Patients aren’t the only ones who are stressed these days about our health-care—system.
The Shocking research: A surprisingly large number (42%) of physicians described themselves as “burned out,” according to the Medscape National Physician Burnout & Depression Report 2018.
Other research has found that at least half of physicians are experiencing professional burnout.
What’s causing all this discontent? The unhappy and stressed-out doctors most often blamed bureaucracy—all the record-keeping and other tasks that take time away from patient care.
Many also cited long hours and lack of respect from administrators, colleagues and even patients. Even more troubling, research shows that when physicians are burned out, their patients suffer, too.
To find out what medical consumers need to know about this increasingly common problem and how to get what they need from their doctors, Bottom Line Health spoke with Tait Shanafelt, MD, a leading physician and researcher who has extensively studied physician burnout.
Are some doctors more at risk than others? Yes. Doctors on the front lines of patient care, including internists, family doctors and emergency physicians, appear to be at the highest risk—perhaps, in part, because they bear such a heavy administrative/clerical burden in coordinating care and communicating via the electronic portal, refilling prescriptions, etc.
Women in medicine are more likely than men to report burnout—perhaps because of their need to juggle more—responsibilities at home than their male colleagues. And while burnout can show up as early as medical school, it peaks in the—middle-career years.
How does this affect patients? When physicians are burned out, it may impact their personal relationships first—but—patients eventually will be affected as well. Studies have linked physician burnout to poorer quality care, reduced safety and reduced patient satisfaction.
Burned-out physicians also report more medical errors. Studies have suggested that when doctors are burned out or dissatisfied, their patients are less likely to follow instructions—perhaps due to a lack of trust and/or a lack of compassion demonstrated by the physician.
Patients treated by burned-out doctors even recover from surgery more slowly than the patients of more engaged doctors, though the reasons for this are not fully understood.
Burned-out physicians also are more likely to cut back and work part-time…or even retire early—decisions that can contribute not only to physician shortages in some communities but also to a lack of continuity in patient care.
What might a burned-out physician look like in the eyes of a patient? Most patients will not notice anything—at least not at first. That’s because most physicians want to serve their patients and will try to hold things together professionally, even when they are struggling on the inside.
Eventually, however, some physicians may become noticeably less patient and empathetic and more distracted. They may come across as callous or cynical. They may be less responsive to questions during doctor appointments, phone calls and electronic messages.
New patients may believe that the doctor has always been that way—and unfortunately, the profession certainly includes some doctors who fit that mold.
But a patient who has a long-standing relationship with a caring and skilled physician may well notice the change. In fact, physicians who start out as the most empathetic and committed caregivers sometimes have the hardest time setting healthy limits around work.
As a result, these often-beloved physicians may have higher risks of eventually burning out because they are more likely to take extra time with patients, which means that they then must update charts after hours or on weekends.
If I think my doctor might be burned out or headed for burnout—and I want to continue the relationship—is there anything I can do? It’s easy to primarily view doctors through the professional lens and forget that they are human, too. They like to hear that their hard work and effort on behalf of their patients are making a difference. So if you feel grateful for your doctor’s care, write a note or just say a few words of thanks at the end of your visit.
If you have a close relationship with your doctor and you do notice signs of burnout, it is also OK to say something such as, “I’m worried about you. You seem tired. Are you taking care of yourself?” If you initiate such a conversation, communicate kindness. That kind of concern from a patient could be a wake-up call for a physician who does not realize that his/her work has started to suffer.
What can I do to steer clear of burned-out physicians in the first place? Look for medical practices, hospitals and other institutions that are well run and adequately staffed. How can you know if this is the case?
For one thing, if you are having a good experience—in everything from scheduling your appointments to getting your follow-up phone calls returned—there is a good chance that the doctors working there are having good experiences, too. That’s because they are backed by a supportive team and an efficient system.
In a well-run medical practice, you should get prompt attention from staff as you check in and go to an exam room. If the doctor does not see you right away, another member of the team should come in to check your vital signs and ask some questions.
When the doctor comes in, he/she may be accompanied by a scribe who will take notes or a nurse who will help you with follow-up instructions—research shows that this extra support in note-taking increases physician satisfaction.
If a practice does not have that level of support staffing, then appointment times should be generous enough for the physician to give you adequate attention and to attend to electronic record-keeping and other logistics.
If you leave a medical appointment feeling rushed and harried, your physician may feel this way, too—and both of you could suffer.
What Exactly Is Physician Burnout?
Burnout, in any profession, has three components—emotional exhaustion, cynicism and a diminishing sense of effectiveness.
Burned-out doctors have…
- Lost enthusiasm for their work.
- Lost their sense of human connection with colleagues and patients.
- Have started to feel that nothing they do really matters. They no longer believe that they can make a difference—even if that’s the reason they became doctors in the first place.