physician burnout

Research suggests that occupational burnout among physicians exceeds 50% in the USA.{{cite journal | vauthors = Rothenberger DA | title = Physician Burnout and Well-Being: A Systematic Review and Framework for Action | journal = Diseases of the Colon and Rectum | volume = 60 | issue = 6 | pages = 567–576 | date = June 2017 | pmid = 28481850 | doi = 10.1097/DCR.0000000000000844 | s2cid = 1302010 }} This refers to not only physicians currently practicing medicine, but also those in training. Signs of burnout have even been traced back to medical students who have experienced disconnect between taught professional behaviors and those witnessed in practice.

"Our data show wide variability in the prevalence of burnout by clinical specialty, and that anxiety, social support and empathy during medical school relate to the risk of burnout during residency," says Liselotte Dyrbye, M.D., a Mayo Clinic researcher and first author of the article "Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians{{cite journal | vauthors = Dyrbye LN, Burke SE, Hardeman RR, Herrin J, Wittlin NM, Yeazel M, Dovidio JF, Cunningham B, White RO, Phelan SM, Satele DV, Shanafelt TD, van Ryn M | display-authors = 6 | title = Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians | journal = JAMA | volume = 320 | issue = 11 | pages = 1114–1130 | date = September 2018 | pmid = 30422299 | pmc = 6233627 | doi = 10.1001/jama.2018.12615 | author-link3 = Rachel Hardeman }}{{Retracted|doi=10.1001/jama.2019.0167|pmid=30912842|intentional=yes}}"

In an argument explained in Economic and Political Weekly, Edmond Fernandes, lead author stated that being motivated by the best intentions is not enough; they need to be given adequate rest. The time to regulate work hours is long overdue. With growing population in a country like India, the number of doctors remains grossly insufficient to strike this balance which leads to physician and resident fatigue ending up in medical errors and complications. {{Cite web |date=2016-04-21 |title=Wounded Healers {{!}} Economic and Political Weekly |url=https://www.epw.in/journal/2016/17/commentary/wounded-healers.html |access-date=2024-03-20 |website=www.epw.in |language=en}}

Burnout has been referred to as a compilation of cynicism, depersonalization, and a low sense of accomplishment.{{cite journal | vauthors = Gazelle G, Liebschutz JM, Riess H | title = Physician burnout: coaching a way out | journal = Journal of General Internal Medicine | volume = 30 | issue = 4 | pages = 508–13 | date = April 2015 | pmid = 25527340 | pmc = 4371007 | doi = 10.1007/s11606-014-3144-y }}{{cite web | vauthors = Berg S | title = How to recognize and respond to burnout in a fellow physician | publisher = American Medical Association | date=30 August 2018 | url = https://www.ama-assn.org/practice-management/physician-health/how-recognize-and-respond-burnout-fellow-physician | access-date = 12 July 2020}} Other symptoms included feelings of emotional exhaustion, inadequacy, and detachment. This is thought to be due to imbalances whether that be in regards to workload, personal values, incentive, justice, and a sense of community. Factors such as time pressure, chaotic work environments and a lack of alignment between physicians and executives have been known to exacerbate this burden. These elements can cause clinicians to become frustrated and overwhelmed. Moreover, the correlation between lack of control and burnout has been explored and shows that an increased sense of lack of control has been linked to a greater risk of being affected by burnout.

One study,{{cite journal | vauthors = Tawfik DS, Profit J, Morgenthaler TI, Satele DV, Sinsky CA, Dyrbye LN, Tutty MA, West CP, Shanafelt TD | display-authors = 6 | title = Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors | journal = Mayo Clinic Proceedings | volume = 93 | issue = 11 | pages = 1571–1580 | date = November 2018 | pmid = 30001832 | pmc = 6258067 | doi = 10.1016/j.mayocp.2018.05.014 }} claimed that "We found that physicians with burnout had more than twice the odds of self-reported medical error, after adjusting for specialty, work hours, fatigue and work unit safety rating(...)"

