Burnout is a “Public Health Crisis”

Physician burnout has been called a “public health crisis” that has adverse effects on patients, the healthcare workforce, costs, and physician health.13,2 Provider burnout has been a growing problem in all aspects of healthcare4 for many years. Burnout has been recognized as a significant factor in lowered patient safety, decreased quality outcomes, lower patient satisfaction, and increased costs.5 Burnout is recognized as a major issue for all healthcare providers, including physicians,6 3 nurses,7 8 and medical students.9 Burnout in physicians is an independent predictor of suicidal ideation and substance abuse.10 Recently the high rate of physician suicide, which is the highest rate of any profession,11 has brought the human costs of burnout to greater public awareness.11,12

In 2018, 78% of physicians in the United States reported one or more symptoms of burnout,15 an increase of 4% compared to 2016, and more than 33% consider themselves fully burned out.3 Physician burnout may be under-reported, since one coping strategy is withdrawal from practice by reducing days worked or leaving clinical practice in favor of non-clinical employment. Under-reporting may also be reinforced by cultural mores that deem burnout shameful.16

Physician burnout is not unique to the United States. It has been reported in multiple countries. A 2019 review and meta-analysis of 37 studies involving 15,183 French physicians found 49% had burnout, and 5% had severe burnout.17

The annual organizational costs of physician burnout attributable to turnover and reduced clinical hours is approximately $7,600 per employed physician per year.1 As an example, a health care organization with 100 employed physicians has burnout attributable cost due to turnover and reduced clinical hours of $760,000 per year. There are additional costs associated with medical errors, malpractice lawsuits, lower interpersonal teamwork, reduction in professional effort, and staff turnover. The increasing incidence of physician burnout and its negative impacts on all aspects of health care is an increasing concern for health systems due to decreased patient access, increased physician errors and both direct and indirect costs.14

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References

  1. Han S, Shanafelt TD, Sinsky CA, et al. Estimating the Attributable Cost of Physician Burnout in the United States. Ann Intern Med. 2019. doi:10.7326/m18-1422
  2. Jha AK, Chaoui AA, Iliff AR, Defossez S, Bombaugh MC, Miller YR. A Crisis in Health Care: A Call to Action on Physician Burnout. 2019.
  3. Kane L. Medscape National Physician Burnout, Depression & Suicide Report 2019.
  4. Physician Burnout The Root of the Problem and the Path to Solutions.pdf. 2017.
  5. Bodenheimer T, Sinsky C. From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Ann Fam Medicine. 2014;12(6):573-576. doi:10.1370/afm.1713
  6. Moore LR, Ziegler C, Hessler A, Singhal D, LaFaver K. Burnout and Career Satisfaction in Women Neurologists in the United States. J Women’s Heal. 2019. doi:10.1089/jwh.2017.6888
  7. Sanchez M, Simon A, Ford D. PTSD in Tx ICU Nurses. J Hear Lung Transplant. 2019;38(4):S93-S94. doi:10.1016/j.healun.2019.01.217
  8. Vahedian-Azimi A, Hajiesmaeili M, Kangasniemi M, et al. Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study. J Intensive Care Med. 2017;34(4):311-322. doi:10.1177/0885066617696853
  9. Worly B, Verbeck N, Walker C, Clinchot DM. Burnout, perceived stress, and empathic concern: differences in female and male Millennial medical students. Psychology Heal Medicine. 2018;24(4):1-10. doi:10.1080/13548506.2018.1529329
  10. Dyrbye LN, Meyers D, Ripp J, Dalal N, Bird SB, jan Sen. A Pragmatic Approach for Organizations to Measure Health Care Professional Well-Being. Nam Perspectives. 2018;8(10). doi:10.31478/201810b
  11. Anderson P. Doctors’ Suicide Rate Highest of Any Profession. 2018.
  12. Chou S. Do No Harm: The Story of the Epidemic of Physician and Trainee Suicides. Am J Psychiatry Resid J. 2017;12(4):10-10. doi:10.1176/appi.ajp-rj.2017.120406
  13. West C, Dyrbye L, Shanafelt T. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529. doi:10.1111/joim.12752
  14. Berg S. How much physician burnout is costing your organization. 2018. https://www.ama-assn.org/practice-management/economics/how-much-physician-burnout-costing-your-organization
  15. Hawkins M. 2018 Survey of America’s Physicians: Practice Patterns and Perspectives. 2018.
  16. Hill AB. Breaking the Stigma — A Physician’s Perspective on Self-Care and Recovery. New Engl J Medicine. 2017;376(12):1103-1105. doi:10.1056/nejmp1615974
  17. Ziad K, Laurent B, Marianne H, Villes V, Christophe L, Guillaume F. Burnout in French physicians: a systematic review and Meta-analysis. J Affect Disorders. 2018;246(International Journal of Nursing Studies 52 2015):132-147. doi:10.1016/j.jad.2018.12.056
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