Becoming a licensed medical practitioner requires a grueling amount of schooling that can leave many individuals burnt out before they even become a practicing physician. The path to becoming a board-certified physician in North America requires an undergraduate degree (about 4 years), a medical degree (another 4 years), and residency as a specialist (which takes anywhere from 3 to 8 years). This amounts to 11 to 16 years of training. Physicians also are often left with heavy amounts of debt from medical school, and they are paid relatively low wages as residents. This may lead to some level of dissatisfaction among career physicians.
These grueling commitments may be behind the rate of burnout among physicians according to a 2018 assessment of happiness among physicians in Medscape. Though there are a great number of physicians who remain happy with their profession, overall, the burnout rate has been increasing on an annual basis. Interventions on an individual and organizational level must be taken to improve the quality of work of a physician.
How happy are they?
The majority of physicians are relatively happy with their life outside of work. In fact, 76 percent of responding physicians in the Medscape survey stated they are somewhat happy to extremely happy with their home life. One of the factors that correlates with a physician’s happiness outside of work is the specialty that they practice. The top five specialties with the happiest practicing physicians are Allergy and Immunology, Dermatology, Emergency Medicine, Ophthalmology, and Plastic Surgery. The lower five specialties ranked by physicians’ happiness are Cardiology, Public Health & Preventive Medicine, Oncology, Infectious Diseases, and Internal Medicine.
Regardless of the specialty the physician is in, a growing number of physicians have been dissatisfied with their choice of profession. Physicians Practice surveyed 1187 U.S. physicians in the 2018 Great American Physician Survey to gain insight into the outlook physicians have on medicine and their profession. On a scale of 1 to 5, with 5 being “strongly agree” and 1 being “strongly disagree”, the average score given for “I used to enjoy being a physician much more, but today it’s more stressful” was 4.1, a decrease from the year before (4.14). On a scale of 1-10, 10 being extremely happy, physicians gave a rating averaged to 6.78. Physicians are experienced increased work stress and are becoming increasingly unhappy with their work, a issue that must be addressed.
The root of the problem
This rise in physician burnout is not necessarily related to their interaction with patients. According to Dr. Steven Defossez, VP of Clinical Integration at the Massachusetts Health and Hospital Association, physicians’ requirement to obey strict bureaucratic and administrative guidelines that make physicians feel like they have a “loss of autonomy” and that they are “being forced to use still-primitive EHRs (Electronic Health Record).” This lack of freedom has increased stress in physicians, contributing to the feeling of burnout. The combination of these factors culminates in high burnout rates among physicians. In the 2019 MedScape report on physician burnout, the survey results showed that 59 percent of physicians identified “too many bureaucratic tasks” as what contributed most to their burnout.
A recent article by Healio states that physician burnout rate has increased. Marcela G. del Carmen MD, MPH, states that “physician burnout is negatively associated with altruism, professionalism and quality and safety of care.” These exact qualities are those that physicians portray to patients to make them feel comfortable and safe in a hospital setting; however, this has been having negative implications on the physician, including lower job and patient satisfaction, and they are leading lower qualities of lives as a result.
Del Carmen was one of the researchers leading a nationwide study to decipher factors that are linked to physician burnout. They found that the number of physicians burning out per year increased from 40.6 percent to 45.6 percent and is associated with increases in exhaustion and cynicism. Del Carmen attributed this increasing dissatisfaction of physicians to declining quality of care provided by them.
Though the issue of physician burnout may seem like an insurmountable problem, there are preventative measures that physicians can take to mitigate the effects of their burnout. Christopher Cheney, senior clinical care editor at HealthLeaders, recently authored an article that describes two major interventions that have the ability to reduce physician burnout: organizational and individual interventions. Organizational interventions address issues negatively affecting physicians in the workplace. These organizational issues include excessive workload, work inefficiency, and work-home balance.
Cheney offered solutions to these problems, claiming that “fair productivity goals, duty-hours limits, and appropriate job role assignments” could solve the issue of excessive workload. Work efficiency could be optimized through the use of electronic medical records and shifting clerical burdens to non-physician administrative staff. The problem of work-home balance could be solved by supporting more flexible work schedules for physicians.
Cheney also suggests that physicians can make their work experience better on a more independent basis as well. Individual interventions that physicians may adopt include prioritizing and delegating tasks appropriately, attending training to learn workplace skills such as healthy ways to manage stress, and embracing an overall positive outlook to more easily fulfill work roles designated to the physician. For these interventions to take place, Cheney asserts that healthcare organizations must make a conscious effort to recognize the burnout issue among healthcare professionals and find ways to address the problem so that America can collectively fix the emerging problem of physician burnout.
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BoardVitals. (2017) ‘Survey: Are Physicians Happy with Their Jobs?’ Retrieved from https://www.boardvitals.com/blog/are-physicians-happy-with-their-jobs/.
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