Fatigue, insomnia, loss of appetite, lack of motivation, forgetfulness, suicidal thoughts … If a patient described these telling symptoms of burnout, you’d take them seriously. As a surgeon, you are 15 times more likely to experience burnout than any other professional, and that number just keeps getting higher. The current medical climate is a landmine for practitioners, and part of the solution lies in understanding burnout, and how medical professionals and hospitals can be proactive in handling it.
Where does burnout come from?
By the time students become attending physicians, they already have accumulated hours of financial, emotional and mental stress with little support for their well-being — not a healthy first step in a budding career. As they progress in their profession, burnout just gets worse. A survey of physicians by the Mayo Clinic and the American Medical Association found that between 2011 and 2014, doctors reported a 20 percent increase in one or more symptoms of burnout, and an 80 percent increase in the number reporting suicidal thoughts.
What causes burnout?
One of the top reasons for burnout cited by physicians is the use of Electronic Health Records (EHRs). While the adoption of EHRs provides numerous benefits in the digital age, “these tools also create clerical burden, cognitive burden, frequent interruptions and distraction...” according to Dr. Tait Shanafelt, Mayo Clinic physician and lead author of the study that linked physician burnout to the increased clerical burden of EHRs. It is clear that EHRs are not yet user-intuitive enough, and put the doctor-patient relationship at risk.
What are the outcomes of burnout?
The harmful effects of surgeon burnout vary in impact, but ultimately all of them are detrimental to patients. According to a 2014 study by The New England Journal of Medicine, almost 50 percent of physicians attribute symptoms such as overwork, stress and fatigue as playing a significant role in medical errors. Doctors deal with consequences such as alert fatigue, which is a result of overexposure to excessive information, or decision fatigue, which comes from having to make multiple decisions throughout the day. An effect of decision fatigue was found in a 2014 study in JAMA Internal Medicine which showed the possibility of physicians prescribing antibiotics, even when unnecessary, had increased by 26 percent in the fourth hour of work.
What happens to surgeons and physicians who suffer from burnout can be even more disturbing, particularly when it comes to undiagnosed depression or other mental illness, substance abuse or access to lethal instruments. Reporting tells us that 300 to 400 doctors commit suicide every year, and are twice as likely to commit suicide than the general population. Female physicians are 2.5 to 4 times as likely to commit suicide than women in other professions.
What are some solutions?
While the picture seems dire, hospitals and physicians can help alleviate burnout and advocate for well-being.
- For physicians struggling with EHRs, the use of medical scribes mitigates the crushing amount of clerical work.
- Wellness committees are being established by the American Medical Association and hospitals to discuss solutions to burnout unique to their institution.
- Utilizing the whole medical team, including scribes, nurse educators, physician assistants, and nurse practitioners, helps delegate the delivery of information and care necessary for optimal patient health.
The medical community must address the serious problem of surgeon and physician burnout. Fortunately, there are many avenues from which to tackle these issues. Through open communication and collaboration, surgeons, physicians and hospitals can recognize how burnout affects their lives and organization, and create a healthier work environment for everyone.
Those in the medical profession are generally seen as high- to over-achievers. Burnout starts early on in medical school, largely because of the financial pressures of rising tuition. When students go on to the advanced medical training positions required for their certification, the pay is low, the days are long and competition to be the best is tough.
Coupled with the pressure to see as many patients as possible, and a lack of engagement with their healthcare institutions, physicians become overloaded and struggle to fulfill their primary responsibilities of patient care. As professionals who have committed their lives to helping others, it’s no wonder that doctors develop depression and are dissatisfied with their work.