In recent years, quite a bit has been written about physician burnout. More and more of today’s practitioners are experiencing it. In fact, almost every issue of Medical Economics, the journal for the business side of Medicine, contains a lengthy discussion of the subject. It’s a serious problem that perplexes individuals and institutions, and has led to decreasing numbers of private practitioners.
In this context, Burnout is defined as fatigue, frustration, or apathy resulting from prolonged stress, overwork, and intense activity. The practice of medicine fits the definition perfectly as it is rife with stress, overwork, long hours, sleep deprivation, and intense activity. I always knew I was only one phone call away from a sleepless night, and extra hour, or two, in the office, or a harrowing drive to the hospital at 3:00 AM. But a busy, well-trained physician is not fazed by a flurry of action or emergencies. Most physicians thrive on being busy and challenged intellectually. It becomes problematic, however, when the physician does not feel his services are being adequately compensated. It becomes frustrating when third party payers lower the monetary value of your services, make unreasonable demands before issuing payment, or reject your claim for payment, outright.
In its “2023 Physician Burnout and Wellness Survey,” Medical Economics delves into the minds of physicians to determine root causes and solutions to the problem.
When asked “Have you felt burned out from practicing medicine at any point during your career? The answer for 92% of those surveyed was “yes.”
When asked “Do you feel burned out now?” 68% said “yes!”
When asked “What has contributed the most to your feelings of burnout?” 36% cited too much paperwork and regulations, 17% said “work too many hours/poor work-life balance,” and 9% said “insufficient pay/declining reimbursement.”
Only 7% felt overwhelmed by patient needs and 6% were affected by loss of autonomy and control of one’s career.
When it pertains to financial earnings and productivity, 70% of physicians believe burnout has a negative effect. Only 13% did not think it had a negative impact.
When asked “Have your feelings of burnout ever made you want to quit practicing medicine?” 76% said “yes.” Comments made were “I’m counting the days until retirement,” “I want to quit, but I feel trapped,” “I dread going to work another soul sucking shift,” “ Everyone I know wants to leave medicine. Paperwork and administrative burden of charting keep us from spending quality time with patients.”
When asked “How do you cope with burnout,” 27% said exercise, 20% said spending time with family and friends, 13% do nothing, 8% overeat, 8% rely on religious convictions, and 7% immerse themselves in hobbies.
When asked about solutions to burnout, comments were “better reimbursement, need to see fewer patients, better work/life balance,” “we need less paperwork and regulations,” “improvement in reimbursement, reduction in barriers to providing patient care such as prior authorization, change in social status with clear delineation between Physicians and mid-level providers.”
In my mind, burnout, happiness, and career satisfaction are all inter-related. If your business is doing well financially, most of the time happiness and career satisfaction are a certainty. You love what you do, you feel adequately compensated, and feel you’re making a difference. But when payers (insurance companies, Medicare) impose burdens upon a physician to make his/her job harder, anger and disillusionment set in. Then, when payers deny payment or pay less than the agreed-upon amount, the physician feels betrayed and undervalued. One can provide free service for only so long until expenses exceed income, sustaining your business (practice) becomes impossible, and major burnout poisons the physician into thinking about a career change.
Burnout, unfortunately, isn’t going away any time soon. It’s only going to get worse. A young person spends 10-15 years after high school earning a professional degree, training to take care of every conceivable medical illness, to gain prestige and respect from his patients only to be replaced by by a nurse practitioner or physician assistant with 10% of the training and experience. Yet they are given equal status. And reimbursement woes remain to where it seems Medicare and the Federal government are squeezing the physician as tightly as they can until they can tolerate no more.
The only solution to burnout, it seems, is to regain the perception that you are doing good for people, being adequately rewarded for it, and feeling respected. Today’s practitioners know they can make a difference for people, but they also know that Medicare, in particular, will try to make it difficult in any way they can.
Reference: 2023 Physician Burnout and Wellness Survey Medical Economics 2023 September:10-15.
