Clinician Burnout Persists

An expert weighs in on how organizations can make the business case to address systemic problems that contribute to physician fatigue.

The healthcare industry has been battling clinician burnout for years, yet the problem rages on.

Indeed, The Physicians Foundation most recent survey of more than 17,000 physicians across the United States found that more than 48% experience feelings of burnout almost always or constantly, with an additional 25% reporting that they experience some feelings of burnout. 

However, physicians aren't suffering in silence the way they might have five or 10 years ago. Today's healthcare leaders are acutely aware of the problem.

"We continue to wrestle with physicians' ability to enjoy practice," says James Bleicher, MD, MHCM, regional president of SSM Health's St. Louis-Missouri market.

For insights into what experts do know about preventing and healing burnout—and where leaders like Bleicher can go from here—HealthLeaders spoke with Russell Libby, MD, board member of the Physicians Foundation and founder, president and medical director of Virginia Pediatric Group.

HealthLeaders Media: Do we have any good news on the burnout front?

Russell Libby, MD: Yes, I think we're learning a lot, and we have some really top-flight people focused on that and some meaningful institutions trying to create a rally around it.

If you look at the Mayo Clinic, Stanford, the American Medical Association—these are all organizations that are trying to identify root causes, trying different solutions to help to improve, and measuring as they go so they have a sense of what's working and what's not working.

Related: Stop Ignoring Physician Burnout

HLM: What are the ongoing barriers?

Libby: Leaders must understand that this is going to be an ongoing and everyday process that has to be integrated into the way any of these places operate.

It is an essential thing for us to consider whenever we look at and measure the quality of a health system: Are they looking at their work force and are they measuring their joy in practice and professional satisfaction?

Are they adapting and adjusting to the changes they need to make? And are they able to reflect that in better outcomes, more cost-efficient care, and better patient engagement?

HLM: What steps is the Physicians Foundation taking to facilitate these changes?

Libby: We at the foundation are trying to create opportunities for groups who are in a situation where they've thought about this and might need some funding to be able to implement some of these programs and get the data that they need to be able to substantiate a real business case that seems to be necessary for most of these institutions to actually implement change, and to change the way they operate and deal with physicians.

We're getting more data. We're also trying to at the Foundation help support national/international conferences, summits, places where we're getting people together to share their experiences, ideas, and to publish consensus work.

HLM: On top of the strains physicians have already been facing from regulatory burdens, electronic health records, etc., now their reimbursement is making a protracted transition from fee for service to value. How does that contribute to physician fatigue?

Libby: You're going to find that when you start changing the rules all of a sudden, you can't change the way you operate quite as quickly—it creates a lot of stress for people for sure.

Related: Feedback Floods in on CMS's Proposed Physician Fee Schedule

I think when doctors don't understand how they're being measured but they're aware of the threat of seeing more patients and being paid less, it undermines their sense of comfort and fulfillment.

And there is at least a listening ear from CMS more so than there ever was. I commend them for being willing to listen and to delay implementation of certain legislative mandates and to find ways to help doctors to adjust without undermining their practice integrity—but it's really hard.