An alarming 50% of American physicians and caregivers experience burnout—and that number is growing. Burnout produces dissatisfied and unfulfilled patients, families and care teams while also compromising care quality, including increased medication errors and hospital-associated infections.
Symptoms of caregiver burnout include feelings of depression, emotional exhaustion, withdrawal from relationships and professional inadequacy. Tragically, physician suicide attempts are both more common and significantly more likely to be successful, averaging 1.4 to 2.3 times those in nonmedical professions. More broadly, some 30% of primary-care physicians age 35-49 plan to leave medicine, and there's an expected shortage of 25,000 surgeons by 2025.
Recognizing these challenges, a group of physicians, nurses, healthcare executives and others is working hard to reduce physician burnout and restore joy and purpose to medicine. Over two days last November, rural, suburban, urban and military health system professionals, primary- and specialty-care providers, and think tank and education leaders came together at the Johnson Foundation at Wingspread. Together, front-line caregivers and physicians who have experienced burnout, hospital and health system executives, resiliency and neurology experts, healthcare writers, and health technology entrepreneurs collaborated to develop a deep understanding of this noteworthy problem.
Factors contributing to caregiver burnout were explored at the macro, micro and individual caregiver levels. In addition to discussing burnout causes, specific solutions to restore joy and resiliency to caregivers were explored in depth, resulting in five major focus areas and sixteen compelling ideas to combat burnout as outlined below.
Restore humanity to healthcare
- Create standardized metrics that will enable measurement of our efforts to reduce and eliminate burnout.
- Redesign the physical environment to increase social interaction among care team members, such as team lounges rather than role-specific break areas. A particular focus on physician-nurse interaction should be reinforced.
- Create clinical fellowship programs for career renewal.
- Ensure a healthy practice climate for physicians across mental, emotional, physical and spiritual domains.
Improve medical training
- Ensure that the patient-physician relationship is always at the center of all medical training.
- Incorporate critical communication, empathy, team-based learning and burnout recognition skills in training programs.
- Establish common accreditation requirements across all healthcare disciplines.
- Create a medical school debt forgiveness program in exchange for subsequent community service-based practice.
- Foster enhanced burnout solution collaboration among external stakeholders who created the current system, including CMS, The Joint Commission, the legal community and specialty societies.
Engage patients in the process
- Promote care models that engage patients as full partners in their own care.
- Change the way patient satisfaction is measured to include new and real-time feedback capturing the nuanced voice of the patient and family so physicians can understand their role in the process.
Optimize technology to enhance the physician-patient experience
- Find ways to support caregivers in meeting technical obligations without losing the patient narrative and sacred patient-physician relationship.
- Use technology to support, rather than impede, physician-patient interaction.
- Enlist EHR vendors to open their systems to reduce complexity, which can help mitigate burnout, optimize outcomes, and encourage more physician-patient interaction. IT vendors should embed clinical IT consultants to observe caregivers' daily challenges in real-world settings to guide their development work.
Reform healthcare in ways that truly support physician and patients
- Build a vibrant HealthCorps that places front-line caregivers in underserved communities to improve access, integrate behavioral health and primary care, promote total wellness and advocate for community health needs.
- Engage insurance companies in reform to reduce administrative hassles that challenge providers and ensure support for community health systems that commit to maintain and improve health.
The report (PDF) outlines a path that begins our journey to restore essential humanity to care and make the patient and provider experience the very best that they can be. This is an important and essential task for all of us—physicians, nurses, executives, patients and families. We need bold leadership, renewed energy and an industry-wide culture that holds these values sacrosanct to mentor the next generation of healthcare leaders so that they will embrace and continue this important work. Please join us in our journey.
Dr. William Maples is executive director and chief experience officer at the Institute for Healthcare Excellence, Omaha, Neb.; Dr. Bridget Duffy is chief medical officer at Vocera, San Jose, Calif.; Tom Cosgrove is founder, QPatient Insight; and Dr. Ronald Paulus is president and CEO at Mission Health, Asheville, N.C.