Physician Burnout
By Darlene Lien and Caroline Sha
What is Physician Burnout?
Physician burnout is characterized by a long-term stress reaction encompassing an array of symptoms. These include but are not limited to: fatigue, exhaustion, trouble concentrating, anxiety, insomnia, irritability, and depression. But perhaps the most defining traits of physician burnout are a sense of emotionlessness and loss of interest in one’s work or personal life.
The COVID-19 pandemic has heightened the challenges that physicians face, such as by increasing workload, thereby increasing burnout. A research study conducted by the American Medical Association in 2022 found that overall, 62.8% of physicians reported at least one manifestation of burnout in 2021 — this translates to approximately three out of every five physicians reporting burnout.
In a similar study, researchers at Mayo Clinic further highlighted the challenges faced by physicians within the first two years of the pandemic. In these early days, physicians lacked adequate personal protective equipment and were overwhelmed with increasing workloads and staffing issues. And often, the impact of the COVID-19 pandemic on physicians is not well understood and discussed.
With the pandemic continuing as an ongoing concern, physician burnout remains a crucial topic. In a report by the American Medical Association in 2022, physician burnout continues to be rising, with a 4% increase compared to their previous benchmark. Hence, addressing physician burnout is paramount in healthcare and the delivery of quality patient care.
Causes of Physician Burnout
The causes of physician burnout are varied and complex, and they may differ from physician to physician. However, there are a few common factors that physicians cite when discussing where their burnout stems from.
One such factor is excessive workloads. In one study, researchers found that high work overload increases the risk of developing burnout by a factor of three. Physicians often report working long hours (more than 40 hours per week) with little time for breaks, especially as trainees; this high burden of work not only physically and emotionally drains physicians, but also limits the amount of time they can spend with each patient, lowering both physician and patient satisfaction.
Another important cause of physician burnout is the amount of administrative tasks many physicians have to complete. These tasks can include duties such as charting, managing insurance issues, and other forms of paperwork. According to one study by the Mayo Clinic, physicians spend half of their workday and an additional 28 hours every month working on administrative tasks, which greatly lowers job satisfaction and well-being.
Finally, a major factor contributing to physician burnout is a perceived lack of autonomy. Whether it is due to bureaucratic rules or an inability to address root causes of diseases, such as poverty, physicians may feel disillusioned and powerless when facing the larger systems at play in society. Such feelings may decrease motivation to continue working in the field and contribute to feelings of cynicism and hopelessness.
Consequences
Being highly prevalent in healthcare, physician burnout can have negative effects both on a personal and professional level. On a personal level, physician burnout can impact one’s physical and physiological health and manifest differently in severity. In general, physicians often complain of feeling tired and exhausted and may report feelings of stress and depression. These conditions not only negatively impact the physician’s well-being but may lead to increased risks of substance abuse and suicide.
In addition, physician burnout can also disrupt the physician’s professional environment. These impacts include: increased medical errors, increased risk of malpractice, failed relationships, lower patient satisfaction scores, and longer patient recovery. Moreover, these consequences can also result in profound consequences for not only specific healthcare organizations but also the broader healthcare system, which relies on an effective and cohesive healthcare unit.
One study by a team of researchers aimed to examine the role of physician burnout in patient satisfaction and adverse patient outcomes. A major finding in their review was that out of 11 studies, four observed a direct association between burnout and adverse patient care. Among these four studies, two involved unnecessary referrals, one involved a transfer of patient care to another provider, and the last one exhibited an adverse medical outcome experienced by the patient.
While more studies should be performed to better understand the complex link between physician burnout and decreased quality of patient care, current research scholarship demonstrates that burnout can clearly affect patients’ experiences. These tragic consequences create a ripple effect that is oftentimes concealed in a vacuum. Moving forward, tackling the toll of burnout on physicians and the medical workforce will aid in the delivery of quality patient-centered care.
Possible Solutions
An important step to addressing physician burnout is to invest into more research on the topic, as mentioned above; such studies can not only identify specific causes of burnout, but also determine what policies and programs work when it comes to addressing it.
Moreover, by reducing administrative burdens, physicians can spend more time with patients and decrease the amount of hours worked. While it may be difficult to do, policy-makers can start by identifying tasks that interfere with a physician’s ability to care for patients.
However, such solutions are just a start for the complex and entangled issue of physician healthcare. The problem cannot be resolved overnight and requires systemic change enacted through cooperation between physicians, patients, and administrators.
References
“7 Effects of Physician Burnout | iScribe Health,” July 11, 2018. https://www.iscribehealth.com/blog/7-effects-of-physician-burnout/.
American Medical Association. “Pandemic Pushes U.S. Doctor Burnout to All-Time High of 63%,” September 15, 2022. https://www.ama-assn.org/practice-management/physician-health/pandemic-pushes-us-doctor-burnout-all-time-high-63.
American Medical Association. “What Is Physician Burnout?,” February 16, 2023. https://www.ama-assn.org/practice-management/physician-health/what-physician-burnout.
“Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017 — Mayo Clinic Proceedings.” Accessed November 27, 2023. https://www.mayoclinicproceedings.org/article/S0025-6196(18)30938-8/fulltext.
Eisenstein, Leo. “To Fight Burnout, Organize.” New England Journal of Medicine 379, no. 6 (August 9, 2018): 509–11. https://doi.org/10.1056/NEJMp1803771.
Mangory, Kashan Yasin, Lavin Yadgar Ali, Karin Isaksson Rø, and Reidar Tyssen. “Effect of Burnout among Physicians on Observed Adverse Patient Outcomes: A Literature Review.” BMC Health Services Research 21, no. 1 (April 21, 2021): 369. https://doi.org/10.1186/s12913-021-06371-x.
“Physician Burnout | Annals of Internal Medicine.” Accessed November 27, 2023. https://www.acpjournals.org/doi/full/10.7326/0003-4819-135-2-200107170-00023?casa_token=n-oLdGVTGh0AAAAA%3Ab-qmuxZUhC2zj1BKoCG0DJaXMES4-tDQc5KeryfL7w952yPpFyU2hfnVV2eMolODnuj0lzs1r3K3Sbdp.
Rotenstein, Lisa S., Roger Brown, Christine Sinsky, and Mark Linzer. “The Association of Work Overload with Burnout and Intent to Leave the Job Across the Healthcare Workforce During COVID-19.” Journal of General Internal Medicine 38, no. 8 (June 1, 2023): 1920–27. https://doi.org/10.1007/s11606-023-08153-z.
Shanafelt, Tait D., Colin P. West, Lotte N. Dyrbye, Mickey Trockel, Michael Tutty, Hanhan Wang, Lindsey E. Carlasare, and Christine Sinsky. “Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic.” Mayo Clinic Proceedings 97, no. 12 (December 1, 2022): 2248–58. https://doi.org/10.1016/j.mayocp.2022.09.002.
