Physician Health

WHO adds burnout to ICD-11. What it means for physicians.

Burnout is now categorized as a “syndrome” that results from “chronic workplace stress that has not been successfully managed,” according to the World Health Organization’s International Disease Classification (ICD-11)—the official compendium of diseases. What does this update mean for physicians who, as a profession, face widespread burnout?

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.

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Burnout appears in the ICD-11 section on problems related to employment or unemployment. According to this handbook, burnout is described as:

  • Feelings of energy depletion or exhaustion.
  • Increased mental distance, or feelings of negativism or cynicism related to one's job.
  • Reduced professional efficacy.

However, it is important to rule out adjustment disorder, anxiety and mood disorders. Additionally, this syndrome is limited to work environments and should not be applied to other areas of a person’s life.

“What is important here is to understand that in the ICD-11 definition, burnout is identified as an occupational phenomenon and not a medical condition,” said Christine Sinsky, MD, vice president of professional satisfaction at the AMA. “Burnout is primarily related to the environment, such as when there is a mismatch between the workload and the resources needed to do the work in a meaningful way.”

“Although burnout is more prevalent among physicians, it affects people in other occupations as well,” noted Dr. Sinsky. “Patients working in other fields can experience the occupation syndrome of burnout.”

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The best response to burnout “is to focus on fixing the workplace rather than focusing on fixing the worker,” said Dr. Sinsky. “The ICD-11 definition of burnout is consistent with our research and our approach, which is that burnout is related to stressors within the environment rather than related to weakness on the part of susceptible individuals.”

With this new addition of burnout to the WHO’s ICD-11, physicians and health systems should continue to look at fixing stresses in the work environment.

“The most powerful interventions to reduce burnout are to improve workflow efficiency, teamwork and leadership,” she said.

The AMA’s STEPS Forward™ open-access modules offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine, create a strong team culture and improve practice efficiency. One set of CME modules specifically addresses workflow and process.

STEPS Forward is part of the AMA Ed Hub™, an online platform that consolidates all the high-quality CME, maintenance of certification, and educational content you need—in one place—with activities relevant to you, automated credit tracking and reporting for some states and specialty boards.

Leadership, measurement matter

While taking a team-based approach can relieve physicians of tasks that drain joy from practice, it takes organizational leadership to make the necessary changes.

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For example, the University of Alabama Birmingham’s general internal medicine division found that when physicians have autonomy and the chance to develop as leaders, it helped bring their burnout rate to 13%. Through leadership programs, physicians can experience personal and professional development.

The WHO news “adds further credence to the recommendation that we have been making that organizations regularly measure and respond to physician burnout within your clinician work force,” said Dr. Sinsky.

The AMA also offers practice transformation strategies and resources designed to increase professional satisfaction and physician well-being.