• Changing overall healthcare landscape{{Cite journal| vauthors = Otokiti AU |date=2020-10-26|title=Digital Health and Healthcare Quality: A Primer on the Evolving 4th Industrial Revolution|url=https://www.intechopen.com/online-first/digital-health-and-healthcare-quality-a-primer-on-the-evolving-4th-industrial-revolution|journal=Contemporary Topics in Patient Safety |volume=1 |language=en|doi=10.5772/intechopen.94054|isbn=978-1-83962-403-2 |doi-access=free}}

The healthcare landscape continues to evolve, and factors like an aging population,{{Cite book|url=http://www.nap.edu/catalog/13444|title=Best Care at Lower Cost: The Path to Continuously Learning Health Care in America|date=2013-05-10|publisher=National Academies Press|isbn=978-0-309-28281-9|location=Washington, D.C.|doi=10.17226/13444 |pmid=24901184 | veditors = Smith M, Saunders R, Stuckhardt L, McGinnis JM | collaboration = Committee on the Learning Health Care System in America |author1=Committee on the Learning Health Care System in America |last2=Institute Of |first2=Medicine |last3=Smith |first3=M. |last4=Saunders |first4=R. |last5=Stuckhardt |first5=L. |last6=McGinnis |first6=J. M. |s2cid=173866008 }} physician shortage, change from volume-based care to value-based care,{{cite journal | vauthors = Putera I | title = Redefining Health: Implication for Value-Based Healthcare Reform | journal = Cureus | volume = 9 | issue = 3 | pages = e1067 | date = March 2017 | pmid = 28409068 | pmc = 5376155 | doi = 10.7759/cureus.1067 | doi-access = free }} Patients as customer{{cite journal | vauthors = Flores M, Glusman G, Brogaard K, Price ND, Hood L | title = P4 medicine: how systems medicine will transform the healthcare sector and society | journal = Personalized Medicine | volume = 10 | issue = 6 | pages = 565–576 | date = August 2013 | pmid = 25342952 | doi = 10.2217/pme.13.57 | pmc = 4204402 }} are some drivers of the change. These changes are happening rapidly and concurrently with a consequent adverse impact on physician burnout.

• Increased Pressure from Regulators and Payers

The changing overall healthcare landscape creates a situation whereby the regulators and payers demand more accountability, increased healthcare quality, and reduced cost. These demands also increase physician burnout.{{cite journal | vauthors = West CP, Dyrbye LN, Shanafelt TD | title = Physician burnout: contributors, consequences and solutions | journal = Journal of Internal Medicine | volume = 283 | issue = 6 | pages = 516–529 | date = June 2018 | pmid = 29505159 | doi = 10.1111/joim.12752 | s2cid = 3664698 | doi-access = free }}{{cite journal | vauthors = Patel RS, Bachu R, Adikey A, Malik M, Shah M | title = Factors Related to Physician Burnout and Its Consequences: A Review | journal = Behavioral Sciences | volume = 8 | issue = 11 | pages = 98 | date = October 2018 | pmid = 30366419 | doi = 10.3390/bs8110098 | pmc = 6262585 | doi-access = free }}

• Overall change in technological environment and consequence of the 4th industrial revolution{{Citation| vauthors = Otokiti AU |title=Digital Health and Healthcare Quality: A Primer on the Evolving 4th Industrial Revolution|date=2020-10-26|url=https://www.intechopen.com/online-first/digital-health-and-healthcare-quality-a-primer-on-the-evolving-4th-industrial-revolution|work=Contemporary Topics in Patient Safety - Volume 1 [Working Title]|publisher=IntechOpen|language=en|doi=10.5772/intechopen.94054|isbn=978-1-83962-403-2 |access-date=2021-03-20|doi-access=free}}

