There is a disease sweeping the nation that has significant consequences for every person living in this country, even if they never contract it directly. And despite its lethality, there is precious little being done about it. It’s called physician burnout, and it affects all of us.
Doctors, on average, spend at least eight years in college, followed by years of postgraduate training during which time they work 80 hours a week. They graduate with a mountain of debt, face the constant fear of malpractice litigation, and are burdened by incessant demands to see more patients in less time with more administrative paperwork. On top of which, there’s compassion fatigue – helping the sick, the injured and the dying is rewarding no doubt, but often emotionally draining. All of this leads to physician burnout.
More than any other profession, doctors face burnout, and the rates have been increasing. A recent study by researchers at the Mayo Clinic found that the number of physicians suffering from burnout is 54%, up from 45% in 2011. And physicians are more than twice as likely to commit suicide than non-physicians; every year, 400 doctors in this country take their own lives.
Why should you care? Because the emotional health of doctors has a direct effect on the broader public. There are a plethora of stories of physicians who describe the chilling consequences of their depression. One surgeon wrote in a recent blog, “my depression…was exacerbated by work. I clearly wasn’t performing to the best of my abilities, and my patient complications and complaints were increasing. A patient died from a post-operative bleed. Would I have managed it better if I wasn’t suffering myself? (When I spoke to the patient’s wife, as he lay dying 20 feet away, she asked me if I was OK.)” Burnout causes a lack of clarity in thinking leading to medical mistakes. “Given the extensive evidence that burnout among physicians has effects on quality of care, patient satisfaction, turnover, and patient safety, these findings have important implications for society at large,” researchers from Mayo Clinic told Forbes.
But it’s not just that doctors who are burned out are more likely to make errors – they’re also more prone to biases noted a recent report. And, it’s clear that bias clouds judgment and causes physicians to treat certain patients differently than others. “Physicians who are burned out, stressed and generally frustrated over near-term crises or long-term concerns are more likely to react negatively to patients,” said a recent study.
Beyond medical errors and poor patient interactions, physician wellbeing also affects access to care. A recent Physicians’ Foundation survey found that 44% of physicians were planning on reducing patient access by either cutting back on patient load, working part time, closing their practice to new patients or retiring. Physicians are getting tired of the “turnstyle” medicine they are being forced to practice – seeing more patients in less time – rather than building the relationships that inspired them to enter the profession. Increasingly, however, the physician-patient relationship is being supplanted by the economic demands of a medical machine. While some have tried to fight back with efforts to unionize, others simply retire or find alternate careers. Such erosion of the profession, especially when coupled with an expected doctor shortage over the coming decades due to fewer trainees, has the potential to seriously impede access to care.
As physicians, we have the humbling privilege of caring for the sick, the weak and the injured. We spend years perfecting our skills in diagnosis and treatment so much so that the idea that we may be suffering ourselves is difficult to accept. We can no longer afford to ignore the fact that burnout affects not only ourselves and our families, but our patients as well.
This is not an issue physicians can address alone. Indeed, a concerted effort is required across all stakeholders. Hospitals must work to foster environments where the economic demands of a viable enterprise are balanced against the need for a happy and healthy physician workforce. Policy makers must consider the ramifications of increasing administrative burdens and reducing reimbursements which only serve to fuel physician fatigue. As a society, we need to ensure we look after the professionals we entrust with our health. When over half of all physicians are burned out and the trend is continuing to rise, there is a silent healthcare epidemic in this country that needs to be addressed. How long can we continue to ignore what is becoming a “critical condition”?
Anees Chagpar is a Yale associate professor of surgery and Director of The Breast Center — Smilow Cancer Hospital at Yale-New Haven.