Is health reform contributing to physician burnout?

Many physicians feel burnt-out from their careers

A recent Medscape survey asked doctors of all specialties whether they experienced feelings of cynicism, loss of enthusiasm and low personal accomplishment with their work. Unfortunately, the percentage of physicians with burnout has increased since the last survey in 2013, with 46 percent overall reporting these feelings. When looking at specific specialties, the most burnt-out physicians are critical care and emergency doctors. Half of primary care physicians, family doctors, internists and general surgeons also felt burnt-out. These survey results are alarming as they reflect poor physician well-being.

Physician well-being is a burgeoning area of focus

A generation or two ago, few people talked about the physical and mental health of our doctors. However, in the last decade, researchers have begun to characterize professional burnout and associated problems. For example, physicians have one of the highest rates of suicide compared to other professions. Family physicians and internal medicine doctors are the most likely to say they would not choose their specialty again if they could redo their careers. Psychiatrists and anesthesiologists have a higher rate of substance abuse than other specialists. These studies have cast a spotlight on trying to improve physicians’ satisfaction, well-being, and mental health by addressing the unique challenges physicians face.

My residency program incorporates a wellness curriculum

Trainees face a unique set of circumstances, working long hours in stressful situations. The regulatory body for residency programs has put limits on the hours that interns and residents can work. However, simply changing our work hours is not enough to ensure our mental and physical well-being. In order to help us meet the unique challenges of being medical residents, my residency program developed a curriculum with lectures by psychologists, mediation sessions, reflective exercises and development of coping skills. Although our training is easier than that endured by physicians in the past, residents still develop depression, commit suicide and undergo divorce, and a wellness curriculum helps reduce these devastating consequences.

Burnout is everywhere

Even in my practice, I have colleagues, trainees and supervisors who report some degree of dissatisfaction, frustration and disappointment with their work. I know some physicians who left medicine to work in industry or consulting. Most of those who are burnt out feel that paperwork, bureaucratic tasks, and insufficient reimbursement for the hours worked are the main contributing factors. Unfortunately, changes like the Affordable Care Act or implementation of computerized health care may exacerbate these causes rather than ameliorate them. In pursuing some admirable goals, we cause other unintentional negative consequences.

We need to reduce burnout and improve well-being

Physician burnout affects patient care; burnt-out physicians cannot exhibit the compassion necessary to care for patients, and they are unlikely to go above and beyond their clinical duties. There is an urgent need for research in improving physician well-being, such as training in coping mechanisms, development of mindfulness techniques and restructuring the bureaucracy of medicine. I am early in my career and still go to work with excitement, curiosity, and engagement, but I am deeply aware of the risks of this profession and hope to maintain my well-being. What are your thoughts on physician burnout?

Craig Chen is an anesthesiology resident.  This article originally appeared in The American Resident Project.

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