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Analysis

Physician Burnout: Professional Identity could be Key Factor

By Christopher Cheney  
   July 27, 2018

For physicians, nourishing core professional values such as curiosity and love of knowledge could ward off burnout.

The practice of medicine has changed in ways that are damaging the professional identity of physicians and fueling burnout, a cardiologist and medical school professor says.

Knowledge is at the heart of the physician identity, says John E. Brush Jr., MD, FACC, a cardiologist at Sentara Healthcare in Norfolk, Virginia, and professor of medicine at Eastern Virginia Medical School in Norfolk.

"Physicians study hard to become who they are. They became board certified specialists by taking exams that certify that they have the requisite amount of knowledge to call themselves specialists. But the current practice environment has blown physicians off course," Brush told HealthLeaders Media this week.

Among physicians, automation and business-like relationships in clinical settings have eroded the veneration of scientific knowledge and the desire to apply knowledge that benefits patients, he says.

"Medicine has become so automated and transactional that physicians have forgotten about that central mission and have lost their sense of professional identity."

Dehumanizing effects
 

Several factors practice environment have become dehumanizing for physicians, Brush wrote in a recent JAMA Cardiology article.

"Physicians are now spending more time with computers

and less time with patients. They are pushed to provide greater productivity but are burdened with increasing administrative tasks, leaving little time for reflection and study. They have become homogenized into providers, a term that signifies how transactional medical care has become."

Digital innovation is threatening to overtake the reliance on physician knowledge and reasoning for medical judgment, Brush wrote.

"This is the digital age of dizzyingly rapid innovation involving digital health, big data, precision health, and artificial intelligence. Disruptive innovations could revolutionize how clinical problems are solved."

Brush told HealthLeaders that two developments have had particularly profound impacts on the practice environment: electronic medical records and the drive toward more productivity measured by relative value units.

"These factors have had a dehumanizing effect on medical practice. These factors have also distracted physicians from their central mission—to use specialized knowledge to improve the health of their patients."

Battling burnout
 

Reconnecting with devotion to knowledge can help physicians regain their sense of professional identity and curb burnout, Brush told HealthLeaders.

"Having a firm idea of identity can re-humanize physicians and give them a renewed sense of mission. Remembering the love of knowledge and renewing the sense of curiosity and wonder of science can provide a beacon—a true north—that can re-orient physicians and help them avoid burnout."

Knowledge and professional identity are essential to warding off physician burnout, he says.

"A firm appreciation of knowledge and a clear sense of professional identity can give them resilience. Physicians need to have the courage to stand firm against the distractions of modern medicine and nurture their love of knowledge. A renewed love of knowledge can be the cure for physician burnout."

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


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