By Jennifer Larson, contributor Sep 11, 2018
Your patients and colleagues may think that you’ve got it altogether—at
least most of the time—but down deep you suspect that something is wrong. Consider
this checklist to see if any of these feelings apply to you:
A sense of lack of accomplishment
Lack of enthusiasm for your work
Sound familiar? These are common symptoms of physician burnout. If you
or a colleague are exhibiting these symptoms on a regular basis, you could be suffering
from this all-too-common condition.
In an August 2018 commentary in the American
Journal of Medicine, Kenneth A. Ballou, MD, and Andrew G.
Alexander, MD, described these three symptoms of physician burnout. They also
pointed out that burnout is more than just a problem with a physician’s work–life
balance; it can threaten a doctor’s health and medical career.
“[Doctors who feel this way] are not alone,” said Ballou. “Those
feelings are not just feelings that they feel or that their friends feel. This
is almost universal. Everybody is kind of fed up with this system, and it seems
to be only getting worse, not better.”
In some cases, physician burnout could even be life threatening. The
suicide rate among physicians is more than double the rate among the general
population, according to research presented at the 2018 American Psychiatric
Association’s annual meeting in May.
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From burnout to recovery
The Agency for Healthcare Quality and Research describes burnout as “a long-term
stress reaction marked by emotional exhaustion, depersonalization, and a lack
of sense of personal accomplishment.”
This description rings true to family medicine physician Clark Gaither,
MD. Gaither remembers how he felt when he developed physician burnout. He knew
something was wrong, but he wasn’t sure exactly what. But he knew it was
“I wasn’t enjoying what I was doing anymore. It felt like drudgery,” he
recalled. “I dreaded going to work on Monday, and I looked forward to the
weekends. But I couldn’t even enjoy the weekends because I dreaded going back
to work on Monday again.”
Gaither eventually walked into his partner’s office and said, “If
something doesn’t change, I am going to have to leave medicine.”
All the demands that come along with the business of medicine,
including the time pressures, had worn him down. So Gaither made some changes.
He cut down his hours to try to achieve a better work–life balance. He
also began blogging and speaking about physician burnout, and authored a book on the subject titled Reignite, which was released
in March 2018. He now serves as the medical director of the North Carolina
Physicians Health Program (NCPHP), which works to support the well-being and
recovery of medical professionals, and consults with organizations on how to
avoid job-related burnout among their staff.
The No. 1 factor in physician dissatisfaction
Based on a review of several studies on physician burnout, Ballou
and Alexander’s article discussed potential contributing factors, including
many “major transformational medical practice events that occurred between 2011
and 2014,” leading to the development of burnout in physicians.
The electronic health record (EHR) quickly rose to the top
of their list.
“I think that’s something that’s going to resonate with a lot of
physicians,” said Ballou.
Many physicians report spending hours working on their charts on their
own time, which upends their work–life balance. “This really eats away at their
precious downtime, when they should be with their families or doing things that
make them happy,” said Ballou.
They also worry that the documentation requirements affect the doctor–patient
relationship, distracting them from their patients. In fact, the 2016
Survey of America's Physicians, conducted by Merritt Hawkins on
behalf of The Physician’s Foundation, found that only 11 percent of physicians
reported that EHRs have improved patient interaction, compared with 60 percent
who said they’ve done the opposite.
The current design and utilization of the EHR could be the culprit.
Many practices and organizations have invested large amounts of money
and time in their EHR technology and implementation, since they’re essentially
required for quality reporting and billing, noted Russell Libby, MD, a board
member of the Physicians Foundation and president of the Virginia Pediatric
The EHR was more or less created to be an efficient billing tool—not so
much an efficient patient care tool. Perhaps it’s time to change that. Some
experts believe that pressure from physician groups could result in the design
of a new type of EHR that would work better for physicians.
“That will be an incredible tipping point,” said Libby.
Showing signs of burnout?
Diagnosis and treatment
Do you wonder if you’re suffering from job-related burnout, or are in
danger of doing so? Gaither suggested doing some self-education on the topic,
including checking out burnout assessment tools like the Maslach Burnout
If you’re showing signs, it may be helpful to pull back and take stock
of your situation.
“Acknowledge that you have a problem,” said family practice physician
Marjorie Binette, MD, founder and editor of the health and wellness blog Sisters in Health.
“That’s important. Some physicians may feel that they have failed in some way
and then they don’t express their concerns. That leads to a bigger problem.”
After acknowledgment, you can explore ways to address your situation. Find
ways to optimize workflow at the office, if that seems to be a contributing
factor. Look for ways to carve out time to do the things that bring you
satisfaction. Binette also suggested talking to your peers about how they keep
their personal and professional lives in balance.
“Let’s take care of ourselves so we can take care of our patients
better,” Gaither said.
If electronic medical record use is a problem for you, Ballou and
Alexander’s commentary suggests a few ways to address that particular problem.
“Make your note meaningful, and never make your EHR more important than
your patient,” they wrote. “Demand more productive voice recognitions-linked
diagnostic EHRs in the future. Lobby to rid medicine of bullet-point-based
reimbursement. For the sake of our profession, get out of the current EHR rut,
and enjoy the balance of the rest of your life as a doctor.”
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