Physicians often feel caught between doing the work their patients need and what is mandatory in their organization. When those competing demands do not align, it can create a situation that is unmanageable for many doctors and other health professionals, which leads to burnout. But why is burnout more common among physicians than other highly trained professionals?
Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face. By focusing on factors causing burnout at the system-level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction.
“Our patients know that we act differently, that we don’t sit down and take the time with them. We used to do that,” AMA member Kevin Hopkins, MD, said at the 2019 American Conference on Physician Health, co-sponsored by the AMA, Mayo Clinic and Stanford Medicine.
Dr. Hopkins is a family physician and primary care medical director for Cleveland Clinic Community Care—a population health institute. A pioneer in advanced models of team-based care, Dr. Hopkins and his colleagues have used the model to improve patient care as well as satisfaction among physicians, health professionals and practice staff.
Research has found that compared with professionals with other doctoral-level degrees, physicians work more hours each week, are less satisfied with work-life integration and are likelier to experience symptoms of professional burnout.
During a presentation at the conference, Dr. Hopkins outlined why he sees burnout as being more common among physicians than among other professionals.
Whether you know a physician, are married to one or are a doctor, you may understand that by and large they are high achievers who work long hours, said Dr. Hopkins, adding that doctors are “highly motivated.”
“They didn’t make it this far in life by accident,” he said. “Nobody wakes up one morning and says, ‘Well, somehow, I got through medical school and residency and I’m a licensed physician.’”
Physicians are driven to help make people better, said Dr. Hopkins. “We all want to be fixers.”
Physician burnout also has a lot to do with the practice, organization or health system in which doctors work because health care is a complex environment with a lot of working parts moving at once. For example, in an ambulatory environment there is specialized equipment that may not be available, and the exam room might not be set up in an ideal way.
“There’s people coming and going. There’s a lot of distractions,” said Dr. Hopkins. “No longer is there a physician lounge and some places there no longer is a private office. I have three people that share an office, so there’s a lot of distractions.”
“We feel a need and a sense of urgency to fix problems for people to make them better. We feel personally responsible if they don’t get better,” he said. “I went through a stretch—for the first six months of this year—where I had 10 patients pass away and, if I am available, I almost always go to the funeral.
Dr. Hopkins’ children started to wonder why he was going to funeral homes so often. His response: “Because your dad’s not a very good doctor.” However, Dr. Hopkins’ wife pointed out that he was such a great doctor that he felt responsible for a death even if the patient was 93 years old and had multiple comorbidities.
“Some of it is the paradigm—the need to take on everybody else’s problems—and that’s what’s exhausting us,” he said.
This causes burnout because of work overload. Physicians are experiencing too much work and not enough time to accomplish the laundry list of what needs to be done. In his 20 years as a physician, Dr. Hopkins has seen a rise in the amount of work he must do for each patient. He also receives more phone calls and inbox messages while trying to see more patients.
Like most physicians, Dr. Hopkins has some patients come in with 15 complaints for a 15-minute visit, which makes it impossible to address the problems that day. Yet because he doesn’t have an available appointment for six months, Dr. Hopkins feels compelled to do so, which can contribute to feeling a loss of control.
Learn more about the members of the care team that have helped Dr. Hopkins and his Cleveland Clinic colleagues address these and other challenges.