Health worker burnout will intensify if healthcare employers, health insurance companies and communites fail to address the crisis, Surgeon General Dr. Vivek Murthy cautions in a report issued Monday.
Burnout was on the rise prior to the COVID-19 pandemic. Among healthcare workers, 35% to 54% of nurses and physicians and 45% to 60% of medical students and residents reported burnout prior to 2020, according to National Academy of Medicine data included in the surgeon general's report.
Reports of increasing physical and emotional strain, workplace violence and time spent away from families during the pandemic indicate a compounding crisis among health workers, Murthy wrote.
The Bureau for Labor Statistics anticipates 1 million registered nurses will be needed by the end of the year, the report notes. Murthy also cites a Mercer Health Care Market Analysis that estimates a shortage of 3 million low-wage health workers, many of whom are women of color, in the next five years. The Association of American Medical Colleges projects a shortage of up to 139,000 physicians by 2033, according to the report.
"Today, when I visit a hospital, clinic or health department and ask staff how they're doing, many tell me they feel exhausted, helpless and heartbroken," Murthy wrote. "They also confess they don't see how the health workforce can continue like this."
Employee shortages have a ripple effect. Physicians may have to limit time with patients. Shortages make it difficult for patients to get routine preventive care and emergency care. Strained access to care exacerbates health disparities among marginalized communities. Shortages also make it difficult for health systems to prepare for COVID-19 surges or future public health emergencies, the surgeon general wrote.
Understaffing and burnout will persist without systemic changes that address workers' mental health, the report says. The healthcare system is at stake, Murthy wrote.
The report makes recommendations for health systems, insurers, health workers and community members that Murthy contends would help retain staff and support their mental health.
Health systems must foster environments that value healthcare workers' well-being by guaranteeing living wages, paid sick and family leave, and rest breaks, the report says.
Employers should also encourage collaboration and social support to combat worker loneliness, according to the surgeon general. One way to commit to employee well-being is to create a chief wellness/well-being officer role, he wrote.
Murthy calls on health systems to provide confidential mental health services, including hotlines and employee assistance programs. He also calls on health insurers to improve mental health coverage for health workers.
Following the COVID-19 pandemic, health systems must strive to prevent workplace violence, combat the spread of misinformation and provide adequate personal protective equipment to employees, Murthy wrote.
Health insurers should support workers spending more time with patients. the report says. "When healthcare is constrained to be delivered in 15-minute intervals, trust and communication between patient and provider can suffer," Murthy wrote.
The report also calls on community members to recognize when healthcare workers they know need help. Symptoms of burnout can include irritability, withdrawal from family and friends, and excessive alcohol use.
While the long-term impacts of the pandemic on worker well-being are unknown, leaders and organizations must be proactive in supporting the mental health of their staff, many of whom worked tirelessly to care for their patients, the surgeon general wrote.
"We owe health workers far more than our gratitude," Murthy wrote. "We owe them an urgent debt of action."