In today’s increasingly connected world, most of us are expected to produce more, consume more, and be more “on" than ever before. So, it might not be so surprising that, as a whole, we reportedly experience an increase in the symptoms commonly associated with burnout.
Job burnout is a select type of work-related stress—a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. Someone feeling burned out by work may become cynical or critical at work, lack the energy to be consistently productive, feel less focused, or harbor a sense of disillusionment about their career.
Outside of work, they may use substances—from food or drugs to alcohol—to feel better or sometimes, to not feel. Their sleep habits might change. They may be troubled by unexplained headaches or other physical complaints.
The effects of burnout are well-documented across every profession. Still, they run particularly rampant in healthcare, where packed workdays, demanding pace, time pressures, and emotional intensity can put clinicians at high risk for emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment.
Any healthcare provider knows that to make progress against problems, it’s best to break them down. To do that, let’s dissect the causes of burnout in healthcare and analyze its impact among different professions in the field.
Although a myriad of factors causes burnout, recent physician surveys have helped to identify common themes. Take Medscape’s 2019 National Physicians Burnout & Depression Report, which surveyed more than 15,000 physicians across more than 29 specialties about a variety of topics, including burnout, depression, and happiness at work. Of those surveyed, over 44% of physicians feel burned out, though doctors in some specialties are suffering more than others.
When asked about the most significant contributors to burnout, 59% of responders said they had to deal with too many bureaucratic or administrative tasks—like charting and paperwork—while 34% said they were spending too many hours at work.
According to a 2016 Health Affairs study on unnecessarily high costs of physician practices, on average, U.S. physicians spend 2.6 hours per week complying with external quality measures. In an outpatient setting, this is enough time to see approximately nine additional patients. Moreover, a 2016 study from the Annals of Internal Medicine indicates that for every hour of clinical face time that physicians spend with patients, they devote an additional two hours to administrative and clerical work.
In a 2017 message to their "fellow health care CEOs," 10 prominent health system CEOs—including those from Mayo Clinic, Cleveland Clinic, and Johns Hopkins Medicine—said that "burnout among physicians is a national health crisis," and "addressing it a matter of absolute urgency."
While countless reports focus on the impact of burnout on physicians, it’s clear that healthcare providers across the industry are feeling less than enthused with their roles. Take WebPT’s study on the state of rehab therapy in 2018, for example, which shows that while most physical therapists enjoy their day-to-day jobs, they are concerned about the direction the field is heading—and even more alarmed about the state of healthcare in general.
Nursing burnout is a significant reality in the field, too. One 2001 Health Affairs study on Nurses’ Reports On Hospital Care In Five Countries found that 43 percent of nurses working at U.S. hospitals experience symptoms of emotional exhaustion, likely not only from constant exposure to sick or dying patients but also might be a natural vulnerability to burnout. Another 2011 study reported that burnout is a challenge among 37 percent of nurses providing direct care in nursing homes and 33 percent of hospital nurses.
While burnout in physician assistants (PAs) is less studied, some reports suggest it may be similarly high. A 2018 report from the AAPA Research Department indicates that 46.2 percent of PAs are exhausted at work. What’s more, 1 in 8 PAs said that they were currently considering quitting their job due to stress.
Burnout is also highly prevalent among mental healthcare providers, spanning areas like psychology, marriage and family counseling, and substance abuse counseling, to name a few. A 2012 study from Administration and Policy in Mental Health and Mental Health Services Research estimates that between 21 and 67 percent of mental health practitioners experience signs of burnout.
In the 2019 Medscape survey, urology, neurology, physical medicine and rehabilitation, internal medicine, and emergency medicine were among the most burned-out healthcare specialties. Of the lowest rates, 28 percent of those working in public health and preventative medicine, 32 percent of those practicing in nephrology, and 33 percent of pathologists reported burnout.
While the work environment plays a significant factor in work burnout among all types of healthcare professionals, a workplace’s setting and structure may be of importance too. A 2018 new study of 235 healthcare professionals working in 174 small independent primary care practices in New York City found they reported a burnout rate of 13.5 percent compared to exceedingly higher national averages of healthcare professionals reported symptoms of burnout.
A study published in South Dakota Medicine also found that family practitioners who work in rural areas have significantly lower burnout rates than those who practice in medium-sized or more substantial metropolitan areas. Of 302 professionals surveyed, 25 percent reported burnout in a rural healthcare setting, compared to 37.5 percent in medium-sized towns, and 51.4 percent of those practicing in metropolitan areas.
From specialty providers to hospital CEOs, the consequences of burnout impact the well-being of all kinds of healthcare workers at every point in their career. Employees with burnout often show display less commitment to their organization, spread negative attitudes, and have higher rates of absenteeism. One 2005 report from the Journal of Behavioral Medicine determined that burnout is a significant predictor of future sick leave.
At an institutional level, burnout results in higher job turnover and increased thoughts of quitting among physicians and nurses. It also results in decreased workforce efficiency. A 2016 Mayo Clinic study estimated the loss of productivity due to healthcare burnout as the equivalent of eliminating the graduating class of seven U.S. medical schools. The findings may suggest that exhaustion may play a critical role in an ongoing national shortage of physicians and nurses.
Given the reasoning for many healthcare professionals to choose work in the field out of the opportunity to help people, it’s troubling that many studies have also demonstrated that provider burnout is detrimental to patient care. For example, the number of significant medical errors committed by surgeons finds a connection with surgeon burnout and the likelihood of being involved in a malpractice suit.
In another study, researchers surveyed 422 family physicians and clinicians who worked in 119 ambulatory care clinics. More than half of the professionals reported experiencing time pressures when conducting physical examinations. Nearly a third felt they needed at least 50 percent more time than was allotted for this patient care function. Also, almost a quarter said they needed at least 50 percent more time for follow-up appointments.
Research in the nursing field, in particular, associates higher levels of burnout with an increased risk of patient mortality and the spread of hospital-transmitted infections. One 2008 study from Health Care Management Review indicates that patients who receive care from a provider suffering from burnout are twice as likely to report low provider professionalism or little satisfaction with their care experience.
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