Nearly 50 years have passed since the first published mention of physician burnout. Clinical psychologist Herbert Freudenberger described the “excessive demands on energy, strength or resources” and wrote of how it resulted in “fatigue, frustration, cynicism.” And though initiatives, programs, and solutions to address burnout have grown, the concerns first cited in 1974 have grown as well—now reaching the undeniable crisis.
In a recent survey, 61 percent of physicians reported feeling burned out in 2021. That represents more than a 50 percent jump compared to three years prior. No doubt, COVID-19 amplified this issue, with physicians today feeling more overwhelmed, overburdened, and under-supported than ever. Staff shortages, rising costs, shrinking margins, and greater technological and operational complexity… all of that contributes to the pressures that primary care physicians (PCPs) face.
A burned-out, unhappy workforce impacts the physicians themselves and shrinks access to care, with high turnover rates resulting in higher health care costs across the board. Nearly $1 billion of excess health care expenditures for public and private payers annually can be attributed to PCP turnover, with more than a quarter of that specifically connected to burnout.
Perhaps surprisingly, many physicians remain hopeful—and that represents an opportunity for transformation and turnaround. Amid the host of challenges that physicians face, 46 percent of them would still recommend entering the medical field to younger generations. PCPs haven’t lost the desire to care for their patients or to make a difference in their lives; they’ve just grown fed up with a system that impairs their ability to do so.
Fifty years is far too long to wait for a real solution to a crisis that should never have existed to begin with. Our physicians deserve personal and professional fulfillment and a system that fosters their ability to help patients live healthier lives. It’s time to empower physicians to realize the true impact and promise they could have in their communities.
Realizing a new reality for PCPs requires a new system
To address these problems, we must reimagine the primary care model and move away from the traditional, reactive, volume-based approach. We must move to a model that focuses and incentivizes meaningful, relational care experiences.
A critical part of this new model is to adopt a team-based approach to care that has been proven to reduce clinician burnout effectively and lead to improved patient outcomes. With the support of an extended care team—and with the right data and technologies to automate, prioritize and inform interactions—PCPs gain the expanded bandwidth and freedom they need to put more focus toward providing personal, expert care to every patient.
Another essential part of this model is incentivizing quality rather than just quantity. Transitioning from the current fee-for-service system (FFS) to a model that includes value-based and prospective payment structures will enable PCPs to deliver longitudinal, proactive care that improves clinical and financial outcomes for all. The FFS model has hindered this kind of meaningful care. Or, to put it more bluntly, very little joy (or quality) can be produced in volume-based anything.
PCPs remain critical in helping communities thrive, but we can’t accomplish true change without a drastic shift in our health care landscape. By putting into place solutions and infrastructure that support physicians and patients by prioritizing relationships and outcomes, we will see a transformative impact on our physician workforce—leading to increased quality of care, improved patient outcomes, and reduced costs.
Christopher Crow is a physician executive.