Exhausted Doctor Leaning by Window

Physician burnout is a fact of life in the health care industry. How is your organization addressing this malady?

Industry trends

How to Diagnose and Remedy Physician Burnout

  • Curt Mayse
  • 8/29/2017

“I don’t like doing this anymore.”

“I wish we could go back to a simpler time.”

These statements are warning signs, and it is likely that most physicians have had these thoughts, even if they have not voiced them.

Leading practices are asked daily to live up to high expectations in all facets of practice management, and physicians are critical to improving overall leadership, staff morale, and productivity. When they are absent or not living up to the group’s expectations, it effects the entire practice.

Burnout makes it nearly impossible for individual physicians to provide compassionate care for their patients.

Physician burnout is so common in medical group practices across the country that many professionals are struggling to find tangible solutions to address this epidemic. Making small steps in the right direction may involve improving staffing levels or technology and operations, but the biggest impacts can come from proactive leadership and better communication.

What is burnout?

Burnout makes it nearly impossible for individual physicians to provide compassionate care for their patients. This long‐term stress reaction is characterized by depersonalization, including cynical or negative attitudes toward patients, emotional exhaustion, a feeling of decreased personal achievement, and a lack of empathy for patients.

Burnout progresses through various stages. In the early phase, a physician might have a feeling of dissatisfaction or a lack of enjoyment in the job. Disengagement goes a step further to the feeling that, “I don’t want to do this.” Disengaged physicians are no longer invested in the organization because they can no longer see themselves involved in the future of the group. Burnout in its final stage is simply, “I can’t do this anymore.”

On an individual level, the manifestations of burnout tend to fall into five categories:

  1. Apathy toward colleagues
  2. Indifference to patients
  3. Loss of joy in the practice of medicine
  4. Feeling overwhelmed and frustrated
  5. Increased mental health concerns

Contributing factors

When objectively looking at practices facing physician burnout, it is important to ask what personal and organizational factors can contribute to the situation. The most common environmental causes include:

  • Lack of control over work conditions
  • Financial pressures
  • Time pressure
  • Chaotic workplaces that are inefficient and frustrating
  • The perception that voiced concerns or needs are not being heard
  • Technology difficulties
  • Lack of alignment on values (around mission, purpose, and compensation) between providers and their leaders

Organizational consequences

Symptoms of burnout may occur from time-to-time, but like any illness, a chronic condition has serious implications for physicians, their patients, and the organizations they serve. The business consequences for medical groups include negative patient experiences, poor quality of care, and difficulty recruiting and retaining physicians.

Remedies for burnout

So how do you recognize and remedy physician burnout? Improving physician engagement is one approach, and many organizations already have strategies to engage physicians in activities to keep them enthusiastic. However, when significant physician burnout sets in, leadership is tested. By measuring and responding to burnout, leaders are able to reduce stress, intervene with programs and policies that support professional well‐being, and ultimately alleviate or prevent burnout.

One useful tool is having “meetings with meaning.” Clinicians have limited time to meet, and research indicates that restructuring meetings to address clinical cases or challenging patients and issues that concern them, rather than administrative issues, reduces clinician stress. These restructured meetings have a defined timeframe and a limited agenda that both engages physicians and respects their needs. Necessary administrative work must be accomplished, but a four-hour board meeting at the end of a day frustrates everyone.

Another key issue to address early is physicians’ sense of lack of control. Physicians spend a great deal of their professional life training to be in positions of autonomy, and suddenly they are thrown into a group practice and asked to “reduce variation” or “standardize clinical behavior.” This can be tough for experienced physicians. Thankfully, there are many ways to improve feelings of control and reduce feelings of chaos. Leadership can explore options such as:

  • Providing more part‐time options or flexible scheduling, such as seven days on, seven days off for ambulatory practices, or flexible scheduling at the beginning and end of the day for clinicians who are parents
  • Consistently scheduling support staff (e.g., medical assistants or nurses) with the same providers
  • Outsourcing time‐consuming tasks, such as coding, to other departments or other staff
  • Implementing a scribe program to reduce documentation time
  • Piloting a call “cap and trade program” in which providers are compensated more if they are willing to take more call time. This may relieve the burden on providers who find it difficult to take call shifts because of personal obligations.

There are many approaches to addressing physician burnout, but you have to recognize the symptoms and take a first step. In a recent Minnesota Medicine Magazine article, David Rothenberger, the Jay Phillips Professor and chair of the department of surgery at the University of Minnesota still sees a bright future regardless of the pressures of the profession:

Despite countless stressors, medicine remains extremely rewarding. But what motivates most physicians, including surgeons, is not ruthless competition, not regal salaries, not relentless regulations. As Daniel Pink asserts in his book Drive, truly healthy motivation is not about money, power, or prestige. Instead, it’s about autonomy, creativity, and purpose. Our profession still offers the opportunity for a relatively autonomous, creative and purpose-filled career, but only if it doesn’t overwhelm us first!

How we can help

Burnout is a serious condition that affects the productivity of any organization. CLA professionals offer a breadth of experience from a wide range of clinical settings. We draw on years of experience serving the health care industry as well as our national resources to help you address your unique challenges.