Buried in paperwork, snarled in endless technology turnover, hemmed in by increased performance monitoring and challenged by a new breed of empowered (and often ill-informed) patients, morale among doctors is at the lowest levels ever recorded.
Over half of physicians are burned out and/or dissatisfied with their work-life balance, which compares unfavorably to the general employed population. More than 60% of doctors are somewhat or very pessimistic about the future of medicine, and over half of doctors would not recommend a career in medicine to a young person, with some surveys going as high as 90%. A survey of doctors and nurse practitioners showed:
THE TOP 5 MOST BURNED OUT SPECIALTIES
- EMERGENCY MEDICINE (>70%)
- UROLOGY (63.6%)
- PHYSICAL MEDICINE AND REHABILITATION (63.3%)
- FAMILY MEDICINE (63%)
- RADIOLOGY (61.4%)
Nine specialties showed a >10% increase in burnout 2014 over 2011.
CAUSES OF BURNOUT
- Loss of autonomy and control over work
- Too many bureaucratic tasks
- Too many patients
- Feeling like “a cog in a wheel”
- Increased performance measures (quality, cost, patient satisfaction)
- Increased complexity of medical care
- Technological fatigue, especially EHRs
- Changes in the doctor-patient relationship (shift from “patient” to “healthcare consumer”), i.e., difficult patients
Maintenance of certification (MOC) is also a driver of physician dissatisfaction. MOC is a recertification program that allows doctors to maintain specialty board status and consists of completing training and evaluative modules, and taking an exam. Doctors complain that it is too burdensome: expensive and time consuming. Internists will spend an average of $23,607 each in MOC costs over 10 years. The cumulative cost of MOC to the healthcare system is estimated to be $5.7 billion over 10 years.
SYMPTOMS OF BURNOUT
- Emotional exhaustion
- Increased depersonalization
- Decreased sense of personal accomplishment
- Suicidal ideation
CONSEQUENCES OF BURNOUT
- Early retirement, scaling back clinical duties
- Decreased patient safety
- Decreased quality of care
- Increased healthcare costs
- More testing and referrals
- Greater malpractice risk
Physician burnout doesn’t just affect doctors. It affects all of us. Burned out doctors make more mistakes and appear to deliver lower quality of care. Beyond patient care and doctor well-being, burnout impacts the bottom line. Replacing a physician who retires early or leaves medicine to pursue other career opportunities costs between $250K and $1M.
AND PHYSICIAN BURNOUT ISN’T JUST A US PHENOMENON
82% of physicians in England experience mental illness. In Germany, 66% of physicians report some degree of burnout. In China, it’s 82%.