The technological environment is experiencing a rapid evolution from analog-legacy systems to digital systems. This is fueled in part by the Mores law, which postulates that there will be a constant reduction in the price of the memory capacity of computer systems. In 1981, the cost of a gigabyte was $300,000 and by the year 2000, it had dropped to $10. In 2010, the price of storing a gigabyte of data dropped to just 10¢.{{Cite journal| vauthors = Grenier AA |date=2010|title=No Place for a LadyTales of Adventurous Women Travellers, Barbara HODGSON, Vancouver: Greystone Books, 2002, 216p. Dreaming of EastWestern Women and the Exotic Allure of the Orient, Barbara HODGSON, Vancouver: Greystone Books, 2006, 192p |journal=Téoros: Revue de recherche en tourisme|volume=29|issue=2|pages=156|doi=10.7202/1024883ar|issn=0712-8657|doi-access=free}} The 4th industrial revolution is a consequence of the digital process. The 4th Industrial Revolution is a philosophical and ideological construct by the world economic forum that postulates how digital, physical, and biological technology have uniquely combined together in our contemporary world, creating new opportunities and challenges.{{Cite web| vauthors = Marr B |title=The 4th Industrial Revolution Is Here - Are You Ready?|url=https://www.forbes.com/sites/bernardmarr/2018/08/13/the-4th-industrial-revolution-is-here-are-you-ready/|access-date=2021-03-20|website=Forbes|language=en}} Although the 4th Industrial Revolution is considered by many as a direct extension of the 3rd, the 4th differs due to the unprecedented volume and velocity of data and enhanced global interconnectivity.{{Citation|vauthors = Otokiti AU |title=Digital Health and Healthcare Quality: A Primer on the Evolving 4th Industrial Revolution|date=2020-10-26|url=https://www.intechopen.com/online-first/digital-health-and-healthcare-quality-a-primer-on-the-evolving-4th-industrial-revolution|work=Contemporary Topics in Patient Safety - Volume 1 [Working Title]|publisher=IntechOpen |doi=10.5772/intechopen.94054|isbn=978-1-83962-403-2 |access-date=2021-03-20|doi-access=free}} This has impacted healthcare and all other sectors. This drive from legacy systems to digital systems demands that physicians adapt to changes quickly, which can be stressful and increase burnout

• Electronic health record and its lack of usability

The implementation of the electronic health record (EHR) is associated with physician burnout.{{cite journal | vauthors = Tajirian T, Stergiopoulos V, Strudwick G, Sequeira L, Sanches M, Kemp J, Ramamoorthi K, Zhang T, Jankowicz D | display-authors = 6 | title = The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey | journal = Journal of Medical Internet Research | volume = 22 | issue = 7 | pages = e19274 | date = July 2020 | pmid = 32673234 | pmc = 7392132 | doi = 10.2196/19274 | doi-access = free }}{{cite journal | vauthors = Otokiti AU, Craven CK, Shetreat-Klein A, Cohen S, Darrow B | title = Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System | journal = JMIR Research Protocols | volume = 10 | issue = 3 | pages = e25148 | date = March 2021 | pmid = 33724202 | doi = 10.2196/25148 |pmc=8294464 | doi-access = free }} The reasons include lack of EHR usability, demand for standardized documentation as against free flowing narrative texts, and redundant documentation. Excessive data entry requirements, lack of interoperability, and notes geared toward billing tend to be the highest factors contributing to EHR-induced physician burnout.{{cite journal | vauthors = Kroth PJ, Morioka-Douglas N, Veres S, Babbott S, Poplau S, Qeadan F, Parshall C, Corrigan K, Linzer M | display-authors = 6 | title = Association of Electronic Health Record Design and Use Factors With Clinician Stress and Burnout | journal = JAMA Network Open | volume = 2 | issue = 8 | pages = e199609 | date = August 2019 | pmid = 31418810 | doi = 10.1001/jamanetworkopen.2019.9609 | pmc = 6704736 }}{{cite journal | vauthors = DeChant PF, Acs A, Rhee KB, Boulanger TS, Snowdon JL, Tutty MA, Sinsky CA, Thomas Craig KJ | display-authors = 6 | title = Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review | journal = Mayo Clinic Proceedings. Innovations, Quality & Outcomes | volume = 3 | issue = 4 | pages = 384–408 | date = December 2019 | pmid = 31993558 | doi = 10.1016/j.mayocpiqo.2019.07.006 | pmc = 6978590 }} Research indicates that the use of EHRs has increased the amount of time spent on documentation for patients by their respective doctors by 11%-22%.{{Cite journal |last1=Pollock |first1=Jordan R. |last2=Moore |first2=M. Lane |last3=Llanes |first3=Aaron C. |last4=Brinkman |first4=Joseph C. |last5=Makovicka |first5=Justin L. |last6=Dulle |first6=Donald L. |last7=Hinckley |first7=Nathaniel B. |last8=Barcia |first8=Anthony |last9=Anastasi |first9=Matthew |last10=Chhabra |first10=Anikar |date=2022-04-08 |title=Medical Scribes in an Orthopedic Sports Medicine Clinic Improve Productivity and Physician Well-Being |url=https://arthroscopysportsmedicineandrehabilitation.org/article/S2666-061X(22)00020-7/abstract |journal=Arthroscopy, Sports Medicine, and Rehabilitation |volume=4 |issue=3 |pages=e997–e1005 |language=English |doi=10.1016/j.asmr.2022.02.003 |pmid=35747641 |pmc=9210372 |s2cid=248064612 |issn=2666-061X|doi-access=free }} {{Cite journal |last1=Baumann |first1=Lisa Ann |last2=Baker |first2=Jannah |last3=Elshaug |first3=Adam G. |date=2018-08-01 |title=The impact of electronic health record systems on clinical documentation times: A systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S0168851018301635 |journal=Health Policy |language=en |volume=122 |issue=8 |pages=827–836 |doi=10.1016/j.healthpol.2018.05.014|pmid=29895467 |s2cid=48360096 }}

