The coals of occupational burnout have left few unscathed. Pillars of labor, marred by the soot of a faltering economy, sag under the weight of a leaden national morale as the workforce continues to ebb and stall haphazardly. And now, according to a recent Mayo Clinic study, even physicians — champions of hope atop the healthcare mast — are wavering in the heat.
Nearly half of the 7,288 physician participants (45.8 percent) exhibited at least one symptom of burnout, the Mayo study found. Specifics draw the line darker still — 37.9 percent of doctors cited extreme emotional exhaustion, while 29.4 percent reported experiencing a sense of “high depersonalization,” which is, according to the Mayo Clinic, the sensation of watching oneself from afar, significantly displaced from present reality and self.
Analysts posit that this physician Fahrenheit 45.8 won’t be cooling off anytime soon, either.
"The rates are higher than expected," lead author of the Mayo study Tait Shanafelt, MD, told USA Today. "We expected maybe 1 out of 3. Before healthcare reform takes hold, it's a concern that those docs are already operating at the margins."
When contrasted with survey responses from 3,442 non-physician working adults in the United States, 37.9 percent of doctors signaled burnout whereas only 27.8 percent of non-physicians reported the same singe. Moreover, 40.2 percent of doctors reported being disenchanted with their work-life balance compared to the 23.2 percent reiterating similar dissatisfaction in the non-doc control group. Study authors labeled such results as alarming, but other correspondents familiar with healthcare’s heat were far from astonished.
“Does it surprise me that a good proportion of physicians experience some form of elevated stress?" Terrance Bedient, vice president of the Medical Society of the State of New York, in Albany, opined for HealthDay News. "No, it does not. Everyone is subject to the stresses of personal issues and social concerns related to the family. But physicians also labor under particularly high expectations and demands, increasingly limited independence, and a dropping rate of compensation, historically speaking, for their work."
Researchers found that the heightened demand drive for doctors initially sparks on the degree path — those who possessed an MD or a DO degree were more likely to experience burnout than other college degrees, the study noted. From graduation day onward, depending on specialty, a doctor’s road to practice success can be riddled with several more burnout detours along the way.
"There have been other studies done on doctor burnout, but we assumed it was the surgical specialties who would be at primary risk," Shanafelt said. "Instead we found out it's the physicians on the front line of care who are at the greatest risk."
The highest rates for burnout among specialties were discovered in emergency medicine, general internal medicine, neurology and family medicine. Pathology, dermatology, general pediatrics and preventive medicine displayed the lowest burnout rates.
The consequences of burnout can be fairly devastating: Quality of care can face a serious downturn as medical errors and early retirement go on the upswing.
"This is relevant to patients and doctors alike, because physician burnout and dissatisfaction have been linked to poorer patient outcomes, medical errors, patient dissatisfaction and serious physician issues such as suicidality," co-author Colin West, MD, at the Mayo Clinic's divisions of general internal medicine and biomedical statistics, told HealthDay News. "Also, with healthcare reform and anticipated increased demand for front-line care providers, the severity of distress among these physicians is particularly concerning."
Bedient spoke of resources available to physicians to assuage burnout and thus, keep them practicing longer, happier.
"State medical and physician support programs, which are already in place in every state in the country, have been extraordinarily successful in helping doctors with this and other kinds of stress-related problems," Bedient said. "The difficulty is that physicians, like people in general, often have trouble figuring out where to turn for help. So we really have some work to do to encourage physicians to look at their own stresses, figure out what kind of help they need, and to feel comfortable reaching out for that help when they need to."
Other studies conducted on behalf of physician burnout further the need for lawmakers to produce solutions quickly. A report from Physician Wellness Services and Cejka Search showed that of the 2,000 doctors surveyed, 87 percent experienced stress and burnout on a daily basis. An earlier national report by physician Mark Linzer, MD, director of the Hennepin Healthcare System in Minneapolis, found that 26.5 percent of doctors mentioned burnout, citing more than one symptom.
"The Affordable Care Act is going to put more pressure on the front lines,” Linzer told USA Today. “This new study could be an important wake-up call the country needs to hear to build healthcare teams to meet the need."
Coordination on the provider frontlines, Linzer added, is key to easing the burn in the meantime.
"It used to be all about the clinician caring for the patient. Now it needs to be the clinician, nurse, care coordinator and others. When you start expanding the numbers of types of people who are caring for a patient, that helps a doctor and patient a lot."
For the sake of physicians and patients, Mayo and other medical experts alike hope this fire won’t reign in the years to come.
“The fact that almost 1 in 2 U.S. physicians has symptoms of burnout implies that the origins of this problem are rooted in the environment and care delivery system rather than in the personal characteristics of a few susceptible individuals. Policy makers and health care organizations must address the problem of physician burnout for the sake of physicians and their patients," the current Mayo team concluded in their report commentary.
The study was published in the journal Archives of Internal Medicine.
Photo attributed to Menchi via Creative Commons license.