Physician Health

The physician vacation is surf, sun and EHR. Let’s change that.

Georgia Garvey , Contributing News Writer

Physicians in the U.S. are facing another troubling trend: They are taking less time for vacation, working while on vacation and getting no EHR inbox coverage while they’re out. All are factors that contribute to higher burnout rates, according to a study published in JAMA Network Open.

For the study, researchers found that two-thirds of the 3,024 physicians surveyed said they had to continue caring for their patients while on vacation.

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Almost 60% reported taking three or fewer weeks of vacation per year, with one in five taking a week or less of vacation. More than 70% worked during a typical vacation day, with one-third of them working 30 minutes or more per vacation day. And only 49% of the physicians had full coverage of the EHR inbox while they were out, the study found.

“Like other workers, physicians have a human need to periodically truly unplug from work and recharge,” said Christine A. Sinsky, MD, the study’s lead author and vice president of professional satisfaction at the AMA. “Health system leaders who want to reduce burnout, and thereby also anticipate reducing turnover and improving quality, can make tangible changes to support physicians taking full vacation.”

When less vacation was taken, work was done while away and there was no EHR inbox coverage while out, there was an increase in the physicians’ risk of burnout, according to the study. It is a tremendous and ballooning problem not just for physicians but for health systems, insurers and patients.

Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.

Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.

A way forward on burnout

To prevent burnout, Dr. Sinsky said, health systems must remove the burden of an unfair decision from physicians’ shoulders when it comes to vacation.

“You can't rely on the physician to heroically compensate for a dysfunctional system,” Dr. Sinsky said. “Too often, currently, that's the place that physicians—who have a really highly developed sense of mission and responsibility to their patients—are placed in. … They have this ethical question that they face: Do I burden my partners? Do I abandon my patients? Or do I continue to respond to their needs while I'm on vacation?”

Frequently, she said, physicians are forced to shortchange themselves as well as their spouses and relationship partners, which in turn stresses their personal relationships.

But the positive news coming from the study, Dr. Sinsky said, is that the results offer clear, practical ways that health system leaders can reduce physicians’ risk of burnout and improve their overall well-being.

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“It gives them something very tangible that they can do that we could anticipate will reduce burnout,” she said. “For example, by ensuring that the compensation system in play at that organization does not penalize physicians for taking their full vacation, and that the team structure does not require that physician to continue to care for patients while on vacation.”

At the heart of many physicians’ concerns about taking enough vacation, researchers found, were financial concerns or worries about finding someone to cover for their clinical responsibilities. One way to alleviate the problem, Dr. Sinsky said, could be to use incentives that only count a certain number of weeks per year toward measuring productivity.

It’s also crucial, she said, that physicians be relieved of the responsibility of EHR inboxes while they are on vacation. The first step starts long before the vacation request, though.

“If you structure the inbox as a physician-only responsibility, you've already made it very difficult—and unnecessarily so,” Dr. Sinsky said, noting the study apparently has struck a chord with physicians who are feeling overburdened and with health care leaders seeking ways to prevent burnout.

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