Wherever the art of medicine is loved, there is also love for Humanity.
Hippocrates, father of medicine.
Two studies authored by Mayo Clinic and AMA, that published in 2014 showed rates of burnout among physicians to be as high as 54%, and significant increase of 10% from 2011, just 3 years ago.
This prompted a recent survey by NEJM Catalyst Insight Council which I feel is worth looking at. Healthcare is placing a tremendous burden on physicians with no end in sight and decreasing reimbursement they are compounding this burden by adding stress to their non-health industry related burden.
How does one define burnout “it’s a syndrome of depersonalization, emotional exhaustion and a sense of low personal accomplishment” this can develop slowly over time due to chronic persistent stress, inability to cope with inefficiency in system and increasing workload.
Ninety six percent of respondents in the Catalyst survey felt that physician burnout is real problem. More members from northeast [46%] felt the problem to be more serious as compared to west [32%] Midwest [31%] and south [31%], as we know most new regulations and quality measures start in the northeast which can be a source of increase burnout.
Top factors mentioned in physician burnout were
Increased clerical burden: 62%
Increased productivity requirements: 51%
Reimbursement model: 21%
Erosion of professionalism: 21%
Excessive metrics: 18%
Excessive work hours: 11%
I tend to agree with the reasons although I am surprised that excessive work hours are last on the list. This tells us that physicians by nature are hardworking and consider this a part of their job although almost every physician works more than 40 hours per week unlike most Americans who work.It is the burdensome nature of EMR that is cited as the cause of the increase in the clerical burden. This often leads to diminished quality of care since more time is spent on finishing clerical data rather than patient care and often times requires taking work home to finish on personal computers, effecting personal relationships as well. Increasing cost of practice and diminishing reimbursement creates an economic mismatch which prompts longer hours and more burnout, a vicious cycle with no end in sight.
Physician burnout is resulting in early retirements, taking non clinical jobs, working for other industries and in extreme cases even committing suicide. Data reveals that one physician commits suicide every day.
With physician shortage looming instead of retaining physicians we are losing them. I know of several physicians that left or are leaving medicine because of the above factors.
Is there anything being done other than lip service? I searched the net at length and found nothing concrete that is being done. I feel that each organization needs to look at themselves and dedicate resources towards this very serious and growing problem. We at the medical society will be paying a lot more attention to this problem and also bring it to attention of the public, hospital organizations and the legislatures.
Mian A Jan MD