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As physicians, we are no strangers to the effect burnout has had on our community. After all, the greatest physician shortage of our time is partially due to physician burnout, leaving doctors too exhausted to continue working in medicine.
The impact of this burnout is starting to manifest in how fragile our healthcare system is, where patients are unable to access adequate medical attention. The AMA states that 83 million people across the U.S. currently live in areas without a primary care physician.
That shortage could reach staggering heights, with the nation lacking at least 21,000 primary care physicians by the year 2033.
It’s difficult to find anyone satisfied with the U.S. healthcare system, but that dissatisfaction has become more than just the ‘daily grind.’ From healthcare spending to patient outcomes to physician well-being, let’s discuss what burnout entails:
- Signs Of Physician Burnout
- Burnout Effects On Patient Welfare And Administrative Issues
- Working Towards Burnout Eradication
Sounding the Alarm on Physician Burnout
In hindsight, mass burnout among physicians was a long time coming. The physician shortage was on the rise due to an aging population, which impacted the healthcare workforce going forward. Fewer doctors entered the field than those retiring from it, leading to a shortage overall.
According to the AAMC, more than 40% of America’s doctors will be 65 years old or older within the next decade. The AMA also predicts that a significant number of those older doctors will retire before they turn 60, around 12% to 29%.
It’d be one thing if early retirement were the direct cause of physician shortages. In reality, the cracks in the healthcare system showed up more following complaints of increasing administrative burdens, a broken Medicare system, overworked and undervalued primary care physicians (PCPs), and more.
The vulnerabilities in our healthcare system following the COVID-19 pandemic, a health crisis no one was prepared for. The pressure of being in such a high-stress situation took a physical and mental toll on the existing medical workforce, making physician burnout an emergency rather than a passive issue.
The effects of the pandemic on the physician workforce are still under review, but the warning signs are evident. One out of five doctors has stated that they plan on leaving their practices within the next couple of years. This comes on top of the news that one-third of physicians plan on reducing work hours in general.
Physicians are vital to the healthcare infrastructure. Yet, their needs are not met, with many doctors reporting enormous budget and salary cuts for the fifth time in a row, interference in patient care through administration, and no substantial support from the organizations meant to protect them.
This is surprising when you consider how expensive physician burnout is for the government, costing the U.S. healthcare system $4.6 billion per year. With an overburdened healthcare system, it isn’t just physicians who face difficulties. It’s also the many patients who don’t have accessible medical care.
How is Patient Care Impacted by Burnout?
Physician burnout directly leads to poor patient outcomes. Not only are doctors in short supply, but they are also overworked. The medical fraternity has dwindled over the years, and 86% of physicians fear for the future of healthcare in the U.S.
The truth is that 76 million Americans live in healthcare deserts — areas with no access to basic healthcare services such as low-cost pharmacies, hospitals, and clinics. Most of the population doesn’t live in urban areas, so they are more at risk of inaccessible healthcare.
For example, 65% of rural areas are currently facing a primary care shortage, so they are exposed to a higher risk of cardiovascular disease, stroke, and an overall lower life expectancy.
When physicians are stretched thin, patients suffer. Research shows that physicians suffering from burnout are twice as likely to be involved in medical error incidents, which can affect both physician well-being and work-unit safety. They are also twice as likely to be rated as ‘unsatisfactory’ by patients, which leads to decreased trust in their doctor-patient relationship and turns the patient away from follow-up appointments.
Patient care isn’t up to the standards set, which alienates patients from seeking primary care. This study explains that loss of quality care is estimated to be associated with at least 18.4% fewer primary care visits.
As burnout speeds up the physician shortage, we see health inequity soar alongside dwindling patient turnover.
The most vulnerable communities in our country cannot readily access medical care, and this is exacerbated when physicians are already overworked and have to make their patients wait longer for appointments. It can take up to 26 days to schedule a physician appointment in some of our largest metropolitan cities, as per data from 1,304 physician offices.
Longer wait times are a hindrance for the general population, but even more so for patients who can’t afford to be flexible with appointment scheduling, such as those with disabilities, caregiving responsibilities, or transportation difficulties.
Consequently, this is why patients choose to bypass the long lines at primary care and go straight to the emergency room for their healthcare needs.
However, this creates yet another issue: the emergency departments are put under additional strain with this new influx of patients who don’t need immediate medical attention, which is up to 90% of the time. This could be dire for patients brought into the emergency whose treatment can’t be delayed.
After all, healthcare delayed is easily healthcare denied.
Tackling Burnout For Better Physician Welfare And Patient Outcomes
While burnout isn’t the only thing breaking the healthcare system, it is one of the biggest contributing factors. The physician shortage is leading to a major public health crisis, and the key is to mitigate burnout as much as possible.
However, it isn’t as simple as it sounds. The healthcare system is a large and complex organism, with doctors playing a major role in its operations. And its improvement requires a multi-faceted approach:
Debt relief for medical students
Student loan debt is one of the biggest issues that plagues the American youth, and none have it worse than medical students. The average doctor is graduating from medical school with a debt of around $200,000, according to the AMA, which is not an easy amount to pay back.
The stress that comes from such a significant amount of debt is a lot to deal with, alongside the life decisions they need to make regarding their practice. The availability of better debt relief options can ease some of that stress and allow them to make choices that are based on more aspects than just salary.
Expand residency spots
The race for residency spots is a hot topic every year. And though the number of residency spots is increasing, it is not at a fast enough rate to meet the demands of a growing population.
It is estimated that an additional 1700 spots are needed to combat the physician shortage. Most of them have to be specifically for primary care, as that is the field currently undergoing the most strain when it comes to resources. Primary care physicians make 44% less income than their specialist counterparts.
Improving mental health for doctors
Doctors need to seek out help in terms of their mental health, but the culture around it is still stigmatized. According to Medscape, for every 10 doctors, four of them stated that they chose not to seek mental health solely in fear of their employer finding out and the possible retribution that would follow.
The correlation between depression and burnout is evident, with worsening depression directly increasing burnout symptoms; evidence displayed that within a large sample of physicians who met criteria for depressive episodes (0.5%), half (50.7%) were also impacted by burnout.
So, a focus on the improvement of mental health access for doctors would be an asset in tackling burnout. There are bills in place to promote this, such as the Dr. Lorna Breen Health Care Provider Protection Act.
Reduction in administrative duties for physicians
Nowadays, physicians are more than just clinicians. They have to look after paperwork, be in a leadership role, and generally get tasked with more administrative roles that they aren’t trained for. These additional duties add to the already hectic environment, leaving doctors burned out.
60% of doctors stated that too many bureaucratic tasks are the major contributor to their burnout. Easing administrative responsibilities would help doctors do their jobs more efficiently without distractions.
For doctors, burnout manifests as a myriad of issues, such as impaired attention and function, alongside mental health issues like anxiety and depression. Burnout also directly impacts patient care, with twice the risk for medical errors and a decrease in positive patient outcomes.
Therefore, it is imperative to mitigate its effects and ensure that our healthcare system is working at its best to benefit both patients and physicians alike.
