Diksha Mohanty, M.D., Steven Lippmann, M.D.

Physician burnout is an emerging problem. Burnout is described as work-related discontent of doctors, with emotional fatigue, skepticism, and hopelessness; it may be a product of prolonged professional stress. Recent research documented significant symptoms in half of all physicians surveyed. Lack of action in response to this problem may be ascribed to denial by doctors affected, shortage of evidence-based solutions, and ambiguity regarding monetary repercussions. It is deleterious to individual practioners and also clinically at patient care, with negative financial implications. It results in suboptimal illness outcome and at diminished patient safety and satisfaction.

Provider stress is caused by time-related pressure, poor workflow design, and inadequate autonomy. The current electronic medical record complexity causes much distress for many physicians, especially in time management and reduced degrees of patient contact. The Maslach Burnout Inventory is the standard for assessing burnout severity, and the Zero Burnout Program survey is a tool to identify those affected. Managing physician burnout requires an individual, practice, and organizational-focused strategies.

Doctors should employ coping skills to identify and handle distress. Self-care methods advocated in the pursuit of well-being include ensuring proper diet, rest, exercise, and avoiding substance abuse. Maintaining a balance with personal life, as in family, friends, and hobbies is important. A greater sense of purpose usually follows acquisition of newly updated medical skills and education. Discussion with colleagues and/or organizational leaders can be beneficial.

Practices should streamline over-burdened schedules to promote patient contact and encourage dialogue about concerns between physicians and their leadership. Involvement by nursing and other staff at minimizing office difficulties is advised.

On the organizational and governmental level, greatly simplifying the electronic health record and/or the provision of medical scribes should diminish burnout-inducing stress. Policy modifications to better focus clinical documentation requirements, minimize insurance barriers, and ease regulations would aid professional engagement among physicians, with enhanced autonomy. Universal access of patients to affordable health care with better insurance coverage and appropriately available pharmaceuticals would be profoundly helpful. This should promote greater physician satisfaction. Doctors, practices, professional groups, and lawmakers have shared responsibility in ensuring physician health; that yields benefit to our patients.

Suggested Reading 

1. Shanafelt TD, Hasan O, Dyrbye lN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc 2015; 90(12);1600-1613
2. Shanafelt T, Goh J, Sinsky C. The business case for investing in physician well-being. The J Am Med Assoc Inter Med 2017; doi:10.1001/jamainternmed.2017.4340
3. Linzer M, Guzman-Corrales L, Poplau S. Preventing Physician Burnout – Steps Forward [Internet]. Stepsforward.org. 2017. Last accessed on December 4, 2017 https://www.stepsforward.org/modules/physician-burnout
4. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet 2016; 388(10057):2272-2281