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More doctors are suffering burnout, and health systems must do more

A panel of doctors said it’s not about building more resilience. Health organizations must provide resources and reduce the burden that burdens their physicians.

More doctors are experiencing burnout and it is becoming a serious concern for healthcare leaders.

Physician burnout has reached a new high, according to a study published in Procedures at the Mayo Clinic. Researchers reported that 63% of physicians had experienced burnout by 2021, compared to 38.2% in 2020. The American Medical Association collaborated with researchers from Stanford University School of Medicine and the University of Colorado School of Medicine on the research.

Health matters hosted a virtual roundtable on Thursday with several healthcare leaders. Alan Weil, Health matters editor in chief, asked the participants, all doctors, about tackling burnout.

Some members emphasized one point early in the discussion. They focused more on the need to make structural changes, in organizations and health policy, than on empowering doctors.

“The problem isn’t a lack of resilience among individual physicians,” said Christine Sinsky, the AMA’s vice president of professional satisfaction.

Policy makers are paying more attention to the well-being of doctors and other health professionals. President Joe Biden signed a bill this year providing grants to healthcare organizations to address burnout and mental health. Health groups pushed for the bill, called the Lorna Breen Act, after an emergency physician died by suicide in April 2020, early in the COVID-19 pandemic.

An organizational challenge

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

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

Physicians, including the panelists, identified many factors that contribute to burnout, including the stress in treating COVID-19 patients for more than two years. Growing staff shortages add to doctors’ burdens, especially as health systems now see patients who postponed care during the pandemic and are now quite sick.

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However, some burdens are more familiar, including the stress of documentation and hassle of dealing with electronic health record systems. Physicians spend more of their time outside of work dealing with patient record documentation, panelists said.

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

“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 their work culture prioritizes their well-being, according to a questionnaire released earlier this month by the Physicians Foundation.

Healthcare organizations need to give their doctors resources to get help, but they need to make sure doctors know what help is available, said Amy Frieman, chief wellness officer of Hackensack Meridian Health.

“It’s not just having the resources … it makes doctors aware of those resources, but more importantly, making them feel comfortable accessing those resources,” Frieman said.

Many doctors are still concerned about seeking help for their mental health because they fear it could have harmful professional consequences, including with their licensure. Nearly 4 in 10 said they were either scared or knew someone who was wary of seeking help because of questions about licensure or insurance applications. At the behest of health advocates, some licensing boards have amended questions about mental health.

Panel members agreed that reducing the administrative burden on physicians will greatly improve their well-being. A Medscape A survey of physicians in January 2022 found that bureaucratic aspects of health care emerged as the main contributing factor to burnout.

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

Doctors find less satisfaction in their jobs, largely due to burnout, the AMA study found. Just over half of all doctors (57.5%) 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

Female doctors in particular suffer from burnout, panel members agreed. More than two in three female doctors (68%) said they had burnout, compared with 58% of male doctors, according to the Physicians Foundation survey.

“We’re seeing high rates of women who burn out and leave the workforce,” said Vineet Arora, a professor of medicine and dean of medical education at the University of Chicago Medicine.

Female doctors have had bigger career setbacks due to the COVID-19 pandemicaccording to a study published in Jama Network open. Female doctors were more likely to experience work conflict and symptoms of depression, while also having more childcare duties. Women were also more likely to cut hours.

There is a blatant lack of mental health data and doctors of color, said Rachel Villanueva, clinical assistant professor of obstetrics and gynecology at NYU Grossman School of Medicine. She said this underscores the need to “diversify research and the need for color researchers,” as well as the need to find more researchers who are at least interested in the challenges color educators face.

Black physicians and physicians in other underrepresented groups undergo the same red tape of administrative tasks and long hours. However, physicians who are members of minority groups also face “systemic racism”, as well as micro-aggressions and prejudices.

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Doctors ‘deserve better’

Even as doctors increasingly deal with burnout, there’s no clear evidence that it harms patient care, said Lawrence Casalino, a professor of health care policy and research at Weill Cornell Medical College. Casalino was the lead author of a recent study in Health matters on how physician burnout affected patient outcomes.

“At least in the short term, burnt-out doctors can provide better quality patients,” Casalino said. “Conscientious physicians may work harder than other physicians and may be more concerned about their patients, and may be more prone to burnout.”

However, he added, “‘How much that can be sustained is another question.”

The Physicians Foundation has partnered with the Lorna Breen Foundation to raise awareness about the need to protect physicians’ mental health. They have also launched a campaign, “Vital Signs”, to prevent suicide by doctors.

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

“There’s no denying that our doctors need and deserve better,” Price said.

Help is available

Find ways to prevent suicide by doctors

The Lifeline to Suicide and Crisis 988

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