Tag: physician burnout

As Health Professionals Go, So Goes Our Democracy

Jun 19, 2023

By MIKE MAGEE

Last weekend’s New York Times headline, The Moral Crisis of America’s Doctors, spotlights that there is growing concern that the monetarization and corporatization of nursing and medical professions by hospital and insurance power houses, have seriously undermined the mental health and ethical effectiveness of health care professionals. The pandemic has only heightened the crisis.

Since focusing on the social science of Medicine in the 1990’s in Philadelphia, it has been an uphill battle to convince leaders in and out of Medicine that doctors and nurses are critical to individual and societal success. Recently, I’ve come to the conclusion that this may have more to do with a general lack of knowledge of our form of governing, democracy, than a misunderstanding of the stabilizing effect of professional doctors and nurses.

What is democracy? For an answer I turned to John J. Patrick PhD, professor emeritus in history, civics and government at the Indiana University. In his “Understanding Democracy,” he explains that democracy as we know it is a “startling new development.” The practice of rule (krater) by the people (demos), or “demokratia,” dates back 2500 years to Athens, Greece. Citizens did rule by majority vote, but only free males of Greek descent could rise to the status of “citizen.” In those days, individual freedoms took a back seat to unconditional support of the city-community.

Establishing a modern democracy in America has been a bit of a struggle.

A Country Doctor Reads: What if Burnout Is Less About Work and More About Isolation? (NYT)

Oct 13, 2022

BY HANS DUVEFELT

This weekend I read a piece in The New York Times that put a slightly different slant on what burnout, in the case of physician burnout, is or is caused by. We have heard theories from being asked to do the wrong thing, like data entry, to “moral injury” to my favorite, “burnout skills“, when you keep trying to do the impossible because people praise you when you pull it off.

Tish Harrison Warren’s piece is a dialog between her and psychiatrist/author Curt Thompson. He focuses on isolation as a driver of burnout:

Assume that if you’re burned out, your brain needs the help of another brain. Your brain is not going to be OK until or unless you have the experience and opportunity of being in the presence of someone else who can begin to ask you the kind of questions that will allow you to name the things that you’re experiencing.

The moment that you start to tell your story vulnerably to someone else, and that person meets you with empathy — without trying to fix your loneliness, without trying to fix your shame — your entire body will begin to change. Not all at once. But you feel distinctly different.

I’m not as lonely in that moment because you are with me. And I sense you sensing me. That’s a neural reality.

We are Asking Our Physicians to Do Too Much. It’s No Wonder They are Burnt Out.

Nov 1, 2021

By GAIL PEACE

We have heard the phrases “physician fatigue” and “burnout” too often in the last year – and for good reason. Covid-19 has placed an incredible burden on our healthcare providers. However, as healthcare professionals, the stats representing physician burnout are not new for us.

We have seen similar trends and stats for years. Covid-19 did not cause the current state of physician burnout, it has just exacerbated it and further exposed critical issues with the expectations placed on physicians in today’s healthcare system. Ludi conducted a survey of physicians across the country confirming that exact theory:

68 percent of physicians feel pessimistic or indifferent about their occupation
48 percent describe the relationship with their hospital partners/employers as combative or transactional at best

We need to ask ourselves: What is actually causing this dissatisfaction and how can hospitals better align with their physician partners?

According to the physicians surveyed, 68 percent agreed they have too much administrative burden placed on them. More often than not, our industry blames EHRs for dominating administrative time, but from the physicians we surveyed, EHRs are just part of the problem. In fact, 54 percent of physicians indicated they spend 1-3 hours per day on administrative work outside of EHR time, with another 35 percent spending more than 4 hours per day on similar tasks.

Let’s put that into perspective. On top of seeing patients, charting in EHRs, and all the other things physicians are expected to do to take care of patients, physicians are also spending at least another 1-3 hours per day on “everything else.” This everything else includes meetings, training, compliance, policy, etc.

We are asking our physicians to do too much. It’s no wonder they are burnt out.

As Doctor Burnout Climbs, Can We Save Primary Care?