• Excessive administrative workload

One major contributor to physician burnout is the excessive administrative workload. Physicians are required to dedicate a significant portion of their time to non-clinical tasks, reducing the time they can spend with patients. On average, U.S. physicians spend 2.6 hours per week meeting external quality measures—time that could instead be used to see nine additional patients.{{Cite journal |last=Reith |first=Thomas P. |date=2018-12-04 |title=Burnout in United States Healthcare Professionals: A Narrative Review |url=https://www.cureus.com/articles/16398-burnout-in-united-states-healthcare-professionals-a-narrative-review#!/ |journal=Cureus |language=en |volume=10 |issue=12 |doi=10.7759/cureus.3681 |doi-access=free |issn=2168-8184|pmc=6367114 }} Additionally, for every hour spent face-to-face with patients, physicians spend two more hours on clerical tasks such as documentation, billing, and compliance reporting. This administrative burden is a key stressor in the medical field, leading to emotional exhaustion and reduced job satisfaction. A study of 200 medical and auxiliary staff found a significant positive correlation (r = .495) between burnout and administrative workload, highlighting how these tasks contribute directly to physician stress and dissatisfaction.{{Cite journal |last1=Taranu |first1=Sabinne Marie |last2=Ilie |first2=Adina Carmen |last3=Turcu |first3=Ana-Maria |last4=Stefaniu |first4=Ramona |last5=Sandu |first5=Ioana Alexandra |last6=Pislaru |first6=Anca Iuliana |last7=Alexa |first7=Ioana Dana |last8=Sandu |first8=Calina Anda |last9=Rotaru |first9=Tudor-Stefan |last10=Alexa-Stratulat |first10=Teodora |date=November 9, 2022 |title=Factors Associated with Burnout in Healthcare Professionals |journal=International Journal of Environmental Research and Public Health |volume=19 |issue=22 |pages=14701|doi=10.3390/ijerph192214701 |doi-access=free |pmid=36429420 |pmc=9691101 }}

• Long work hours and burnout

Another major factor contributing to burnout is the long and demanding work hours that many physicians endure. The average physician in the U.S. works 51 hours per week, and about one in four works more than 60 hours weekly. These intense schedules often come with limited opportunities for rest, frequent on-call shifts, and the expectation to work weekends, personal time, and even during vacations.{{Cite journal |last1=Jung |first1=FU |last2=Bodendieck |first2=E. |last3=Bleckwenn |first3=M. |last4=Hussenoeder |first4=FS |last5=Luppa |first5=M. |last6=Riedel-Heller |first6=SG |date=2023-02-15 |title=Burnout, work engagement and work hours – how physicians' decision to work less is associated with work-related factors |journal=BMC Health Services Research |volume=23 |issue=1 |pages=157 |doi=10.1186/s12913-023-09161-9 |doi-access=free |issn=1472-6963 |pmc=9930013 |pmid=36793035}} Such prolonged work hours make it difficult for physicians to maintain a healthy work-life balance, leading to higher stress levels and increased exhaustion.

