By Debra Wood, RN, contributor Dec 19, 2017
While some doctors report great satisfaction with their jobs and patient relationships,
feelings of physician burnout are still common.
What determines the difference?
Seventy-one percent of physicians describe patient relationships as the most satisfying aspect of their practice, according to the 2016 Biennial Survey of American Physicians by The Physicians Foundation. Yet daily stressors and factors that interfere with time spent on direct patient care can lead to physician burnout.
More than 74 percent of physicians reported sometimes, often or always experiencing feelings of burnout, according to the survey, with nearly half (48 percent), saying they had frequent or constant feelings of physician burnout.
These figures are concerning for several reasons, including the fact that physician burnout has been associated with worse patient outcomes.
“It affects patient safety, quality of care and cost,” said Kurt Mosley, vice president of strategic alliances for Staff Care and Merritt Hawkins, physician staffing companies of AMN Healthcare.
Physician burnout: The Reasons it Happens?
“Burnout is the result of continuous emotional, psychological and physical stress over a prolonged period of time,” said Jodi J. De Luca, PhD, with Erie Colorado Counseling.
“Regardless if you are full-time or locum tenens, physicians are commonly prone to burnout due to the daily emotional demands and pressures of the hospital environment.”
Frustrations on the job can include electronic medical records, insurance preauthorization, technology, lack of autonomy, and government regulation, including moves toward value-based medicine and grades, Mosley said.
Time allotment guidelines can also leave physicians feeling pressured to see more patients in less time, which adds to workplace stress.
An alternative path with a locum tenens career
A locum tenens career can allow physicians to avoid some of the bureaucratic headaches and long-term stressors found in staff positions that can lead to burnout. Locums tenens providers work short-term assignments that allow them to not only benefit from a change of venue, but also gain a fresh perspective on their profession.
However, locum tenens physicians also need to be careful not to let some aspects of their travel lifestyle add to their stress.
Darin Bergen, PsyD, of Portland, Oregon, said that locum tenens must realize that “coming into a new system you will see things that don’t function well, or that you just don’t like. Unless you are in a position to change those things, it is best to figure out how to function effectively and ethically within the system rather than continually get worked up about how things ‘should’ function.”
These types of frustrations can also be an issue for physicians in permanent positions, Bergen added, but those on staff may have more ability to make changes to the systems they work within.
What to do about physician burnout?
Recognize the signs. “The first step in dealing with [physician] burnout is to know that this is what you are experiencing,” said Jonathan Jackson, PhD, director of the Centers for Psychological Services and Internship Consortium at the Derner School of Psychology at Adelphi University in New Jersey.
“The arrival of symptoms of burnout can be insidious and so not readily identified,” Jackson explained. “Symptoms can look a lot like depression: low energy, worry, lack of motivation and interest in your work, poor sleep hygiene and poor diet.”
“As with depression, motivation to do something about it diminishes, creating a vicious cycle,” he added. “Often a partner, friend or family member will encourage the physician to get help.”
Online surveys and questionnaires may help a healthcare professional determine if he or she is suffering from physician burnout, Mosley reported.
“Physicians have a responsibility to recognize the early signs and seek immediate support and intervention,” De Luca added. She recommended employee assistance programs, offered by many healthcare organizations as a free benefit.
Understand the contributing factors—and make changes. Jackson said the next step is to identify what factors are contributing to physician burnout and try to change them. If a long workday is a problem, cut back.
If every aspect of a physician’s job seems to be an issue, he suggested finding a new one with different working conditions.
Coming up with a list of options or solutions to help in managing stressors provides a sense of control and optimism, De Luca added.
Mosley said some physicians turn to direct-pay, concierge care delivery models. Others start locum tenens careers to avoid some of the frustrations of operating a practice, billing or completing extra paperwork.
“A lot of physicians are choosing to work locum tenens because it gets back to what they went to school for, which is take care of patients,” Mosley said.
Practices and health systems often use locum tenens physicians to help prevent burnout in their own medical staff by avoiding overwork and lightening the physicians’ loads.
“Locum tenens is the perfect solution to the perfect storm,” Mosley said.
Prevent physician burnout with self-care
Jackson, De Luca and Bergen emphasized the need for self-care in preventing physician burnout.
“[Aspects of good self-care] include exercise, yoga and meditation, diet, moderation in alcohol and other drug use, regular work and sleep hours and socializing,” Jackson said. “All of these behaviors are correlated with well-being, and this also works directly against burnout.”
“Getting enough sleep is critical,” added De Luca, explaining that sleep is restorative. Additionally, she said, “taking time off is essential.”
Bergen suggested “learning to say no” where possible to avoid becoming overwhelmed with responsibilities.
“Regardless of personal and professional responsibilities in life, investing in yourself is the best investment you will ever make,” De Luca said. “Investing in yourself means identifying priorities.”
“Life is often hectic, stressful and overwhelming,” she said. “Priorities add structure to life and, thereby, reduce stress.”
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