Sep 10, 2021

By RONALD DIXON

Week after week, I hear from colleagues in diverse specialties about how exhausted they are from practicing medicine.

It’s no surprise that they are looking for careers outside of medicine. The demands and strain are unsustainable.

So it’s also no surprise that a recent survey showed 40% of primary care clinicians are worried that their field won’t exist in five years and that 21% expect to leave primary care in three years as a result of COVID-19-related burnout.

While COVID-19 is the tipping point, this burnout is the result of the relentless and mounting administrative burden placed on us by electronic medical records (EMRs), coding and billing requirements and prior authorizations. And then it is exacerbated by uncertainty mounting in the primary care field, with new medical care entrants popping up everywhere — from retail pharmacies to digital health startups — aiming to create their own primary care model, replacing rather than working with existing ones.

Where it All Began

The roots of this burden began three decades ago with the advent of an acronym that few outside of the healthcare world know of today — the resource-based relative value scale (RBRVS). This payment system, launched in 1989 and subsequently adopted by Medicare in 1992, led to what we know now as the foundation of the U.S. healthcare payment system.

The RBRVS system assigns procedures a relative value which is adjusted by geographic region. Prices are based on physician work (54%), practice expense (41%) and malpractice expense (5%).

Since the initiation of the scale, the relative value of specialist work has remained much higher than primary care. This disparate compensation, in combination with most health maintenance and patient supportive tasks delegated to primary care, has led to significant fatigue.

Mindful Daily Practice Offers an Antidote to Healthcare Burnout

Feb 15, 2020• 1

By GREG HAMMER, MD

Burnout among healthcare professionals is at an all-time high. Its drivers include longer work hours, the push to see more patients, more scrutiny by administrators, and loss of control over our practice. We seem to spend more time with the electronic medical record and less time face-to-face with our patients.

I have faced burnout personally. My son passed away at the age of 29, which was beyond painful. At the same time, I felt burdened by the growing number and complexity of metrics by which I was judged at work. Days in the operating room and intensive care unit seemed more and more exhausting, and my patience was becoming shorter and shorter. I was fortunate to have had a long-standing meditation practice as well as sabbatical time that I used to decompress and re-evaluate my career. Many of us are not so lucky. More than half of physicians have serious signs of burnout, and more than one physician commits suicide every day.

So many of us feel burned out these days because in our rapidly changing profession we are asked to do more for less and with inadequate resources. We suffer from exhaustion, self-criticism, and worry about what will happen next to our practice, our families, and ourselves. If we want to save our practices, patients, marriages- even our lives, we must acquire personal resilience.

Fortunately, we can increase our resilience and happiness and reverse burnout by embracing a few simple principles—Gratitude, Acceptance, Intention, and Nonjudgment (GAIN)—that we can put into motion in our everyday lives at the hospital, at home, or wherever we are.

Burned out on Burnout?

Feb 12, 2020• 1

By SANJ KATYAL, MD

If you are like most doctors, you are sick of hearing about burnout. I know I am. There is a big debate on whether burnout is real or whether physicians are suffering from something more sinister like moral injury or human rights violations. That doesn’t matter. In the end, no matter what name we give the problem, the real issue is that physicians are in fact suffering. We are suffering a lot. Some of us—around one physician per day—are forced to alleviate their suffering by taking their own life. Each year, a million patients lose their physicians to suicide. Many more physicians suffer in silence and self-medicate with drugs or alcohol in order to function.

We are losing more physicians each year to early retirement or alternate careers. There are an increasing number of coaches and businesses whose single purpose is to help doctors find their side gigs and transition out of medicine. This loss comes at a time of an already depleted workforce that will contribute to massive physician shortages in the future. Perhaps even more troubling is that those physicians who remain in medicine are often desperate to get out. It is the rare physician these days that recommends a career in medicine to their own children. We now have a brain drain of the brightest students who would rather work on Wall Street than in a hospital.

As a physician trained in positive psychology, I have been committed to helping other physicians and students improve their well-being. The focus on well-being is a welcome change in medicine. But is it enough?

