If you’re a music buff, you may know the song “Comfortably Numb” from the classic Pink Floyd album, The Wall. It’s a good tune – and sometimes, when I’m at work, it pops into my head.
As a physician, I’m more likely to use the phrase “uncomfortably numb” to describe our operating conditions. We like to be more strategic than tactical; however, we often spend our days in survival mode. We devote most of our time taking care of the things that come crashing into our windshield at any given moment. Because of this, we are not always able to remain as engaged in our day-to-day work as we might like to be.
Every member of the care team is susceptible to burnout. I’m part of a team of physicians, nurses and other care givers, and I know all too well that we are all in danger of crashing at some point. We’re all affected by personal and professional stressors.
Today, more than 50 percent of physicians experience burnout. By these numbers, we can consider this an epidemic. There are several causes of physician burnout, which makes this a difficult issue to address. Physicians are particularly susceptible to being caught between the extremes of life satisfaction and life stressors, and it is this spectrum of extremes that can easily lead to burnout. At one moment, we can experience the euphoric feeling of saving the life of another individual. Moments later, we can experience the complete and utter devastation of losing a patient. Despite my best efforts, I personally have had many patients who did not survive – an experience that is never easy.
The root causes of physician burnout
Different physicians may experience burnout in different ways. I tend to break the causes of burnout into four main categories:
For physicians, autonomy is best in moderation – too much or too little autonomy can be a bad thing. Today, some physicians are experiencing a loss of autonomy. For example, as hospitals are acquired by larger health care systems, physicians may have to adapt to more stringent policies and requirements. These are put in place to regulate the way we practice medicine and protect the patient, but for many experienced physicians who are accustomed to established norms, these new constraints can have adverse effects.
Whether we’re interacting with patients, nurses or other physicians, consistent and effective communication ties our entire industry together. In return, poor communication is detrimental to the goals of health care. Every hospital, group practice and solo practitioner should have communication as the top priority on their agenda. Mistakes happen most frequently when communication fails.
Failure to engage physicians can happen on several different levels: between members of the care team, across the hospital system or out among the community as spokespersons for the hospital.
Organizations that do not effectively engage their physicians will find their most valuable advocates lacking loyalty to their mission. Physician buy-in to organizational values is critical to the success of a system.
Physician expectations are increasing at an exponential rate. From taking care of patients to understanding and executing reimbursement models to safeguarding patient and family satisfaction, we often have our hands full.
Organizational responses to burnout
There are several steps a health care organization can take to proactively avoid burnout. Health systems have a responsibility to provide their physicians with a network of support and the option for at-work resources. Community programs, such as group therapy, meditation, well-being classes and yoga plus good nutrition and exercise can combat burnout.
We need to think about physician burnout on the spectrum of depression, because it shares similarities and symptoms. Something as simple as a physician lounge permits private communication in addition to relaxation, and it’s critical to provide physicians a personal space to decompress.
Another critical step a health care organization can take in combating physician burnout is to invest in an IT infrastructure that optimizes the physician workflow.
Physicians need access to flexible EHR training
Technology is meant to be an answer for stressors contributing to physician burnout. When an electronic health record (EHR) hasn’t been properly implemented or physicians haven’t been properly trained, this can be another stressor, especially at the beginning of the implementation.
I like to compare EHRs to more complicated and intimidating medical tools. Consider robotic surgery systems, which are some of the most exciting technologies that medical professionals use today. To operate a robotic arm and perform surgery with this tool requires hundreds of hours of supervised experience. Specialized surgeons must undergo tedious training courses and mock surgeries before they are certified.
We wouldn’t expect to put a surgeon into a room with this tool and ask them to perform surgery without sufficient training, so why should the EHR be any different? It’s critical to give physicians adequate training and a realistic timeline to immerse themselves into their EHRs. By providing the proper resources, we can empower them to use this technology in the most effective manner possible.
Health IT leading the way in the fight against burnout
There are other elements of health IT that are changing the way physicians work. For example, voice recognition technology has been a complete game changer for documentation. Before this technology, physicians spent a significant portion of their time transcribing notes, correcting records or waiting for transcriptionists to deliver valuable documents. Today, we can record our notes once and be done, eliminating some tedious aspects of note taking.
Preparing for visits, especially when seeing a patient for the first time, has also been simplified through the introduction of the EHR. Before its electronic format, physicians might be handed patient records in manila folders, sometimes filled with hundreds of documents from a range of physicians, clinicians and specialists. Now, the patient record arrives through one easily accessible electronic portal. EHRs bring the most pertinent information to the front of the dashboard in an easily digestible format that makes us better – and happier – at our jobs.
Technology has also elevated the patient-physician relationship. Previously, there were few options to communicate with patients other than in-person or over the phone. Today, we have electronic patient portals, apps and telehealth communications that help us engage the patient within their own health care journey more than ever before. From lab results and X-rays to before and after scans of shrinking tumors, we can help the patient take ownership of their health, which improves our relationship. This has made the medical profession more satisfying for physicians and combats some of the deepest roots of burnout.
Health IT tools ultimately provide an outlet to higher satisfaction among members of our profession. Through a healthy mix of on-site resources and improved IT infrastructure, we can effectively decrease burnout by managing expectations, increasing engagement and improving communication for our physicians.
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