“In nothing do men more nearly approach the gods than in giving health to men.” -Cicero
‘Burnout:’ loss of enthusiasm, low sense of accomplishment, along with persistent feelings of exhaustion and ineffectiveness pervade the medical profession according to a spate of recent studies and articles. The statistics are jarring: research demonstrates that the level of physician burnout has trended upwards in the past two years, with a 25% increase over a four-year period, and all indications suggest no change in course.
An article in the Archives of Internal Medicine about a 2012 study reveals a gloomy picture. The study supporting this conclusion included responses and data from a large sample of physicians nationwide representing a range of disciplines. The findings demonstrated that not only was burnout more common among physicians than other workers throughout the United States, but physicians in specialties at the front line of care were found to be at the greatest risk. The 2016 Medscape Physician Lifestyle Report delivered similar findings, reporting that almost half of all physicians stated that they had experienced burnout. An analysis from researchers at the Mayo Clinic and the American Medical Association likewise reported that doctors’ work-life balance is worsening, with the conclusion that patient care will be negatively impacted.
Even more concerning was data reported in a study published in The Journal of the American Medical Association, suggesting that the rate of depression among doctors in training is much greater than in the general population. The negative effect of burnout among doctors is, moreover, linked to alarming consequences including higher rates of medical error with increased malpractice exposure, larger numbers of staff turnover, physician alcohol and drug abuse, and even suicide. While it is believed that fatalities from physician burnout are underreported, research does reveal that the suicide rate among doctors surpasses that of the general population.
In response to the national epidemic of physician burnout, a chief wellness officer has been added to the staff of Stanford Medicine. In an unprecedented move for an American academic medical institution, Tait Shanafelt, MD is now leading Stanford Medicine’s pioneering program in the area of health care provider wellness. At a time when physician burnout has “nationally reached an all-time high,” Dr. Shanafelt directs the WellMD Center at Stanford Medicine, while serving as associate dean.
Shanafelt has broken new ground in the field of wellness among medical professionals by creating and assessing numerous national surveys that have collected information from over 30,000 physicians and 9,000 workers from other disciplines nationwide. The survey results have confirmed increasing rates of burnout among doctors; in 2014, more than 50% of those surveyed were suffering from “emotional exhaustion, loss of meaning in work, or a sense of ineffectiveness and a lack of engagement with patients.” Shanafelt’s studies have established that while physicians suffer, patients do as well, since burnout leads to increased errors and higher rates of mortality among hospitalized individuals.
Shanafelt opines that the trend of physician burnout is “eroding the soul of medicine.” While many leaders in healthcare recognize that burnout is a serious problem, most do not know how to effectively address it. Complicating the problem, physician distress remains a fairly taboo subject in the workplace. To date, stress management and burnout prevention are not covered comprehensively in medical school or residency training. Shanafelt is working to build and strengthen Stanford’s innovative WellMD Center, where more than 200 physicians have worked since 2016, by implementing peer support, stress reduction, and programs aimed at cultivating compassion and resilience. Another focus of the center’s work is a reduction of pressure among physicians through an improvement in efficiency and simplification of workplace systems.
The first American Conference on Physician Health took place in October at the center, co-sponsored by the American Medical Association and the Mayo Clinic. The primary goal of this event was the creation of a national dialogue surrounding the issue of physician burnout, and the implementation of tools to address physician distress with programs that promote “physician autonomy, efficiency, collegiality, and a sense of community.”
At A4M/MMI, we recognize that the significant and growing problem of physician burnout poses a direct threat to quality of patient care. We believe that there must a collective shift in attitude so that we can move towards an optimal system of healthcare. Only with recognition of the problem will we reach our goal, and help physicians feel motivated and passionate, while moving away from those traditional practices that inevitably lead to doctor burnout. For the past quarter of a century, we have continued the journey to help reshape and redefine the face of medicine, with the goal of reinvigorating physicians so that they can more effectively heal their patients. A4M/MMI faculty emphasize the importance for healthcare practitioners and professionals to rediscover and renew their professional passion, while learning new and innovative methods to prevent burnout before it takes hold.