When we think of the most prestigious careers in America, ‘doctor’ is usually one that ranks near the top of the list. It is surprising, then, that physicians across the country are facing unprecedented levels of burnout, depression, and even suicide. Taking care of at-risk patients is naturally stressful work, but if doctors are too stressed, they are not able to provide the best possible care. That means worse patient outcomes, which can create a feedback loop putting even more pressure on the physicians.
A 2019 survey of over 15,000 physicians by Medscape found that an alarming 44% reported they were feeling symptoms of being burned out. Younger generations of physicians, women, and those who work the most hours seem to be the most affected. What factors are making careers in the medical field so stressful, and what can we do to alleviate that stress? It turns out data can help us figure out these factors and move towards possible solutions.
The causes of physician burnout
Taking a decidedly clinical approach to this problem, the causes should be determined before symptoms are treated. One of the biggest, and newest, sources of stress for physicians is the addition of maintaining electronic health records to their already long list of duties. While electronic records are a beneficial and inevitable result of modern technology with proven results in helping hospitals improve their care, the implementation of these records has added hours of work to physicians’ already packed schedules.
More time spent doing clerical work means less time spent with patients (or less personal time spent outside of the hospital). By some estimates, physicians are spending twice as much time on EHRs as they do on patients. This is obviously bad for the patients, but it also puts a strain on disillusioned doctors who spent years studying medicine with the hopes of working closely with patients and closely following their return to good health.
As Dr. Philip Kroth, professor at the University of New Mexico’s School of Medicine put it, “We are losing the equivalent of seven graduating classes of physicians yearly to burnout and, as they leave the profession, they point their finger at the time now required for them to document their work and how it has led to the loss of quality time spent with patients and families.” Being a doctor will always be a high-pressure and stressful job. But the personal connections with the people they help is what also made it a rewarding job. And now those connections are being eroded.
But the causes of physician burnout go beyond frustrations with EHRs. An unsustainable work-life balance is cited as one of the biggest causes of physician burnout, correlating with an increased average number of hours worked by each doctor. Others point to problems with the culture of the places they work, causing them to feel disengaged. Every healthcare professional is different, and so are the problems that they face.
So what can be done to help alleviate the problem of physician burnout?
The simple solution would be to hire more physicians. That would help solve the problem of them working too many hours and having too heavy of a workload. However, hiring qualified professionals is expensive, and not always within a healthcare system’s budget. And with fewer people graduating from medical school, there does not always seem to be enough doctors to meet the demand.
Hiring intermediary clerical workers to help assist doctors with inputting EHR data could also help reduce the stress of record-keeping. Additionally, the tedious process of EHR record keeping could be reduced or streamlined (even though it was ironically introduced to streamline the record keeping process in the first place). If parts of the process can be automated, then physicians will be able to spend a greater portion of their time with patients. Data management software can be used to keep information concise, consistent, and easily accessible.
In the webinar Combating Healthcare Burnout with a Data-Led Action Framework: Lessons from Minnesota, Rahul Koranne, M.D., MBA, FACP and Dr. Peter Henry M.D. suggested that this problem should be tackled by focusing on the leadership and culture of healthcare systems, rather than on individual problems. Since every doctor is different, their physical and emotional well-being must ultimately be left up to them. Trying to meddle too directly could be seen as invasive.
Instead, make sure the hospital culture that the doctors are working within is one in which they feel their skills are being properly utilized. Allow them enough time to properly understand and connect with their patients. It is important that that medical staff feel their goals are aligned with those of the healthcare system in order for them to feel engaged.
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