Revisiting the Concept of Burnout Skills

Dec 30, 2019

By HANS DUVEFELT, MD

I looked at a free book chapter from Harvard Businesses Review today and saw a striking graph illustrating what we’re up against in primary care today and I remembered a post I wrote eight years ago about burnout skills.

Some things we do, some challenges we overcome, energize us or even feed our souls because of how they resonate with our true selves. Think of mastering something like a challenging hobby. We feel how each success or step forward gives us more energy.

Other things we do are more like rescuing a situation that was starting to fall apart and making a heroic effort to set things right. That might feed our ego, but not really our soul, and it can exhaust us if we do this more than once in a very great while.

In medicine these days, we seem to do more rescuing difficult situations than mastering an art that inspires and rewards us: The very skills that make us good at our jobs can be the ones that make us burn out.

Doctors are so good at solving problems and handling emergencies that we often fall into a trap of doing more and more of that just because we are able to, even though it’s not always the right thing to do – even though it costs us energy and consumes a little bit of life force every time we do it. And it’s not always the case that we are asked to do this. We are pretty good at putting ourselves in such situations because of what we call our work ethic.

Healthcare IT Has Failed Providers, but It’s Not Too Late to Redeem Ourselves

Aug 1, 2019• 4

By GUS MALEZIS

It’s no secret that healthcare providers are among the hardest working of all professionals – their skill and intelligence are matched only by their creativity and commitment to their patients. But the healthcare IT sector, while it has made an effort to assist, has failed to support our providers – doctors, nurses and caregivers – with technology solutions that meet the increasing demands for better, faster, more efficient patient healthcare delivery. Instead, we have cast these providers in the dark, forcing them to function blindly, devoid of necessary information, pushing many of them to the brink of what they can withstand as professionals, pushing them to burnout.

The thing about providers is that, in addition to being hardworking, dedicated, and outstanding professionals, they are incredibly creative and innovative, willing to embrace new technologies and workflows – as long as they can add value to their patients. So how about we – the broader healthcare IT solutions vendor community – focus on delivering technologies that don’t force them to compromise care and efficiency for the sake of security, or compliance and access to data?

We need to do so to address an industry crisis. Physician burnout is on the rise, and it’s increasingly clear that overworked providers have reached the breaking point. They spend valuable minutes battling technology on virtual desktops, mobile devices, biomedical equipment, and clinical SaaS applications – typing in usernames and passwords, loading various apps, and more. All the while, standing beside a patient that is desperately seeking their assistance.

Right now, nearly one-half of all physicians (44 percent) report having feelings of burnout (according to Medscape‘s 2019 National Physicians Burnout & Depression Report). While these numbers should alarm everyone, what the healthcare IT industry should be especially concerned about is that a leading cause of this physician burnout are tools that hinder provider productivity. Instead of simplifying work for doctors and nurses, technology tools are having the opposite effect. Isn’t technology supposed to make things easier?

A Millennial Doctor’s Experience with Industrial Medicine

May 6, 2019• 5

By TALAL HILAL, MD

A survey of 200 physicians under the age of 35 showed that 56% reported unhappiness with the current state of medicine. That number didn’t seem surprising to me at first. I was not particularly “happy” at the time of reading this survey either.

I’ve aspired to become an oncologist for as long as I can remember. In oncology, despite my inability to cure, I can always try to heal. I form connections with patients and their families as they embark on a journey that is quite often their last. I learn from my patients as much as, and at times more than, they learn from me.

But all of this is overshadowed by a sense of heaviness that I frequently encounter as I enter the clinic room. That sense of heaviness hits when a patient tells me of the time when they were placed on a “brief hold” for more than half an hour in order to reach someone to get a prescription refilled or reschedule an appointment. Or when their insurance refused to cover the drug that I had prescribed to them. It is when I hear that clinic visits or treatments are not scheduled due to insurance authorization delays. Or when I’m asked about the cost of drugs and end up having to explain how nobody really knows.

By the time I hear these stories, the “allotted time” for the clinic visit is coming to an end. The emotional burden and physical symptoms of my patient’s cancer diagnosis or chemotherapy side effects often not adequately addressed.