Physician Health

Work overload triples the risk of burnout in health care

Sara Berg, MS , News Editor

It isn’t just physicians who are experiencing burnout. All health professionals have experienced a rise in burnout throughout the pandemic, which has contributed to workforce turnover. This was influenced by increased work demands for all health professionals and signals the need for addressing well-being of multiple role types to reduce burnout and staffing shortages, according to a study published in the Journal of General Internal Medicine

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The study—co-written by researchers from Brigham and Women’s Hospital in Boston, University of Wisconsin School of Nursing in Madison and Hennepin Healthcare in Minneapolis, and the AMA—uses the AMA Coping with COVID-19 Caregivers Survey, which was distributed to 206 organizations across 30 states between April 2020 and March 2021 and surveyed 43,026 health professionals.

Half of all respondents met the criteria for burnout, with 47.3% of physicians reporting that they felt burned out. More than one-quarter of all respondents also expressed an intent to leave their jobs, with 24.3% of physicians said they planned to quit in the next two years.

In addition to physicians, other health workers surveyed included nurses, pharmacists, nursing assistants, respiratory therapists, occupational therapists, speech therapists, medical assistants, social workers, X-ray technicians, and housekeeping, food service, finance, IT and administrative staff.

Work overload was a strong, independent predictor of burnout and intent to leave. When work overload was present, health care workers had 2.2 to 2.9 times the risk of experiencing burnout. Additionally, overloaded doctors and other health care workers had 1.7 to 2.1 times the risk of intending to leave their job in the next two years.

Here are some ways health care organizations can reduce burnout, intent to leave and work overload, as identified in the study. 

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Health professionals—especially nurses and other clinical staff—feel that they are unable to meet unrealistic demands for productivity and efficiency. This has a downstream effect on well-being and work intentions, says the study.

Nurses had the highest reported rates of burnout at 56%, and also were the likeliest (41%) to report intending to leave their job in the next two years.

“Approaches to workload reduction in medicine are haphazard, largely concentrated in trainees and differ from other industries where exhausted workers (e.g., airline pilots) are not allowed to work and workload is closely monitored,” the study says, noting that “a more standardized approach to measuring and limiting workloadcould contribute to reductions in burnout and turnover intentions.”

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.

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5 steps physicians can take to get rid of “stupid stuff”

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“Given evidence that enhanced job control moderates the relationship of workload and burnout, organizations may benefit from exploring interventions to modulate workload,” the study says. Those interventions should also “ensure that employees have a sense of control over their work environment, even in times of unprecedented clinical volumes and ongoing pandemic stresses.”

AMA STEPS Forward® open-access toolkits offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These resources can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency.

“Systemic approaches should include ensuring sustainable compensation, adequate safeguards for mental and physical health, and readily accessible mental health resources for all members of the workforce,” the study notes, acknowledging that “these goals will undoubtedly have to be achieved through both policy and local operational approaches.”

Additionally, substantive reforms to the health care sector may also be needed. This is to create changes that enable organizations to better value caregivers, many of whom are women and from historically marginalized racial and ethnic groups, says the study.