Physicians, undoubtedly, have one of the most demanding jobs out there. Their role requires intense medical training, increased work hours, and a very diverse workload ranging from clinical to administrative work. As a result, some physicians experience what we call burnout, which is described as having physical, spiritual, and emotional exhaustion as well as feeling cynical, ineffective, or unaccomplished at work.
Burnout among physicians is associated with direr consequences since they handle the lives and well-being of human patients. This may lead to worsened health and work-life balance as well as the inability to deliver high-quality care for patients and increased incidences of medical errors.
Although anyone can experience burnout, estimates believe that burnout among physicians is twice the rate than those among other industries. Some factors that may have contributed to the high prevalence of physician burnout are the long working hours, fear of committing malpractice and being sued for it, as well as, the heavy burden of doing documentation and filling out medical records.
According to a study from the American Medical Association, 44% of U.S. physicians reported at least one symptom of burnout in 2017, while a 2018 report from the Physicians Foundation stated that about 78% among their surveyed participants admitted that they feel burnt out at least sometimes. Aside from the rising trend of physician burnout, the suicide rate among physicians is also increasing throughout the years.
Dr. Edward Ellison, who is the co-CEO of the Permanente Federation and executive medical director for Southern California Permanente Medical Group in Pasadena, wrote in an editorial that “beyond the anxiety, depression, insomnia, emotional and physical exhaustion, and loss of cognitive focus associated with physician burnout, an estimated 300 to 400 U.S. physicians take their own lives every year. That number is higher than the suicide rate for the general public by 40% for men and an astonishing 130% for women.”
Aside from the adverse effects of physician burnout to both the physician and the patients, there is also an accompanying economic burden. However, this concept is still poorly understood.
To have a better understanding regarding this matter, researchers from Stanford University, the Mayo Clinic, and the American Medical Association created a mathematical model that allows them to estimate burnout-associated costs-related to physician turnover and physicians reducing their clinical hours. The study was recently published in the Annals of Internal Medicine.
The model estimated that about $4.6 billion — with a range of $2.6 billion to $6.3 billion — can be attributed to physician burnout every year in the United States. These costs are taken into account concerning physician turnover and reduced clinical hours.
Moreover, at an organizational level, the cost is about $7600 — with a range of $3,700 to $11,000 — per employed physician every year. Compared to previous ones, this study’s cost estimate related to physician burnout is significantly lower. The annual burnout-related cost estimate of the 2018 healthcare task force report was $17 billion.
With the use of related research and industry reports, they considered costs of replacing a doctor who leaves their job, including costs to advertise the position, costs needed to hire and train a new physician, as well as the losses of a healthcare organization when the position remains vacant. However, several other factors were not considered because of the difficulty in quantifying, and these include malpractice lawsuits, loss of reputation, indirect lost revenue, and lower quality of care.
Some advocates worry that the trend of physician burnout may be expected to increase in the following years because of the growing aging population coupled with a possible shortage of physicians by 2030.
The co-author of the study, Joel Goh, who is also an assistant professor at the National University of Singapore, even said that “over the next 20 or 30 years, it looks as if the demands are projected to increase, and the supply is basically not going to be able to catch up. We’re starting to feel some of the effects today,” according to Time. With this pressing issue, there could be a more substantial and problematic economic burden in the future, aside from the reduced quality of patient care.
Fortunately, this could be prevented when healthcare organizations start to prioritize the well-being of their physicians. There should be efficient workloads, flexible schedules, as well as an effective support system.
In Cleveland Clinic, the Icahn School of Medicine, and Stanford Medicine, they have initiated the appointment of chief wellness officers to help in addressing the issue regarding burnout among their physicians.