by Ted J. Clarke, MD, Chairman & CEO, COPIC Insurance Company
Featured in the March/April 2018 Colorado Medicine.
Physician burnout has always been a concern, but in recent years, research shows a more widespread impact that threatens personal well-being, professional satisfaction and patient care. Whether it’s anxiety from a medical liability lawsuit or the accumulation of everyday stressors, the factors behind burnout are being examined closely to better understand this issue. The 2018 Medscape National Physician Burnout and Depression Report surveyed physicians across the country and notes that:
- 42 percent of respondents said they were “burned out.”
- The highest rate of burnout occurred in critical care and neurology (48 percent), family medicine (47 percent), and OB/GYN and internal medicine (46 percent).
- Factors cited in burnout: too many bureaucratic tasks (56 percent); too many hours at work (39 percent); lack of respect from administrators, employees, colleagues or staff (26 percent); and the increasing role of EHRs (24 percent).
The report also highlights the connection between burnout and depression, and how physicians are not reaching out for support – 66 percent of male physicians and 58 percent of female physicians have not sought professional help in dealing with these issues. The evidence we are seeing has expanded the conversation from addressing burnout from an individual perspective to exploring larger, systematic approaches that focus on prevention and reinforce wellness.
“There was this assumption that doctors could take on extra work seamlessly, but now it is crowding out our true work as healers. Physicians are at the sharp end of the stick for accountability, regulatory issues, and now even data acquisition and entry – it’s too much,” said Christine Sinsky, MD, vice president for professional satisfaction at the American Medical Association, in a recent New England Journal of Medicine (NEJM) article.
Not surprising, the article cites “clerical burden” as one of the major factors for burnout. Studies have shown that for every hour physicians spend with patients, they spend one to two more hours on tasks such as documentation, ordering tests and responding to patient requests. Most of this work is not reimbursed and physicians trying to keep up often complete it on nights and weekends.
Of particular interest to COPIC is the finding that physicians with burnout symptoms are more likely to report having made a major medical error in the past three months, and receive lower patient-satisfaction scores.
COPIC’s seminar “Healing the Healer – Creating a Wellness Toolkit,” goes beyond common recommendations such as sleep more, eat well and take a yoga class. It focuses on understanding the stress and factors behind burnout to develop a toolkit based on practical solutions to improve wellness and increase satisfaction. In addition, the seminar helps attendees identify the early symptoms of burnout and how to deal with them in ways that support productivity without draining inner resources.
COPIC’s Care for the Caregiver program provides crucial support when physicians need it most – during a lawsuit. This program connects insureds with “peer” practitioners who have experienced the litigation process. These peers offer a shared perspective to address difficult feelings such as anger, guilt, fear and isolation – which can drive burnout and depression. Confidential discussions with a peer encourage open dialogue and focus on the emotional well-being of the individual, not analyzing the medical facts of a case. The ultimate goal is to build resilience so physicians can move forward on both a professional and personal level.
“We’re spending our days doing the wrong work. At the highest level, we are disconnected from our purpose and have lost touch with the things that give joy and meaning to our work,” Sinsky said in the NEJM article. We at COPIC couldn’t agree more and recognize our responsibility to ensure that those who take care of patients are also taking care of themselves.
- N Engl J Med 2018; 378:309-311
- Ann Intern Med 2016;165:753-760.
- JAMA Intern Med 2017;177:195-205.