be time to look for a new doctor.
Additionally, do yourself and your doctor a favor – prepare for appointments! Write down your “story” and your questions before your appointment to make the most of out time-limited appointments.
However, it’s possible that burnout changed your doctor’s demeanor and quality of care. If your doctor behaves unpleasantly, or you feel you are getting subpar care, it’s probably time for a new doctor. For more information on when to consider changing doctors, read my series on this topic: Part 1, Part 2 and Part 3.