Recognizing the Signs of Physician Burnout in Your Healthcare Facility

Physicians are extremely hard-working professionals. It is simply impossible to endure the rigors of medical education and training without knowing how to work hard. However, physicians have no special immunity against burnout. In fact, physician burnout rates are higher than burnout rates in other professions. Moreover, the prevalence of physician burnout is steadily increasing as physician workloads are increasing.

‍What does physician burnout mean for your institution?

‍Numerous studies have shown that physician burnout results in substantial professional and institutional problems. Patients treated by burnt-out physicians are substantially less satisfied than patients treated by healthy peers. Physician burnout leads to added and more serious medical errors, which opens the physician, institution, and the ensuring entity to litigation. Indeed, physician burnout sharply increases the risk of depression and substance abuse. Impaired physicians are even more likely to commit medical errors and are even more vulnerable to adverse litigation.

In short, undetected and untreated physician burnout is a potential catastrophe for your healthcare facility.

‍Detecting the signs of physician burnout

There are three key signs to watch for when looking for physician burnout5

• Burnt out physicians experience mental or emotional exhaustion
• Burnt out physicians depersonalize their patients
• Burnt out physicians no longer believe their work is meaningful

Unfortunately, physicians are adept at hiding or burying the signs burnout, perhaps until serious consequences arise. Therefore, managers must focus on early detection.

At the risk of burdening physicians with yet another form to fill out, managers can request physicians fill out annual "burnout" surveys. The Maslach Burnout Inventory (MBI) is very good at detecting and quantifying burnout; however, it has 22 questions and maybe too burdensome for most. Instead, simple quality of life measures can be used to identify struggling physicians before signs manifest in their work or personal lives.

‍Ways to combat physician burnout

‍Once it has been identified, managers have several options to combat physician burnout. Physician "wellness" programs are relatively inexpensive yet effective means of improving emotional well-being among medical staff. Where possible, attempts can be made to lessen the nonclinical burdens on physicians (e.g., paperwork, EHR). While a discussion of drug screening is a sure way to create dissension in the ranks, passively providing resources for physicians to anonymously contact and attend impaired physician programs is another way to combat physician burnout.

‍Locum tenens can fight physician burnout

‍Locum tenens is a novel and potentially powerful way to combat physician burnout. Locum tenens can reduce physician burnout in several ways:

• The addition of a locum tenens physician can immediately reduce overall work burden for staff physicians.
• Conversely, you may suggest that a physician who is in the early stages of burning out consider a temporary locum tenens position. At the risk of sounding trite, a change of scenery may do some good.
• Since a locum tenens physician arrives with the enthusiasm of entering a novel situation, he or she may happily accept less desirable rotations or shifts that staff physicians dread or actively avoid. The traveling doctor is happy and the existing staff is relieved.

As managers struggle to detect and address physician burnout, they would do well to consider the advantages of locum tenens opportunities to combat this growing and potentially dangerous problem. A few small staff changes may be able to thwart large lapses in patient safety and the resulting legal consequences.

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References

1. Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. Mar 2014;89(3):443-451. doi:10.1097/acm.0000000000000134
2. Fahrenkopf AM, Sectish TC, Barger LK, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. Bmj. Mar 01 2008;336(7642):488-491. doi:10.1136/bmj.39469.763218.BE
3. Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Ann Surg. Jun 2010;251(6):995-1000. doi:10.1097/SLA.0b013e3181bfdab3
4. Brown SD, Goske MJ, Johnson CM. Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior. J Am Coll Radiol. Jul 2009;6(7):479-485. doi:10.1016/j.jacr.2008.11.029
5. Siedsma M, Emlet L. Physician burnout: can we make a difference together? Critical Care. 07/02 2015;19(1):273. doi:10.1186/s13054-015-0990-x
6. Maslach C, Jackson SE. Leiter MP Maslach Burnout Inventory Manual. Palo Alto. California: Consulting Psychological Press, Inc; 1996.