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Analysis

Physician Burnout Crisis Declared by Massachusetts Healthcare Organizations

By Christopher Cheney  
   January 17, 2019

The crisis declaration includes a call for three interventions to help physicians and their employers address burnout.

The Massachusetts Medical Society and three other Bay State healthcare organizations have declared physician burnout a public health crisis.

Recent research indicates that nearly half of physicians are experiencing burnout symptoms, and a study published in October found burnout increases the odds of physician involvement in patient safety incidents, unprofessionalism, and lower patient satisfaction.

"We need our healthcare institutions to recognize burnout at the highest level, and to take active steps to survey physicians for burnout and then identify and implement solutions. We need to take better care of our doctors and all caregivers so that they can continue to take the best care of us," Alain Chaoui, MD, president of the Massachusetts Medical Society and a practicing family physician, said in a prepared statement.

In a report released today, the medical society calls for urgent action in tandem with the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the Massachusetts Health and Hospital Association.

In addition to alarmingly high physician burnout rates, the report lists several dire consequences associated with the phenomenon.

  • Burnout reduces the work effort of physicians about 1%, which is equivalent to losing the graduates of seven medical schools each year
     
  • Burnout-related departures from the medical profession are worsening the country's physician shortage, which is estimated to reach 120,000 by 2030
     
  • Research has linked burnout with medical errors

The Massachusetts report's call to action includes three interventions to reduce physician burnout.

1. Addressing mental health
 

Efforts should be initiated immediately to stop stigmatizing physicians with burnout, the report says.

"Physicians face stigma and professional obstacles to seeking appropriate care and treatment for burnout and related mental health concerns. Physician institutions — including physician associations, hospitals, and licensing bodies — should take deliberate steps to facilitate appropriate treatment and support without stigma or unnecessary constraints on physicians' ability to practice."

In addition, statewide physician health programs are needed to help encourage physicians to seek help for symptoms of burnout, the report says.

2. Improving electronic health records
 

in a recent survey, EHRs were the top "pain point" at physician practices.

The report makes four recommendations to ease the EHR burden on physicians.

  • Involve physicians in efforts to develop user-friendly EHR technology
     
  • Allow software developers to craft apps for certified EHR systems to boost functionality and usability
     
  • Establish application programming interfaces that enable third parties to develop apps for EHRs
     
  • Develop artificial intelligence capabilities such as analyzing physician narratives and clinical documentation

3. Appointing chief wellness officers
 

Research shows effective leadership can have a significant impact on physician burnout. The report calls on health systems and hospitals to have chief wellness officers with five primary responsibilities.

  • Assess the organization's levels and extent of burnout
      
  • Establish quality improvement goals and processes as well as report findings about key areas such as wellness and physician satisfaction
     
  • Report findings, trends, and strategies to C-suite leadership and boards of directors as a dashboard metric
     
  • Develop technological and staffing approaches to easing physician work and administrative burden such as scribes and EHR improvements
     
  • Propagate successful approaches to curbing physician burnout

Skeptical perspective
 

While there is widespread concern in the medical community over physician burnout, alarm over the condition is not unanimous.

In September, a JAMA editorial claimed there is insufficient data about physician burnout to guide an effective response to the phenomenon.

"The term burnout has taken on meaning far beyond what is understood about it as an actual diagnosis or even a syndrome. The medical profession has taken a self-reported complaint of unhappiness and dissatisfaction and turned it into a call for action on what is claimed to be a national epidemic," the editorial says.

Focusing on physician burnout, which is a relatively new diagnosis, could be dangerously misguided, a co-author of the editorial, Thomas Schwenk, MD, professor of family medicine and dean of the school of medicine at the University of Nevada in Reno, told HealthLeaders in September.

"What is more important to note is the high level of depression as a criterion-based diagnosis, with a more clear understanding of pathophysiology and consequences including student, resident, and physician suicide. This would be a more worthy area of focus. It is possible that the use of the term 'burnout' has increased as a sort of more acceptable substitute for a diagnosis that still carries considerable stigma, namely depression," he said.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

Recent research indicates that nearly half of physicians have burnout symptoms.

Consequences of burnout include increased medical errors and worsening of the country's physician shortage.

Proposed interventions to address physician burnout include improvement of electronic health record systems.


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