EDITOR’S NOTE: This is the first in a series of articles on the issue of burnout among physicians – a problem leading medical experts say is not only increasing in prevalence, but also intensity. During the coming month, several of these experts will be making appearances on Talk Ten Tuesdays, the weekly Internet radio broadcast focusing on all things ICD-10.
There’s a good reason adult airline passengers are instructed to put on their own oxygen masks first in the event of an emergency – they have to make sure they address the immediate danger to themselves before they can help those who can’t do the same.
The same principle could – and perhaps should – apply to the untold number of physicians suffering from burnout in the world of 21st-century healthcare delivery.
“The well-being of a free society requires effectiveness of the caregivers in their service to the public. Unfortunately, ours are being endangered by being burned out in their work,” nationally renowned psychiatrist H. Steven Moffic, MD said recently. “From my point of view, burnout means that you are physically, mentally, and or emotionally exhausted, but not from any medical or psychiatric illness – although burnout can lead to a full-blown illness.”
Moffic was one of four healthcare professionals to speak on the topic during last week’s edition of Talk-Ten-Tuesdays. He and another speaker, Washington Physicians Health Program Medical Director Dr. Chris Bundy, both referred to recent large-scale surveys in which more than half of physician respondents admitted to feeling burned out in their daily work – one of the surveys noted a jump from barely 45 percent in 2011 to 54 percent in 2014.
Munroe Regional Medical Center Chief Medical Officer Dr. Larry Field described the increase as a sign of the times that’s plenty noticeable in his Ocala, Fla. facilit, where most members of the physician staff are in their 50s and 60s.
“(Here), there’s a high level of just physician frustration … where they’re thinking about just getting out of medicine and retiring or moving into a second career. But then when you inquire further, they truly enjoy giving care to patients; it’s just all the other things that are ongoing surrounding medicine, particularly … the EHR (electronic health record), … ICD-10, and the continued additional regulation that comes out weekly, that is taking so much time away from them doing the part of medicine that they really enjoy,” Field said. “Part of … my job is to try and help them differentiate between the parts that they like and try to say ‘maybe instead of making as much money, you hire a mid-level provider, a PA, a nurse practitioner, even a scribe to do the drudgery parts of your job and allow you to concentrate on what it is that you enjoy.’ (So far) I was able to at least talk three physicians out of quitting.”
Bundy said the issue extends from older, more experienced physicians all the way down to the youngest ones.
“Medicine is an extraordinarily demanding career, and there’s just been a tsunami of change within medicine over the last (few years),” he said. “(This) is a systemic problem. It starts in medical school and medical training, where we haven’t over the last few decades done a very good job of implementing an ethic or a professional value among physicians about how to take care of oneself.”
Bundy said his work exclusively involves tracking the health of physicians, so it’s an issue he gets an up-close-and-personal look at on a daily basis.
“What I’ve seen over the last few years is the number of referrals that our physician help program gets related to distress and quote-unquote ‘disruptive’ behavior, and often times the root cause of that is profound dissatisfaction and burnout among the docs that we see,” he said. “(And) there’s a question in my mind and in the minds of physician help programs around the country as to whether burnout is perhaps a (precursor) to more serious health problems.”