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Surgeon general: Why fighting burnout is our “moral obligation”

Jul 12, 2022

Throughout the COVID-19 pandemic, thousands of physicians and other health professionals lost their lives to the disease. They put their own health and safety at risk so they could heal and comfort others during these difficult times navigating a health crisis. But now it is time to take care of them. To help, U.S. Surgeon General Vice Adm. Vivek Murthy, MD, released an advisory addressing health worker burnout, which includes many AMA resources.

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“As we transition towards recovery, we have a moral obligation to address the long-standing crisis of burnout, exhaustion and moral distress across the health community,” Dr. Murthy wrote. “We owe health care workers far more than our gratitude. We owe them an urgent debt of action” and the call to action “helps show what is needed and how we can do it.”

Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And the AMA is ready.

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.

“If you think about burnout, we have nurses, we have doctors, we have other health professionals experiencing this,” said AMA member Tina Shah, MD, a recent senior adviser for the surgeon general and expert on clinician burnout. “They may even understand that they're having burnout and some of their employers or their leaders maybe have somewhat of an understanding, but we're really trying to address burnout in a fragmented way.”

“What the surgeon general's advisory does is, No. 1, tell the public that this is not just a doctor's issue. This is every single person in our country's issue. It's a public issue,” said Dr. Shah. “And No. 2, it provides a road map that will hopefully help take out the silos and stitch together all the people who are needed to work on this so that we see the change and feel it.”

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The advisory offers a comprehensive list of resources to help address health worker burnout. Among them are many developed by the AMA. Here are some of the ways health care organizations can address burnout.

A key step in addressing burnout is to build a commitment to the health and safety of health workers into the fabric of health organizations, says the advisory. This should include a commitment to health worker well-being at the highest levels of leadership.

One way to do this is by establishing a chief wellness officer position with dedicated resources and decision-making power. This can include “developing online staff safety hubs with resources, adding well-being metrics into key performance indicators for the organization and linking executive compensation with improvements in health worker well-being,” says the advisory.

The AMA also offers guidance for health care leaders to create the organizational foundation for joy in medicine as well as purpose and meaning in work. This includes the AMA Joy in Medicine™ Health System Recognition Program that aims to recognize organizations that support physician and health worker well-being.

Health systems and organizations also need to develop mental health support services that are tailored to the needs of health workers such as incorporating a proactive, evidence-based approach to suicide prevention. This should include identification and response in the workplace.

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A best practice example that is recognized by the AMA is the Healer Education Assessment and Referral (HEAR) Program, which was developed by the University of California, San Diego, School of Medicine and the American Foundation for Suicide Prevention. The HEAR program was created to prevent depression and suicide through voluntary and anonymous screening and referral. The program has been scaled to over 60 medical campuses and includes physicians and nurses.

“Inefficient work processes, burdensome documentation requirements and limited autonomy can result in negative patient outcomes, a loss of meaning at work and health worker burnout,” says the surgeon general’s advisory. But employers can help by implementing strategies and approaches to reduce administrative burdens. One way to do this is through the AMA STEPS Forward® de-implementation checklist (PDF), which can address common administrative burdens in the workplace.

Organizations can also implement the “Getting Rid of Stupid Stuff” program, which was created by Hawaii Pacific Health. This program asks employees to assess their experiences with the EHR and recommend unnecessary or poorly designed tasks to eliminate to save time each day. Learn how to implement this program with the AMA STEPS Forward toolkit on “Getting Rid of Stupid Stuff.”

“The AMA has really been at the forefront from doing the research to even helping us understand why doctors get burnt out to actually giving us tactical solutions like the de-implementation checklist and other evidence-based solutions in their site, AMA STEPS Forward,” said Dr. Shah.

“In all of the information gathering that led to producing the surgeon general's advisory on health worker burnout, we leaned heavily on the AMA to really understand what the best evidence is to solve this problem and how we can do it,” she said.

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