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Physician Burnout is A Problem We Must Address Now

This blog post excerpts an article by Dike Drummond, MD in the Q4 2015 issue of PX Advisor, our quarterly magazine designed to bring you thought leadership and best practices for improving the patient experience.

It is my belief that the epidemic of physician burnout may be the single largest negative influence on many organizations’ culture, performance, and profitability.

The Prevalence of Physician Burnout

Burnout prevalence has been exhaustively studied in all major specialties and in most first world nations over the last three decades. Here is a telling quote from one of the key researchers: Burnout rates may be higher in the American healthcare industry than in the rest of the world. The 2015 Medscape Physician Lifestyle Survey reported a burnout rate of 46%. This was up from 39.8% in the 2013 survey.

Why is Physician Burnout Important?

Burnout is directly linked to an impressive list of pervasively negative consequences:

  • Lower patient satisfaction and care quality
  • Higher medical error rates, and malpractice risk
  • Higher physician and staff turnover
  • Physician alcohol and drug abuse and addiction
  • Physician suicide

No other internal or external factor has a more negative impact on your organization than burnout.

What is the Pathophysiology of Burnout?

Burnout is a disorder of energy balance. Imagine that each of us has an internal energy account holding our life force. Like a savings account at your local bank, your internal energy account can be in a positive or negative balance. The balance in your energy account has a powerful influence on the quality of your performance, especially for physicians.

Simply stated…

  • We use energy/life force for the activities of our life and medical practice.
  • We recharge the account during times of rest and rebalance.

Burnout is the constellation of symptoms that occur when your energy account is in a negative balance. You can continue to function in this depleted state—i.e., residency is a work hardening experience where physicians learn to practice with a negative energy balance. However, dozens of studies show skills and performance suffer when you have a negative energy balance.

Burnout’s Three Cardinal Symptoms

The accepted standard for burnout diagnosis is the Maslach Burnout Inventory, developed by Christina Maslach at the University of San Francisco in the 1970s. Her team was the first to describe burnout and name the syndrome. Here are the three main symptoms:

  1. Exhaustion - The physician’s physical and emotional energy levels are extremely low and in a downward spiral over time. A common thought process at this point is, “I’m not sure how much longer I can keep going like this.”
  2. De-personalization - This is signaled by cynicism, sarcasm, and the need to vent about your patients or your job. This is also known as “compassion fatigue.” At this stage you are not emotionally available for your patients, or anyone else for that matter. Your emotional energy is tapped dry.
  3. Lack of Efficacy - You begin to doubt the meaning of your work. A common thought is, “What’s the use, my work doesn’t really serve a purpose anyway.” Or you may worry that you will make a mistake if things don’t get better soon.

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