Physician Burnout: Where Do We Go from Here?

When I made the decision 18 years ago to leave clinical medicine after three years in general practice, I felt chronically stressed and had trouble sleeping. I practiced with a general feeling of unease, sensing that the environment was not set up to catch inevitable human errors before they would cause harm to a patient.
Once I transitioned to freelance writing two years ago, I learned that about half of practicing physicians report at least one burnout symptom. I read the formal definition of professional burnout: emotional exhaustion, depersonalization, and feeling ineffective at work. I finally understood why I had left.
Recently I’ve been writing about potential remedies for physician burnout. Based on interviews and my review of published studies, I believe individual, structural, and cultural interventions are needed.
Individual physicians can take several steps to mitigate stress. They can practice stress-reduction techniques, such as meditation and mindfulness. They can make it a priority to take breaks, even brief ones, during the workday. They can access peer support when dealing with stressful cases, or if needed, they can seek help from professional groups.
However, individual solutions are not sufficient to deal with the degree of stress present in most clinical environments today — structural changes are also needed. These changes should ensure that physicians have sufficient support staff to ensure efficient patient flow and help with required documentation. These changes should also include giving physicians more control over their schedules by offering shared positions, flexible hours, and some protected time each week to pursue the aspects of medicine that are personally meaningful to them.
Although hospital and physician practice leaders may balk at the initial outlay of resources needed to make some of these changes, many of them, such as flexible scheduling, are inexpensive in the longer term. Any funds spent to reduce practice stressors will likely be rewarded with less physician departure and lower recruitment costs, which were estimated in a 1999 study to be $250,000 per physician.
Changes in organizational culture are required if individual and structural solutions are going to stick. Leaders need to encourage and model a healthy balance between work and personal responsibilities. They need to take steps to create a culture of trust and respect. They need to monitor the level of stress among physicians and pay attention to reducing work-related hassles.
Although structural and cultural changes often require action on the part of leadership, physicians can play an active role in promoting these changes. They can advocate for specific improvements and seek leadership positions to directly shape the practice environment in the organizations in which they practice.
Burnout is a solvable problem. It is my hope that, in the future, no physician will need to leave practice for self-preservation and all patients will be cared for by energized physicians who are able to practice with the passion that drew them to medicine in the first place.
For more information, contact Physician Health Services at (781) 434-7404 or visit www.physicianhealth.org. –