How physician burnout worsens patient care

It’s no secret that primary care doctors are getting burnt out.

Last July, I pointed to a study observing that “large numbers of physicians claimed a lack of control of their work, a chaotic work pace and time constraints during patient visits,” and, “more than a quarter complained of burnout. More than 30 percent indicated they would leave the field within five years.”

Now there’s data showing that unhappy physicians provide worse patient care.

Evan Falchuk recently cited study finding “on days the doctors felt positive moods, they spoke more to patients, wrote fewer prescriptions, ordered fewer tests and issued fewer referrals. However, when doctors were in a bad mood, they did the opposite.”

As primary care doctors see an increasing number of patients, combined with more bureaucratic obstacles threatening the physician-patient relationship, they invariably deal with more bad days than good.

Health reformers need to find ways to improve the deteriorating morale of doctors, by offering solutions to strengthen the relationship they have with patients, and the minimize any intrusion in the exam room. Sadly, few of those ideas have been articulated:

Our system too often deprives doctors of the time and space they need to get to know a patient, think about their problem, consult with colleagues, and offer sound advice. These are the things patients want from their doctors. What’s more, doing these things are a big part of why people become doctors in the first place. Unfortunately, there isn’t much of anything in the health care reform proposals that addresses this deeply fundamental problem, and so it will continue, or get worse.

And patient care, unfortunately, will continue to suffer.

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  • http://www.empowerbpo.com Jason Gaya

    Dear Kevin.
    Thanks for the information. I think the paced up environment does the damage to the patient – doctor relationship. The pulls and pushes of the daily hospital routine create escalations. The best way ahead is to use social influence that hospital staff wield over each other. The aim should be listen and discuss each other’s problems, and iron out the problems, if ignored, can lead to confrontations.

  • http://storytellerdoc.blogspot.com storytellerdoc

    Your post makes sense. It seems everyone providing health care is starting to worry more and more about burnout. In the ER, especially, a couple hard, frustrating shifts can set one back for a while, both physically and mentally. More sleep, and you must take care of yourself with some outside interests.

  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    And JCAHO’s easy/pat solution to this (which make it much easier for the suits squeezing every last dime/bit of time out of the doctor to deflect blame), is to label every physician who is not perfect in his/her demeanor as “disruptive”.

    No consideration is given to what comes first . . . the chicken or the egg . . . i.e. what is making doctors so unhappy?

    Nobody talks about staying in “the game” until their 70′s anymore. Almost every doctor of my generation that I converse with these days is talking about getting out within five years. And that’s amazing to me because (as opposed the medico-legal hell two clueless small-town nimrods put me through because I dared defy them to put a patient first), they’ve had relatively “normal” experiences.

    Nothing in any of the “reform” bills I’ve seen has addressed the real issues behind physician burn-out and dissatisfaction. If you think we’ve got a mess now, JUST WAIT FIVE YEARS.

  • ninguem

    Atlas needs to shrug. If getting burned out and overworked, then identify the biggest hassle and worst payments and cut them loose from the practice.

  • VoxRusticus

    The beatings will continue until morale improves!

  • jsmith

    You’re right of course, but you’re preaching to the choir. The rest of society doesn’t care about this issue–at least not yet. Maybe never. I precept med students, a very fun thing to do by the way (temporary anti-burnout measure). But the med students see this and can feel this issue with primary care. It’s turning them off.
    Short term, it will be interesting to see next month’s match results in primary care. Long term, I think the medical profession will hand off adult primary care to the nursing profession (pediatrics is a special case), if they’ll take it. And they probably will. Except for a few dead-enders, docs will all subspecialize. The world will continue to turn, we’ll still get paid. Tough to see my profession die though.

  • http://www.mcgath.com Gary McGath

    As one of your newer patients, I hope you don’t burn out too soon.

  • Rezmed09

    The most common and powerful way for Primary Care to be heard on this issue is to vote with your feet. No matter, market forces will correct the problems that PCP’s are faced with. Market forces will more than likely involve more mid-levels with more specialization. It is the era of Walmart, and cheaper, well trained, specialized mid-levels will replace many PCP’s for the best business solution.

  • AnnR

    A good reason to withhold judgment on your Doc over any one visit.

  • http://dj-astellarlife.blogspot.com/ Diane J Standiford

    Funny, my doctor never is burned out when I visit, never overbooked, has plenty of time with me, easy as pie and a great guy. His clinic ruled to refuse all drug co. sellers. (I bet that gave him extra time) His crew is happy too. Yes, I ask. AND I can tell the miserable doctors, one common theme I note–they overbook. (And take many out of country vacations, oops, I mean speaking engagements for drug companies.) Like any job, do what you love, money will follow. Job situation bad? Work to improve it, that’s what the rest of us have to do—if we love the work we do.

  • http://www.physiciandispensingsolutions.com My2Cents

    I work with a lot of doctors that were initially stressed, due to the increasing demand to see more patients. Adding an ancillary like physician dispensing, will reduce this stress levels doctors experience .

    Doctors can strengthen their relationships with their patients & can move at their own pace. Adding additional patients to make up for lost income isn’t the answer. Adding services that produce ancillary income is a very real solution for most private practices.

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