More doctors are exhausted and health systems need to do more

It’s not about building more tolerance, a group of doctors said. Healthcare organizations must offer resources and reduce burdens that tax their physicians.

More doctors are experiencing burnout, which is becoming a serious concern for health care leaders.

According to a published study, physician burnout has reached a new high Mayo Clinic Proceedings. Researchers reported that 63% of physicians experienced burnout in 2021, compared to 38.2% in 2020. The American Medical Association teamed up with researchers from Stanford University School of Medicine and the University of Colorado School of Medicine in the study.

Health Affairs On Thursday, he held a virtual roundtable with several health care leaders. Alan Weil, Health Affairs editor-in-chief asked participants, all physicians, to address burnout.

Some members highlighted a point early in the discussion. They focused on the need for structural changes, changes in organizations and health policy rather than empowerment of doctors.

“The problem is not a lack of continuity on the part of individual physicians,” said Christine Sinsky, AMA vice president of professional satisfaction.

Politicians are paying more attention to the welfare of doctors and other health workers. President Joe Biden signed legislation this year directing grants to health organizations to address burnout and mental health. Health groups pushed the bill, dubbed the Lorna Breen Act, after an emergency room doctor died by suicide in April 2020, early in the COVID-19 pandemic.

Organizational problem

It’s important to understand that burnout is different from mental illness, the panelists agreed.

“Burnout is not a mental illness,” Sinski said. “It’s occupational distress syndrome.”

Doctors, including panelists, cited several factors that contribute to burnout, including the stress of treating COVID-19 patients for more than two years. Growing staff shortages add to the burden on doctors, especially as health systems see patients who delayed treatment during the pandemic and are now seriously ill.

However, some burdens are more familiar, including the burden of paperwork and challenges with electronic medical record systems. The panelists said that doctors spend most of their time dealing with documents in patient records outside of work.

“Burnout is both an experience-level and an individual-level phenomenon,” said Samuel T. Edwards, an associate professor of medicine at Oregon Health & Science University and a physician with the Veterans Affairs system in Portland.

“Burnout is an organizational-level phenomenon that requires an organizational-level response,” Edwards said.

Many doctors do not feel that their employers are concerned about their well-being. Just over one in three doctors (36%) said workplace culture prioritized their well-being, according to a survey released earlier this month by the Physicians Foundation.

Amy Frieman, chief health officer at Hackensack Meridian Health, says health care organizations need to provide resources for doctors to get help, but they need to make sure doctors know what help is available.

“It’s not just about having the resources … making sure physicians are aware of those resources, but more importantly, they’re comfortable accessing those resources,” Frieman said.

Many doctors are still wary of seeking help for their mental health because they worry it could have detrimental professional consequences, including for their licensure. About 4 in 10 said they were either afraid or knew someone who was afraid to ask for help because of questions about their license or insurance applications. At the behest of health advocates, some licensing boards have changed questions about mental health.

The panelists agreed that reducing the administrative burden on physicians would go a long way to helping their well-being. A January 2022 Medscape survey of physicians found that bureaucratic aspects of health care emerged as the top cause of burnout.

“Our doctors are incredibly overwhelmed and frustrated when it comes to documentation,” Frieman said.

According to an AMA study, doctors find less satisfaction in their jobs, mainly due to burnout. More than half (57.5%) of all doctors said they would choose a career as a doctor if they could do it over, compared to 72.2% in 2020.

Burdens on women, doctors of color

The panel members agreed that female doctors in particular suffer from burnout. More than two in three female doctors (68%) say they experience burnout, compared to 58% of male doctors, according to a survey by the Physicians Foundation.

“We see high rates of women burning out and leaving the workforce,” said Vineet Arora, professor of medicine and dean of medical education at the University of Chicago Medicine.

Women doctors have suffered greater career setbacks from the COVID-19 pandemic, according to a published study. Jama Network Open. Female doctors are more exposed to work conflicts and depressive symptoms, in addition to carrying out more childcare responsibilities. Women also cut more hours.

Rachel Villanueva, clinical assistant professor of obstetrics and gynecology at NYU Grossman School of Medicine, said there is a clear lack of information about mental health and doctors of color. He emphasizes the need to “diversify research and the need for researchers of color,” while at the very least finding more researchers interested in the challenges facing physicians of color.

Black physicians and physicians from other underrepresented groups endure the same challenges of administrative duties and long hours. However, physicians who are members of minority groups also face “systemic racism,” as well as microaggressions and prejudice.

Doctors deserve better

Lawrence Casalino, professor of health policy and research at Weill Cornell Medical College, said that while doctors are increasingly dealing with burnout, there is no clear evidence that it is harming patient care. Casalino was the lead author of the latest study Health Affairs on how physician burnout affects patient outcomes.

“At least in the short term, burned-out physicians may have better quality patients,” Casalino said. “Conscientious doctors may work harder and worry more about their patients and be more vulnerable to burnout than other doctors.”

However, he added: “How long that can last is another question.”

The Doctors Foundation has partnered with the Lorna Breen Foundation to raise awareness of the need to protect doctors’ mental health. They also created a campaign called “Vital Signs” to prevent physician suicide.

Gary Price, president of the Physicians Foundation, said he was part of a grieving brotherhood. He is among the many doctors who have lost a colleague to suicide.

“It is undeniable that our physicians need and deserve better,” Price said.

Help is available

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