The healthcare community is made up of individuals and companies who are supposed to work together toward a common goal: a society of healthy people.
And yet, patients, doctors, policy-makers, and insurers constantly find themselves odds with one another. Patients are harmed by medical errors, doctors are sued for malpractice, policy-makers are thrown out of office, and insurers grapple with constant rule-changing.
What if the ingredients to the problems that beset the medical community today are baked into the design of the healthcare system? Are things, as currently structured, positioning physicians to burnout and fail patients?
Physician Burnout Is Unavoidable in Current Climate
A string of recent findings suggests that widespread physician burnout is a public health crisis. Burnout strikes at the very core of healthcare—the doctor-patient relationship—and it threatens to undermine the entire system. Many physicians feel they can’t do their job, that they are losing autonomy while being loaded with new responsibilities.
Almost half of all doctors are affected by this syndrome in some form, which involves emotional exhaustion and disengagement. A survey by Merritt Hawkins found that the number of physicians that have experienced feelings of professional burnout increased to 78 percent in 2018.
The U.S. Department of Health and Human Services has predicted a shortage of up to 90,000 physicians by the year 2025. If physician burnout is not addressed, making up this shortage will be much more difficult. Burnout causes physicians to exit their profession early and derails med students who might otherwise save lives.
Burnout is a phenomenon that affects physicians at every level. Med school students and residents are likely affected in greater numbers than veteran practitioners, but those younger physicians are under a lot more oversight. If any part of the healthcare team, especially the physician, is burned out, the consequences can be fatal.
Physician Burnout Linked to Medical Errors
A study published in Mayo Clinic Proceedings found that medical errors are as likely, if not more likely, to be the result of physician burnout than because of unsafe medical workplace conditions.
“Up until recently,” said lead author Dr. Daniel Tawfik, “the prevailing thought was that if medical errors are occurring, you need to fix the workplace safety with things like checklists and better teamwork. . . This study shows that that is probably insufficient.”
It has been 2 decades since the damage caused by medical errors was brought to attention. Despite many well-intentioned interventions and billions of dollars of medical technology, medical errors made by doctors continue to injure, disable, and kill patients every year.
And these problems feed off of one another if they are not addressed. Doctors who have committed a serious medical error have an increased risk of suicidal thoughts.
A ‘Call to Action’ to Address Physician Burnout as a Public Health Crisis
Without considering the mental health of the physician, the system has no chance of seriously lowering medical errors. For too long, the well-being of doctors has been overlooked, and it has had a major impact on patient lives and the system as a whole.
Researchers at Harvard want to reframe the problem and get doctors the help they need. A new report published by Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, the Massachusetts Medical Society and the Massachusetts Health and Hospital Association, calls upon the medical community to institute major changes immediately.
The report is a call to action. They want the healthcare community to recognize that the issue of physician burnout is a public health crisis — it cannot be swept under the rug. In order to reverse this deadly trend, they advocate for making the well-being of physicians a deliberate goal.
What Are the Solutions to Physician Burnout?
This will include immediate steps, such as improving access and expanding mental-health services for physicians. Treatment for physician mental-health should be normalized, and factors which lead to burnout should be anticipated and accounted for. Physicians could be taught how to respond to medical error in a healthy way.
Along with cultural changes, the Harvard report calls for modernizing the current electronic record systems to function more like the software that governs cell-phone apps. They imagine software platforms that would allow developers and doctors to produce EHRs suited to their needs.
According to the Harvard study, doctors spend an average of 2 hours on the computer for every hour they spend with a patient. Time spent on the computer takes time away from doctors who might otherwise spend that time face-to-face with their patients. Is that really an improvement in doctor-patient communication?
The new normal sees doctors logging hours at home, so-called “pajama time,” navigating clerical tasks like ordering prescriptions or communicating with insurers. Many physicians work long hours already, and extra time spent wrangling with EHRs certainly contributes to feelings of burnout and alienation.
While small steps toward well-being have been tried in the past, authors in the Harvard study advocate for hospitals and clinics to appoint an executive-level Chief Wellness Officer to oversee the response to physician burnout.
“This is not about more yoga classes in the hospital,” said Dr. Ashish K Jha, the Director of Harvard Global Health Institute. “This is about someone at the highest level of the organization who is responsible for making sure that the workforce is healthy and thriving.”
Physician burnout is a serious problem. Token gestures towards addressing the issue have allowed it to grow into a public health crisis. It’s time to start a new chapter.
