What’s Driving Physician Burnout?

Solutions for preventing and reducing burnout must occur at the organizational and system level
Exhausted physician
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Physician burnout is a serious problem and affects 50 percent of doctors. In fact, it has been called a public health crisis by chief executive officers of the nation’s leading health care delivery systems. Burnout threatens patient safety and quality of care and can impact organizations’ bottom line. 

For example, replacing one physician because of burnout-related turnover is estimated to cost organizations between $500,000 and $1 million in recruitment, training, and lost revenue. Burnout is characterized by emotional exhaustion, depersonalization, and feelings of low achievement and decreased effectiveness. Studies show that the increase in physician burnout is attributable to a loss of control over work, the increasing complexity of medical care, and the implementation of EHRs, which can be time intensive. 

A recent study by the American Medical Association (AMA) found that physicians spend one-half of their day on EHR and desk work and one or two hours at home documenting visit notes and reading through messages. One of the risk factors for burnout is a high degree of work after work, says Christine Sinsky, MD, an internist and the AMA’s vice president of professional satisfaction. “That crowds into our personal time for our families…and for our lives in general,” Sinsky explains. 

Solutions for reducing and preventing physician burnout must occur at the organizational and system level. “As we look to solutions, we want to fix the workplace rather than trying to fix the individual,” Sinsky says. “It’s the work environment that’s primarily responsible for the burnout.” 

Organizations are making efforts to optimize physician well-being, according to Larissa Thomas, MD, an internist at the Zuckerberg San Francisco General Hospital and Trauma Center. Thomas helped author the Charter on Physician Well-Being, recently published in JAMA, which calls for medical organizations, regulatory groups, and individual physicians to proactively engage in specific efforts to reduce burnout and enhance well-being. 

Before implementing any burnout prevention strategies, Sinsky advises practices to conduct a survey and find out what’s driving burnout. She adds that the most powerful interventions are directed at improving the workflow: “80 percent of burnout is driven by systems factors, and only 20 percent is related to individual factors.” Although personal resilience is important, “our first task is to work to improve the environment, rather than asking the people in the environment to just be stronger,” she says.