Physician burnout is on the rise, but providing an environment that boosts doctors’ sense of personal accomplishment and increases professional rewards could help them feel less emotionally exhausted and more energized about their daily work. Experts say it is one of a number of areas that need to be addressed to reverse the burnout trend.
Nearly 55 percent of physicians who responded to a Mayo Clinic survey in 2014 were professionally burned out, up from nearly 46 percent just three years earlier, according to the study in the Mayo Clinic Proceedings. When asked specifically about their sense of personal accomplishment, 16.3 percent of physicians had a low sense of personal accomplishment in 2014; just 12.4 percent felt that way in 2011.
A major driver of physician satisfaction, study authors said, comes from a sense of providing excellent care for patients.
“That is why we went to medical school,” said one of the study’s authors, Christine Sinsky, MD, vice president of professional satisfaction at the AMA. “So anything that gets in the way of taking care of patients takes away from a sense of personal satisfaction.”
And there’s a lot that gets in physicians’ way of taking care of patients these days: chaotic work environments, lack of control in their work environment and time pressures, to name a few.
Transferring administrative tasks away from physicians helps doctors’ sense of satisfaction, Dr. Sinsky said: “This allows physicians to do the job they were trained for instead of spending half their day doing clerical tasks—work that doesn’t require 11 years of education.”
Improving work flow also helps. “When you make things more efficient, physicians have more time to listen to their patients, to connect with their patients and to think more deeply about their patients,” Dr. Sinsky said.
Helping physicians determine what drives their professional satisfaction and giving them the time to pursue that passion also could go a long way in helping combat burnout, too, said Lotte N. Dyrbye, MD, one of the study’s authors and a professor of medicine and medical education and associate chair for faculty development in the Department of Medicine at the Mayo Clinic. For example, some physicians’ passion is helping patients, for others it is teaching the next generation of physicians and still others may find that professional satisfaction from being on the cutting edge of developing new treatments.
“If a physician can spend 20 percent of the week—one of five work days—doing something that is most meaningful, it can help increase their sense of professional satisfaction and lower their risk of burnout,” said Dr. Dyrbye, whose research focuses on physician well-being.
Organizations should also look at what their leadership is doing to encourage physicians they manage. Dr. Dyrbye said “if a division chair or department chair holds career development conversations with physicians underneath them and inspires them to do their best, it makes a difference.”
Medicine as a profession takes a hard look at the things that go wrong and spends little time celebrating successes—more so than in other professions, according to an editorial that accompanied the Mayo Clinic Proceedings burnout study.
“Correct diagnosis or successful surgery outcomes quickly disappear into the background, whereas mistakes become a point of discussion among colleagues, perhaps a focus of dissection at the weekly grand round conference or in a published journal article or potentially the basis of a lawsuit,” the editorial notes. It concludes that “focusing on potential mistakes is a poor recipe for encouraging the highest levels of performance.”
Dr. Dyrbye said physicians work hard and are critical of themselves, and they have a constant drive to do better.
“We sell ourselves short by not celebrating our successes,” she said, noting that recognizing hard work could help physicians feel a sense of personal accomplishment.
For example, Dr. Dyrbye recalls being promoted to professor and the accomplishment being recognized by receiving a piece of paper in the mail. It was a missed opportunity to celebrate the hard work and success into achieving that goal, she said.
“Now in the Department of Medicine, we send notes to faculty when they are promoted, and we frame the certificate,” Dr. Dyrbye said. “It’s a small way to say we recognize the huge amount of work that goes into this.”
Drs. Dyrbye and Sinsky and their colleagues concluded that meaningful change in physician burnout will require a response at the personal and organization levels. Factors such as struggles with work-life balance, work overload and inefficiency, and loss of autonomy contribute to physician burnout. And they need to be addressed, along with systems factors such as sufficient staffing and efficient work flows.
“It is multifactorial; there is not one single culprit or one single magic bullet,” Dr. Sinsky said. Reducing burnout requires interventions at multiple levels.”
The AMA’s STEPS Forward™ collection of practice solutions also offers resources for physicians on improving physician resiliency, preventing physician burnout and preventing resident and fellow burnout.