A new report reveals six goals to pursue to prevent and mitigate clinician burnout and foster professional well-being.
Christine K. Cassel, MD
Physician burnout is a major problem and addressing the epidemic requires systemic changes by healthcare organizations, educational institutions, and all levels of government, according to a new report from the National Academy of Medicine.
Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being outlines six goals that these stakeholders should pursue to prevent and mitigate clinician burnout and foster professional well-being.
Recent studies show between one-third and a half of clinicians report experiencing emotional exhaustion, depersonalization and lack of sense of professional accomplishment: the three major characteristics of burnout, according to Christine K. Cassel, MD, senior advisor for strategy and policy, department of medicine, University of California San Francisco, and co-chair of the committee that wrote the report.
“It is a problem associated with the workplace, not a mental health diagnosis,” Cassel says. “It has consequences both for clinicians and for patients, with studies showing negative impact on quality of care and on patient experience.”
Burnout is created by inefficient systems of care, where the resources available do not match the requirements of the clinician’s job, according to Cassel. “Many complex interacting factors play a role, at the level of the front-line care delivery, the healthcare system and the external environment,” she says. “Healthcare executives’ leadership is necessary to spur the awareness, the innovation and the culture changes required to address most of the causal factors. Burnout and its human effects on clinicians and on patients is a moral issue, but it is also a financial issue.”
The Harvard Business Review estimates that burnout costs the healthcare system $4.6 billion per year.
There are methods that health systems can use to achieve accurate data about the extent of burnout in the organization, according to Cassel.
“Leaders and managers should consider these reports part of their top line information for running a high-quality healthcare system,” she says. “A senior executive should be responsible for the data and the response to it. Board should receive regular reports on clinician wellbeing/burnout.”
Burnout is as big a problem among students as it is in clinicians, according to the report.
“Some of the causal factors are specific to the learning environment so professional schools and academic health centers also have major opportunities and an urgent need for improvement,” she says. “While personal characteristics can enhance resilience in a dysfunctional system, personal characteristics alone cannot begin to address the problem. Most clinicians are motivated by higher values of patient care, and many experience moral distress from the daily conflict between what they know they should be doing for their patients and what they actually can deliver given the obligations and constraints of their system.”
Rodrigo Martinez, MD, chief clinical officer of TransformativeMed, says that one of the major factors contributing to burnout is the lack of sensitivity to clinicians’ work flow needs when designing software. “Reducing this workflow friction would go a long way towards decreasing stress,” he says. “Clinicians are trained to identify pertinent positives and negatives, and current designs can overwhelm the end user with extraneous information. Reducing cognitive burden and streamlining manual effort enable more rapid assessments of patient needs and decrease the time needed to take appropriate actions.”
There are six goals that healthcare organizations should pursue to help combat clinician burnout:
“The National Institute of Medicine’s goals 3 and 4-reducing tasks that do not improve patient care and improving the usability and relevance of health IT-are critically important and closely aligned,” said Jay Anders, MD, chief medical officer of Medicomp Systems. “With the burden that EHRs have placed on clinicians that has fueled high rates of stress and burnout, the key will be to leverage other types of follow-on health IT that help, instead of hurt, work flows and efficiency so that they can focus on the reason they got into medicine to begin with: Patient care. To do that, health IT solutions must give clinicians ready access to the actionable information they need at the point of care for sound clinical decision making. That information must be quickly and easily accessible-and structured in the way that clinicians think and work.”