Healthcare organisations in the US have published a paper
stating that burnout among physicians has become so pervasive that it should be
deemed a public health crisis.

The paper published by the Harvard T.H. Chan School of
Public Health, the Harvard Global Health Institute, the Massachusetts Medical
Society and the Massachusetts Health and Hospital Association (MHA)  includes directives aimed toward curbing the
prevalence of burnout among physicians and other care providers, including the
appointment of an executive-level chief wellness officer at every major health
care organisation, proactive mental health treatment and support for caregivers
experiencing burnout, and improvements to the efficiency of electronic
health records.

The paper is based on the findings of an annual survey by
healthcare company, Merritt-Hawkins that surveys physicians on issues such as professional
morale, practice patterns, career plans and perspectives. Seventy-eight percent
of the physicians surveyed in 2018 said they experience some symptoms of
professional burnout. These symptoms include emotional exhaustion, depersonalisation,
and diminished sense of personal accomplishment.

“Physicians experiencing burnout are more likely than their
peers to reduce their work hours or exit their profession,” the paper notes.

“Burnout has a demonstrable impact on physician work hours
and professional exit. Every one-point increase in burnout (on a seven-point
scale) is associated with a 30–40% increase in the likelihood that physicians
will reduce their work hours in the next two years. Overall, burnout
contributes to a 1% reduction in physicians’ professional work effort. This
reduction roughly equates to losing the graduates of seven medical schools
annually – before accounting for other outcomes of burnout such as early retirement
or leaving the profession altogether,” the authors write.

“The issue of burnout is something we take incredibly
seriously because physician wellbeing is linked to providing quality care and
favorable outcomes for our patients,” said co-author Alain Chaoui, a practicing
family physician and president of the Massachusetts Medical Society. “We need
our healthcare institutions to recognise burnout at the highest level, and to
take active steps to survey physicians for burnout and then identify and
implement solutions. We need to take better care of our doctors and all
caregivers so that they can continue to take the best care of us.”

The steps recommended to address the issue include:

Proactive mental
health treatment and support for physicians experiencing burnout and related

According to the report, physicians face stigma and
professional obstacles to seeking appropriate care and treatment for burnout
and related mental health concerns. “Physician institutions — including
physician associations, hospitals, and licensing bodies — should take
deliberate steps to facilitate appropriate treatment and support without stigma
or unnecessary constraints on physicians’ ability to practice,” the authors

Improving EHR
standards with strong focus on usability

“There is broad consensus that a major contributor to
physician burnout is dissatisfaction and frustration with EHRs. The 2018
Physician Survey identified EHRs as the single most important “pain point”
confronted by physicians in their practice,” the authors write.

“The growth in poorly designed digital health records and
quality metrics has required that physicians spend more and more time on tasks
that don’t directly benefit patients, contributing to a growing epidemic of
physician burnout,” says co-author Ashish Jha, a Veterans Administration
physician and professor at Harvard Chan School. “There is simply no way to
achieve the goal of improving healthcare while those on the front lines — our
physicians — are experiencing an epidemic of burnout due to the conflicting
demands of their work. We need to identify and share innovative best practices
to support doctors in fulfilling their mission to care for patients.”

The appointment of executive-level
chief wellness officers at every major healthcare organisation

The responsibilities of wellness officers as recommended by
the report include:

Studying the scope and severity of burnout across his or her

Reporting findings on wellness/physician satisfaction/ joy
in work as part of institutional quality improvement goals/processes

Presenting findings, trends, and strategies as a “dashboard”
item for institutional CEOs and boards of directors

Exploring technological and staffing interventions like
scribes, voice recognition technology, workflow improvements, and EHR customisation
to streamline physician work and reduce administrative burden

Disseminating successful strategies within a professional

 “In particular, we
recognise the need to further empower healthcare providers and support their
emotional, physical, social, and intellectual health. This report and its
recommendations offer an important advance toward ensuring that physicians are
able to bring their best selves to their lifesaving work. We see it as a
component of our broader efforts to improve the health care workplace for every
single employee, from nurses and direct care workers to lab technicians and
administrative personnel,” co-author Steven Defossez, MHA’s Vice President for
Clinical Integration, a practicing radiologist says.


The full report is available on: