We’ve come a long way in understanding burnout, but healthcare leaders are perplexed when it comes to solutions.
Physician burnout is a constant, chronic problem in medicine, further fueled by public health emergencies like Covid-19 but never quite dwindling to embers in the aftermath of these events. Physicians also are impacted by fear of the virus, significant changes in work and childcare routines, and restrictive social activity.
While Medical Economics® 2020 Physician Burnout Survey shows 65% of physiciansfelt that COVID-19 amplified feelings of burnout, 79% of physicians polled for Medscape’s 2021 National Physician Burnout & Suicide Report said were already burned out before the pandemic hit.
But while we’ve come a long way in understanding this growing problem, which is linked with everything from substance abuse to operating room mistakes, many physicians are still suffering. And healthcare leaders are perplexed when it comes to solutions.
As we adapt to new state of post-Covid normalcy, finding real solutions will only become more important, as patients return to offices for preventive, chronic, and acute-care encounters.
Right Intentions, Wrong Solutions
The escalation of physician burnout since 2010 can be attributed to the convergence of multiple factors. Among them: the adoption ofEHRs to meet “meaningful use” incentive goals, rising overhead costs, and the shift away from volume-driven to more cost-conscious, value-based care models. Today, physician burnout costs the U.S. more than $4.6 billion annually.
Nevertheless, multiple efforts have been made to curb burnout, with varying success rates.A growing number of healthcare organizations have swapped their legacy EHRs for new ones, which promise to do away with excessive alerts and screen-based prompts. A few years ago, the American College of Emergency Physicians recently called for healthcare organizations to promote “wellness,” by offering healthier food choices for working physicians and smoking-cessation programs. And a growing number of businesses are expanding telehealth, so workers might have easier access to mental health and/or counseling benefits.
But these solutions, while well-intentioned, don’t necessarily address underlying dynamics driving burnout.
The EHR, a technology system intended to ease reporting requirements, and improve documentation and collaboration, is a prime exampleMarketed as time saver, these infrastructures often add more time to clinicians’ days because they’re overloaded with complex workflows and never-ending screens for inputting information. In fact, one 2019 study indicates that EHRs contribute to 40 percent of clinical stress.
Revising Our Approach
While changing the institution of medicine has its limits, and some stressors (e.g., being with sick and/or dying patients) are unavoidable, healthcare leaders should consider the following:
- Is their workplace flexible enough?TheNational Academy of Medicine’s paper,“Gender-Based Differences in Burnout: Issues Faced by Women Physicians,”examined the contributing factors to burnout that are more predominant among women physicians and noted that individuals who work fulltime andtake on eight or more hours per weekof home responsibilities are more susceptible to burnout. Offering greater flexibility in work hours – e.g., oneday per week where physicians with can see patients via telehealth, or –gives healthcare workers back some of their most precious asset: time.
- Is theirEHR interoperable in accordance with new legislation? The recent passage of CMS’ Interoperability and Patient Access Rule underscores the need for healthcare providers to communicate with each other to coordinate care. Healthcare providers should ensure their vendor is up to date with the requirements, so they’re not using a system that is slowing them down.
- Is their EHR supporting an intuitive workflow? What’s equallyimportant is having an EHR thateases documentation. In primarycare, for example, an EHR that can be configured to pre-populate data information for the most common acute conditions (e.g. ear infection) could save five minutes for every encounter — or several hours per week. EHRs should also support real-life workflows of healthcare providers. such as complex coding requirements of substance-abuse professionals.
- Are benefits accessible enough? Just because physicians and nurses work in care settings doesn’t mean they have easy access to the healthcare services they need – including preventive screenings and ongoing chronic care. They’re professionals who must work designated hours. Healthcareleaders should shape benefits around their needs, for example, by offering telemedicine for behavioral health visits or on-site health services.
- Is enough being done to de-stigmatize mental health issues?Healthcare workers experiencemental health issues just like other workers but seeking help is still associated with weakness. As Peter Grinspoon, M.D., author of the memoir Free Refills: A Doctor Confronts His Addiction, wrote in 2018 post for the Harvard Health Blog, “medical institutions have tended to address the problem of physician burnout merely by giving their doctors inspirational talks about ‘resilience,’ patting them on the shoulder, and then sending them back into their deteriorating clinical lives.” Physician practice leaders can change this dynamicby ensuring physicians and other workers feel safe to talk about burnout and seek solutions.
While these changes represent some of the best practices by leading organizations, the most important change healthcare leaders can make is changing their mindset. We can’t continue to ignore burnout and hope that it goes away or think that one single “tool” or wellness benefit will fix it. Only by consciously addressing burnout through more comprehensive policies, smarter technology solutions, and a real awareness of the issue can healthcare organizations make a meaningful difference.