By Steve Weichhand, Vice President, Growth and Customer Experience, and Prerna Bhardwaj, Senior Manager, Consulting Services
A Review of Physician and Clinician Burnout
More than one-half of physicians and one-third of nurses experience the symptoms of burnout. Problems caused by burnout extend beyond the direct challenges to the impacted individual — the quality of care suffers, medical errors and malpractice claims increase, and organizations face significant costs related to rehiring and disruptions to capacity. Burnout is estimated to be responsible for billions of dollars in costs for organizations annually (Reith, 2018).
According to the 2019 Medscape National Physician Burnout, Depression and Suicide Report, 44 percent of physicians reported being burned out, 11 percent said they were colloquially depressed (feeling, down, sad, or blue) and 4 percent were clinically depressed. 14 percent of them have had thoughts of suicide and one percent have attempted it.
In fact, doctors have the highest suicide rate of any profession—at 28 to 40 per 100,000—according to a study presented at the 2018 American Psychological Association meeting. That is more than twice the suicide rate of the general population, which is 12.3 per 1000,000 (Anderson, 2018).
Defining Burnout and Identifying its Causes
What is clinician burnout? A study published in the Journal of Internal Medicine puts it succinctly, “Burnout is a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment” (West, Dyrbye, & Shanafelt, 2018). Mayo Clinic studies have found that a 1-point increase in a physician’s burnout score increases by 43 percent the likelihood that the physician will reduce their clinical effort within the following 24 months (Reith, 2018).
There are multiple causes for clinician burnout, and several recent studies agree on the top three culprits. The Medscape report found that although in some cases, burnout among physicians, residents, and nurses are caused by personal issues, most of it is caused by healthcare system flaws (Kane, 2019). Another study in late 2018 titled, “Burnout in United States Healthcare Professionals: A Narrative Review,” found the same to be true among both physicians and nurses (Reith 2018).
In the Medscape Report, the top three issues creating burnout are:
- Bureaucratic tasks mostly related to insurance company and governmental requirements (59 percent reported this as a top cause).
- Spending too many hours at work (34 percent rated this at the top). Both doctors and nurses work long hours overall and long shifts, which affects their health and lives outside of work.
- Increasing computerization of practice. (32 percent of respondents listed it as a top cause. Numerous studies on clinician burnout over the years have put the blame squarely on the electronic health record.
One physician in the Medscape study commented that “There’s so much redundant work due to incompetent third parties’ data collection.” Another said, “All that paperwork sucks all of the enjoyment out of being a physician” (Kane, 2019).
Are you sensing a common theme in these three issues? Well, number three—increasing computerization of practice and the EHR—is obviously a healthcare information technology-related problem. The highest-rated problem—Bureaucratic tasks—is likely also largely IT-related, because much of the response to it is about documentation and charting, although other internal processes and organizational/team issues contribute to redundancy and efficiency issues.
