Recognizing the Signs of Physician Burnout

Burnout is an occupational hazard for high achievers, so it's no surprise that it is becoming more common and severe among physicians, who tend to be very high-achieving individuals. Physicians who face burnout are often the ones who are most passionate about what they do, making burnout more difficult to detect and prevent.

What is Burnout?

Burnout is a condition of chronic stress, and can result in exhaustion, cynicism, and feelings of ineffectiveness.

The physician mired in burnout has difficulty functioning effectively on either the professional or the personal level. About half of all physicians are affected, with female physicians being somewhat more likely to experience burnout.

Prevalence is especially high among the critical care, urology, and emergency medicine specialties, all at 55%. Family medicine and internal medicine follow closely at 54%. For comparison, burnout rates in the non-physician population is generally around 25%.

Why Is Physician Burnout On the Rise?

Burnout rates for doctors in 25 specialties have increased in recent years, according to a Medscape Lifestyle Report. Symptoms reported included feelings of lack of accomplishment, cynicism, and generally not liking coming in to work.

Physicians want to spend time caring for patients, yet they bear increasing responsibility of documentation to comply with regulations and to make sure the practice makes enough money to stay in business.

Bureaucratic Tasks #1 Cause of Burnout

Physicians were asked to rate causes of burnout on a scale of 1-7 in the Medscape Lifestyle Report, where 1 equals "Does not contribute at all" and 7 equals "Significantly contributes." Top on the list, with an average rating of 4.8, was having too many bureaucratic tasks, followed by too many work hours (4.1) and increasing computerization at 4.0. 

According to Medscape, many physicians commented anecdotally to this questions, adding further factor that contributed to burnout. By far the most frequently noted were insurance issues. Others often mentioned causes were threat of malpractice, the change to ICD-10, and lack of patient respect and appreciation.

In general, the physician experiencing burnout isn't tired of caring for patients, but is overwhelmed by the sheer administrative complexity of today's practice. And since administrative requirements seem to always be increasing, burnout rates are increasing too.

What are the Early Signs of Physician Burnout?

Burnout can sneak up on you, so it's important to periodically ask yourself some key questions:

• Am I overly critical or cynical at work?
• Do I hate coming in to the office?
• Have I been irritable or impatient with coworkers or patients?
• Is my energy level dropping?
• Do I find my work not satisfying sometimes?
• Am I disillusioned about being a physician?
• Am I relying on drugs or alcohol (or excess food) to cope?
• Are my sleep and eating patterns off?
• Do I have unexplained physical symptoms like headaches or backaches?

The more "yes" answers, the more likely you are experiencing burnout. It's important to note that these symptoms can indicate other health conditions, like depression or thyroid problems, so consulting your own doctor is advisable.

Preventing Physician Burnout

Preventing burnout requires developing healthy thinking patterns, which begins with recognizing signs of fear of failure or perfectionism. Many physicians have tremendous compassion for patients, yet have little compassion for themselves when they need it.

Are you doing the best you can? Does your family know you love them? Do your patients have trust in you? If so, you deserve some of that compassion you so freely give to others.

Some doctors believe that preventing burnout will ultimately have to begin during medical training, because in many cases, that's where the seeds of burnout are planted. Some medical schools and major clinics have already started incorporating wellness programs for students and physicians in an effort to prevent burnout.

Coping with Burnout

The first step to coping with burnout is acknowledging that it exists and not being afraid to talk about it. Doctors will have to demand and work toward building work environments that provide sufficient support for the doctor-patient relationship, rather than sacrificing that relationship on the altar of administrative chores.

Hospitals and healthcare system executives also need to recognize the dangers of physician burnout and support efforts to prevent it. If too many work hours, bureaucratic tasks, and increasing computerization are contributing to physician burnout, it's time we find ways to tackle these problems.

According to the 2016 Practice Profitability Index Report, almost two-thirds of physicians (64%) spend a day or more per week on administrative tasks (also the #1 reason for merging/selling a practice). Reducing administrative tasks can be as simple as improving workflows at your practice. Improving workflows within the practice is the most powerful antidote to burnout. This approach increases the odds of reducing burnout six‑fold.1

If physicians are spending 1 day or more a week on administrative tasks and improving workflows can help reduce administrative tasks, physicians should then be able to reduce their working hours. Don't be afraid to create new work schedules to help prevent physician burnout. 

[Visit AMA Steps Forward for more great tips on preventing physician burnout]

Recognizing and seeking help for imminent burnout, learning new thinking strategies, and putting technology to work automating administrative processes can all keep the busy physician from succumbing to full-fledged burnout.

1 Linzer M, Gerrity M, Douglas JA, McMurray JE, Williams ES, Konrad TR. Physician stress: results from the physician worklife study. Stress Health. 2002;18(1):37‑42.

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