Physician Burnout

Recognizing & Treating a Growing Phenomenon

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PART 1

Introduction

The growing issue of physician burnout costs healthcare organizations, diminishes patients’ trust, and threatens the careers of our colleagues. It’s time to learn how to diagnose this phenomenon before it becomes unmanageable.

In this article, you will learn about ways to diagnose physician burnout, what effects it has on the medical community, and how to treat this issue.

Understanding Physician Burnout
First, we must recognize the fact that physician burnout has grown significantly in recent years and continues to. A recent Medscape Physician Lifestyle Survey found the percentage of physicians claiming some sort of burnout rose from 45.5 percent to 54.4 percent in just three years. The cause of this burnout is no secret. The top three reasons that physicians claimed were drivers of burnout are: “Too many bureaucratic tasks,” “Spending too many hours at work,” and “Increasing computerization of practice.”  

physician burnout rate
Physicians claiming some sort of burnout rose from 45.5 percent to 54.4 percent in just three years.

Unless your practice still doesn’t have computers, or you’ve invested in technology to reduce time in front of them, assume you and your colleagues now face higher risk of physician burnout as well. Like any good coworker, we should reach out to those we think might be suffering. The rest of this article will help you unofficially diagnose possible symptoms of physician burnout, and provide solutions for mitigating burnout within your practice. Hopefully, the more we know as an industry, the better we can care for our colleagues, and thus patients, in the future.

The top three reasons that physicians claimed were drivers of burnout are: “Too many bureaucratic tasks,”
“Spending too many hours at work,” and
“Increasing computerization of practice.”

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PART 2

Symptoms of Physician
Burnout.

1. Exhaustion

It’s impossible to remain upbeat at all times, especially in a career so physically and emotionally demanding. However, there’s a big difference between being tired at work and exhausted by your profession. Do you notice any colleagues consistently showing up late or needing to leave early? Do they seem more absent-minded or unable to focus? Maybe they’re continually frustrated with the administrative tasks at hand. While these behaviors seem broad and unrelated, it can snowball into larger, potentially serious performance issues, or in extreme scenarios, even malpractice. Physician burnout might begin with exhaustion, but usually ends in something much worse.

2. Depersonalization

Physicians deal with patients face-to-face almost daily. This vital ritual provides the patient with a needed level of trust and accountability that all physicians hope to provide. When colleagues noticeably go from jovial and inquisitive to rushed and indifferent, the patient obviously suffers, and so does the physician. Diligent EHR documentation, while important, can take away from the personalized, one-on-one communication with a patient.

These changes in personality, like making less eye contact or asking fewer questions, are all signs of depersonalization and overall fatigue. If left unaddressed for too long, this could result in a deepening inattentiveness and apathy, neither of which improve the patients’ nor physicians’ experiences.

3. Cynicism

Physicians should never doubt the efficacy of their work, yet some cannot help but feel like the constant stream of patients and their problems will never end—which is true. There will always be people in need of medical attention. But for a physician to feel that nothing he or she does will make a difference is the strongest sign of burnout. A sign of this change might be an increase of biased comments about patients and the futility of treating them. Often this takes the form of comments regarding emotional stability, weight, and intelligence. This Medscape survey found it more likely for a physician to report bias in themselves when they also reported burnout. Conversely, those that reported non-burnout were less likely to report bias.

Physician burnout doesn’t have a check box in the waiting room, and you cannot search for it on WebMd. Recognizing and treating this troubling phenomenon falls on other physicians, nurses, and healthcare workers. While this list of symptoms can help you spot physician burnout among colleagues, it is by no means an exhaustive list. Consider these three as mere indicators of a larger problem — one that if left unchecked could have far more consequences than just a bad day at work.

The growing reliance on computers in medical offices and the amount of time a physician needs to devote in front of them clearly has contributed to this rise of physician burnout. If your medical practice has not yet considered investing in technology that would limit the time spent in front of a computer, let’s connect. iScribe relieves physicians of manual data entry and screen-time, allowing them to focus more on patients.

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PART 3

Effects of Physician Burnout

The seven effects of physician burnout cover a large spectrum of negative consequences, but should not be considered an exhaustive list. If you or someone you work with clearly exemplifies the signs listed below, seek professional assistance. There’s many ways to alleviate the endless stress that physicians endure.

1. Disruptive Behavior

As mentioned in the “Diagnosing Physician Burnout” blog, cynicism can indicate an early symptom of burnout. While being cynical can seem like merely an attitude problem, this sort of negativity to colleagues, sometimes about particular patients, can create awkwardness or conflict that disrupts the normally professional environment of a doctor’s office or emergency room.

2. Increased Medical Errors

A study published by the American Medical Association found that physicians with higher levels of burnout would also be more susceptible to an increase of medical errors. This could be a result of a lack of empathy or focus. As we will discuss below, more medical errors creates exponentially more problems for physicians, patients, and healthcare organizations.

3. Increased Risk of Malpractice

An increase in medical errors opens the floodgates for potential malpractice suits against healthcare organizations. This can pose a serious economic threat to those practices and the many people they employ. Also, a malpractice suit can blemish any typically-outstanding medical professional’s resume, creating lifelong problems of credibility.

Learn how physician burnout can impact the patients and physicians in your practice in this webinar recording.

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4. Failed Relationships

Physician burnout doesn’t just stay at work. It permeates all aspects of a physician's life, because a physician doesn’t simply clock in and clock out everyday. They take the stresses home with them, to their significant others and family members. This increase of exhaustion, depersonalization, and cynicism takes a toll on personal relationships.

