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Featured topic and speakers
Featured topic and speakers
Why are doctors so burned out? How common is physician burnout? What causes physician burnout? Is physician burnout increasing? Why is physician wellness important?
Our guest is chair of the AMA Board of Trustees Willie Underwood III, MD, MSc, MPH. AMA Chief Experience Officer Todd Unger hosts.
Speaker
- Willie Underwood III, MD, MSc, MPH, chair, AMA Board of Trustees
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about how to address physician burnout at the system level. Our guest today is chair of the AMA Board of trustees, Dr. Willie Underwood in Buffalo, New York. And I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Underwood, welcome back.
Dr. Underwood: Thank you very much, allowing me to be here.
Unger: Well, the issue of physician burnout has evolved these last few years, of course, due to the pandemic and, of course, increasing burdens on physicians. Why don't we just start by having you give us an overview of what physician burnout looks like right now?
Dr. Underwood: Well, so any physician can tell you firsthand, it's definitely not great. According to AMA's most recent survey, 63% of physicians experienced at least one symptom of burnout in 2021, and that is roughly—that is up 38% from 2020.
As you can see, the pandemic significantly accelerated the problem of physician burnout. But the feelings still affect us today, and it's not going to go away anytime soon. For the first two years, roughly two out of five physicians said that they intended to reduce their clinical work hours the following year, which is now and the year after.
So 2023, half of practicing physicians still reported being burnout, and nearly 40% of practicing physicians have plans to leave their current role. Man, that looks bad for our entire nation. So at this point, burnout becomes more than just a well-being issue.
It becomes a patient access issue. And we're already a physician shortage. We have a burnout that's driving physicians away from our profession when we need them the most. How does that make sense to anyone? Burnout is now an epidemic in medicine, and treating has to be a top priority for all of us.
Unger: Well, let's talk about treating burnout. We know that fixing the problem has to start at the system level. I want you to tell us a little bit more about why that approach is so important.
Dr. Underwood: Well, it's the system level problem because they're the ones that caused this in the first place. So as you think about it, so you could be an administrative burden, like access reporting requirements and poorly designed EHRs. They could also be workflow inefficiencies and even an organizational culture, like the cultures I've been in, where a 26-year-old knows there's nothing about medicine, telling me what to do and telling me, how I should think about managing my workflow and managing my patients.
So recently, survey showed that every eight hours physicians spend with patients, they spend five or more hours on the EHR. And much of that time is spent outside the regular work hours. These systematic issues are bigger than any one physician could address on their own. They require the attention and commitment of organizations to truly solve these.
So when organizations do address these issues, that is when we see real change. And that's when this problem impacts physicians. They can be evolved and changed in a better and in a more significant way. The AMA has really led this way and shifting the conversation around burnout over the years, from the focus on individual physicians and their resiliency at the system levels to a system-level approach.
So why should it be that this is a problem of physicians? You guys aren't tough enough. You gals aren't tough enough.
No, this is a problem with an organization, with the system, with the structure. And we need them, and we've worked with them to help make this better.
Unger: Absolutely I love your point, too, about that move away from the focus on individual resiliency and to the system level, where the research has shown that about 80% of the burnout emanates from. And of course, the research at the AMA and others have done has now delivered a wealth of best practices on how to address system-level sources of burnout. Can you talk a little bit about some of those best practices?
Dr. Underwood: So there are some—there's multiple strategies, but we're focused on four key areas. And these areas are looking at assessment, commitment, efficiency to practice involvement, and actually teamwork. So when it comes to assessments, organizations should measure burnout at least every three years. That's a minimum.
Every other year would be better. Every year would probably be best. But every three years should be a minimum.
Also essential to make a commitment to addressing burnout. No sense measuring it if you don't address it. One best practice that we recommend an organization establish a formalized well-being committee and an office of well-being. Why? Because you need someone to take responsibility for solving the problem.
Turning this commitment into results means organizations have to focus on practice efficiency and teamwork. Teamwork makes the dream work for all of us. Two best practices we recommend are starting to measure time spent on the EHR and regularly assessing our level of teamwork.
Again, teamwork makes the dream work. If we can't work together, you've got a hostile, toxic environment. You take that home with you, all right. Organizations going on to make even more improvement, all these strategies are more—more are included in a roadmap for the AMA's Joy in Medicine Health System Recognition Program.
Unger: Well, in addition to those best practices, there is a lot of exciting research happening right now. Dr. Underwood, where can organizations go to learn what's working for their peers?
Dr. Underwood: Well, so again, as we just mentioned, so we have our Joy in Medicine Health System Recognition Program. So that program gives us an opportunity where organizations can come, they can apply, get evaluated and they're either silver level, bronze level, gold level. It'd bronze, silver, gold, like the Olympics, right?
So idea, everyone wants a gold, but you got to earn that gold. So there are a lot of practices organizations can go. But conferences continue to be one of the most valuable. Not only do they learn about the cutting-edge research at conferences, but they also collaborate their experience with thought leaders across the nation and some of it internationally as well.
So two of the largest conferences, the topic those issues of well-being are the International Conference on Physician Health and the American Conference on Physician Health. Both are sponsored by the AMA. Ever since we started this, these two conferences have played a pivotal role in shaping the conversation around burnout and sharing best practices.
I've had the opportunity to be at those meetings, not the international one, of course, but the ones in the United States. And I tell you, I learned a lot. But this roadmap to our Joy in Medicine program owes a lot to the research presented at these two conferences every year.
Recently, the AMA also hosted a smaller, more interactive time-saving bootcamp that's really was really well received. And we're looking forward to all the great work that come out of that as well. So a lot also depends on the goals and needs of the organization. No matter what you're looking for, though, thorough support of your peers are invaluable.
Collaboration, working together, finding out what works, utilizing that in your own organization is great. So if you want to learn more and register for future events, check out the linked episodes that are described.
Unger: Well, Dr. Underwood, I know this is a very personal issue for you and that you go to a lot of conferences that are focused on physician health and have been a strong champion of physician well-being for many years now. As both a practicing physician and a leader within the AMA, you have a really unique vantage point. And I'm just curious why this is so important to you? And when you look ahead for the next couple of years, what's your hope?
Dr. Underwood: First of all, we need us to truly understand that burnout is real, that people like myself who joined medicine to make a difference and once loved it, dreamed about it are now waking up at 3:00 in the morning, wondering, did we make the right choice? Why are we doing this? That's unacceptable for them, their families and for our patients.
We also need to create a culture where it's OK for physicians who are suffering to get help. This means removing the stigmatizing questions of credentialing applications and driving nationwide advocacy. We need peer-to-peer networks because they're extremely important.
We can't just be asking colleagues to manage this themselves. They should be allowed to get help. And it should not jeopardize their state licensing or their employment and health systems. I hope our professions and physicians can recapture the joy that they had when they got accepted to medical school, when they got accepted to their residencies, when they got their first job and even their second and third job, the joy that they had instead of wishing that they never did it in the first place.
We work too hard for that. This is not just a physician issue. This affects everyone.
Unger: Dr. Underwood, thank you so much for joining us today and highlighting all those opportunities. I know this issue means a lot to you, and we thank you for your leadership. If you're a health system leader, you can learn more about how the AMA's Joy in Medicine Recognition Program can help you improve physician well-being.
Visit our site at ama-assn.org/joy. And join the more than 70 health systems that we recognize last year alone for their well-being efforts. That wraps up today's episode, and we'll be back soon with another AMA Update. And be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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