Burnout among physicians and advanced practice providers (APPs) is one of the most critical issues in healthcare.
Roughly half of these professionals reported at least one burnout symptom, such as emotional exhaustion and detachment from patients, in a Mayo Clinic survey.
When burnout strikes, a health professional’s ability to provide quality care is diminished, and the likelihood of a safety mishap or medical error rises. Physician burnout costs the U.S. health system approximately $4.6 billion annually in turnover, reduced productivity and other costs.
Across-the-Board Impact of an OB-GYN Hospitalist Program
A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.
In extreme cases, burnout leads to suicide. A physician commits suicide every day in this country—twice the national average. The trauma of a colleague’s suicide has touched the lives of most U.S. physicians and APPs.
Years ago, a colleague of mine committed suicide—and I still wonder if that could have ended differently, if attention were focused on this problem like it is now, if a support network was in place and if we had understood more about stressors and how organizations can help reduce them.
We ask physicians and APPs to be productive and efficient, to prevent safety mishaps and medical mistakes, to provide incredible care despite grueling schedules and to do all this at an affordable price. Documentation and complex new technologies add to this already significant burden.
We did not get here through a single cause, and no single solution will fix it. Burnout is a constellation of symptoms, requiring a multipronged strategy. A leading voice in this effort, Stephen Swensen, M.D., professor emeritus, Mayo Clinic College of Medicine and Science, created a holistic model to combat burnout.
At Banner Health, our burnout strategy—Cultivating Happiness in Medicine (CHIM)—is based on that model, tailored for a large, multistate health system. It includes incorporating burnout into our enterprisewide operating plan and strategic initiatives, annual measurement and designating a team to oversee these efforts.
As part of CHIM, for example, we have a support program for “second victims,” providers involved in an adverse patient event or injury. Recognizing second victims in no way lessens the focus on the patient, but it is essential to help professionals recover and to learn and acknowledge what was their fault and what was not, to help them be ready for other patients who need their help.
Measurement is also essential. We previously used surrogate measures of physician/employee engagement: is this a great place to work, a great place to receive care, etc. In 2018, we began more specific measurement using the Maslach Burnout Survey. From 2017 to 2018, we saw 60% improvement in physician engagement, 36% less physician turnover and 46% improvement in electronic health record speed.
Our experience, over the last 18 months, gives me great optimism.
But the call to action applies to all of us: A decade from now, physician burnout should be rare. We owe it to clinicians to build workplaces where they can thrive and focus on the mission of healing that brought them here.
Marjorie Bessel, M.D., chief clinical officer for Phoenix-based Banner Health, has made ending physician burnout her top priority.