5. Substance Abuse

Another effect of physician burnout is an increase of substance abuse. The same American Medical Association study mentioned earlier found that, “Work-related burnout can spill over into personal life and contribute to broken relationships, substance abuse, and other types of distress.” The consequences of this could exacerbate every effect mentioned so far, particularly the increased risk of malpractice.

Sadly, as is with the rest of the general population, an increase in substance abuse leads to higher suicide rates. Physicians are already at higher risk than other American professions to commit suicide, making the growth of physician burnout particularly life-threatening.

6. Lower Patient Satisfaction Scores

It shouldn’t come as a surprise that a likely outcome of physician burnout would be lower patient satisfaction scores, given the other effects previously discussed. If a physician is more likely to make a medical error, show less empathy, or create an uncomfortable environment for colleagues and patients, a low satisfaction score would logically follow. Diagnosing and treating burnout becomes crucial at this juncture. Other physicians can sometimes cover for a colleague going through a rough time. However, when burnout clearly affects the patient’s experience, that can impact both the healthcare organization’s reputation and bottom line.

7. Longer Patient Recovery

Studies have found that “the depersonalization dimension of physician burnout was associated with patient outcomes of lower satisfaction and longer post discharge recovery time.” It’s clear in this instance that the attitude of physicians goes a long way when treating patients. Just like how a spouse or family member can internalize the stress and negativity that one might bring home from work, a patient internalizes the absent-mindedness of their most trusted healthcare provider. More than any other job, a positive relationship between those seeking medical treatment and those offering, goes far beyond just technical capabilities. The relationship needs strong emotional support. Unfortunately, a consistent trend among all physicians, whether it be surgeons, pediatricians, or orthopedic specialists, is the growing reliance on, and time in front of, EHR systems. This means less eye-contact and more time copying notes into a computer.

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PART 4

Treating Physician Burnout.

As physician burnout continues to grow in the medical community, iScribeHealth has begun exploring how to diagnose this problem and understand the effects it can have. In the following section, we dive into the various methods of treating burnout and a possible solution aimed at preventing this issue altogether. It’s important to note; however, that without assistance from each other, successfully treating or preventing burnout is unlikely.

Acknowledge the problem

This step may seem obvious, but unless you’ve done your own research or spoken personally with someone suffering, it could be very difficult to acknowledge that this problem exists in all practices at all levels. Without a candid acceptance that you or others in your organization might be suffering from this, the three relevant parties — organization, supervisors, and individuals — cannot get together to solve it.

On the organizational side of things, supervisors need to build out processes to consistently assess if physicians are getting burned out. Those supervisors then must implement these processes, while the individual is tasked with looking out for themself and colleagues.

Restore work-life balance

For many physicians, this just simply may seem impossible. Work is life and life is work. But it doesn’t have to be. Work-life balance is an organizational responsibility. Most physicians, given their inherently altruistic nature, will over-work themselves to help patients. They would not have gone through a decade of intensive education if they didn’t firmly believe in this. So, that means it’s the organization’s responsibility to make sure physicians’ shifts are not too long, and that there are enough support staff on duty at any given time.

For the individual, restoring work-life balance might include actively trying to get a reasonable amount of sleep per night, or spending more time with your family. It may seem simple, but restoring these small parts of ordinary routine can have exponential benefits.

Focus on the rewarding aspects of work and practicing self-care

What each individual finds rewarding as a physician differs. Physician leaders should engage their team by asking what can be done to improve the organization as it pertains to each physician’s goals and professional development. This coaching can improve professional development and serve as a mentorship for those over-stressed.

For the individual, “Honest and regular self-calibration should be considered a core component of professionalism,” as stated by the Mayo Clinic. Improving one’s self-awareness can reduce burnout through active mindfulness, cognitive behavioral techniques, and finding purpose in one’s work. While a physician leader can help teach skills concerning self-awareness, the individual must be the one to exercise and develop them.

Increase time speaking to patients and other physicians

More face-to-face communication with patients has shown to have a positive impact on the mental health of physicians. When a closer relationship between the two exists, fewer errors are made, empathy grows in the physician, and the odds of burnout decreases. An emphasis on communication training is one preventative measure organizations can take. These trainings would help physicians focus on the importance of introductions, collaboration with patients, reflective listening, and setting clear expectations.

Decrease time spent in front of EHR

The growing amount of time spent in front of a computer screen has exhausted physicians and become an unavoidable aspect of the job. However, recording patient information will always take priority. As an institution looking to implement organization-wide changes to combat the growing issue of physician burnout, consider investing in mobile EHR efficiency tools. These solutions get physicians away from their screens, allowing them to focus and communicate better with patients. While these apps won’t solve this crisis, it can alleviate a number of pains felt throughout the healthcare industry.


We hope you find this analysis and our recommendations concerning physician burnout useful. To download a recording of our webinar on the topic click here.

If you want to proactively prevent physician burnout, decrease time spent in front of computers, and increase face-to-face patient communication, click here to schedule a demo of the iScribe platform. We’d be happy to show you how our mobile solution does all three while saving your practice money immediately. Even better - we will set all of your providers up and let them try it for free for 2 weeks.

To learn more, watch this recorded webinar on understanding and preventing physician burnout.

In this webinar, Pat Williams and Justin Hipps, founders of iScribe, interview Dr. Allen L. Gee, MD, PHD from Frontier Neurosciences on:

  • The effects of physician burnout
  • The top causes of physician burnout
  • How to prevent burnout in your practice
  • A short demo of iScribeHealth’s mobile EHR solution

Fill out the form to the right to get the webinar recording.