Likewise, burnout has been analyzed using differing conceptual models. One strategy examined burnout as a product of three stages. Stage one consists of exhaustion at work that progresses into detachment and negative feelings at work that later starts to affect patients and coworkers in stage two. Lastly, stage three is composed of feelings of inadequacy and failure. However, a more recent approach sought to choose three stages that served as a bridge between said stages and imbalances. The first groups together all job stressors such as imbalances caused by work demands while the second solely addressed individual strain in the form of anxiety and exhaustion. Lastly, the third described changes in mood and behavior as defensive coping that could be closely linked to cynicism.{{cite journal | vauthors = Brandstätter V, Job V, Schulze B | title = Motivational Incongruence and Well-Being at the Workplace: Person-Job Fit, Job Burnout, and Physical Symptoms | journal = Frontiers in Psychology | volume = 7 | issue = | pages = 1153 | date = 2016 | pmid = 27570513 | pmc = 4981689 | doi = 10.3389/fpsyg.2016.01153| doi-access = free }}

• {{cite press release |date=August 11, 2016 |title=Burnout is caused by mismatch between unconscious needs and job demands |website=ScienceDaily |url=https://www.sciencedaily.com/releases/2016/08/160811171643.htm}}

The progression of physician burnout takes a toll on the individual whether it be a medical student or practicing clinician mainly through adverse psychological affects that have lasting consequences. A concept known as asymmetrical rewards speaks of how physicians are rarely recognized for what they do well, yet there is much attention surrounding medical malpractice suits ready to capitalize on a physician's errors. In addition, clinicians become desensitized to patients and medicine resulting a perspective shift towards viewing patient care as a chore more than a desire to heal. However, the effects of burnout extend past the physicians themselves to ultimately affect anyone in contact with them.

Burnout in physicians appears to be the highest for resident physicians. Due to the large number of hours taken on by resident physicians, they are often more prone to burnout. In addition to the long hours, residents are still in the process of learning clinical knowledge. Stressful events, such as death of a patient, managing a critically ill patient, medical error, and verbal abuse from patients, their families and/or colleagues have been reported in a study done at medical schools in the Philadelphia area.{{cite journal|author1-link=John H. Coverdale| vauthors = Coverdale J, Balon R, Beresin EV, Brenner AM, Louie AK, Guerrero AP, Roberts LW | title = What Are Some Stressful Adversities in Psychiatry Residency Training, and How Should They Be Managed Professionally? | journal = Academic Psychiatry | volume = 43 | issue = 2 | pages = 145–150 | date = April 2019 | pmid = 30697662 | doi = 10.1007/s40596-019-01026-w | doi-access = free }} In this study, researchers found that 70% of residents experienced at least one work-related stress event and that nearly 5% showed symptoms of PTSD from a stressful event at work. Similar to the work-life balance struggle physicians face, residents may struggle to manage everything going on in their lives. Negative effects of this burnout include decreased job satisfaction, being absent while at work and possibility for medical errors.{{cite journal | vauthors = McCray LW, Cronholm PF, Bogner HR, Gallo JJ, Neill RA | title = Resident physician burnout: is there hope? | journal = Family Medicine | volume = 40 | issue = 9 | pages = 626–32 | date = October 2008 | pmid = 18830837 | pmc = 2903755 }} Some studies have even shown reduced feelings of personal accomplishment and emotional exhaustion. Residents who considered themselves to be experiencing burnout report more medical errors than residents who do not.{{cite journal | vauthors = West CP, Huschka MM, Novotny PJ, Sloan JA, Kolars JC, Habermann TM, Shanafelt TD | title = Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study | journal = JAMA | volume = 296 | issue = 9 | pages = 1071–8 | date = September 2006 | pmid = 16954486 | doi = 10.1001/jama.296.9.1071 | doi-access = free }} In a 24 month-long study performed at Mayo Clinic in 2016, found that burnout and low job satisfaction were associated with reductions in professional work effort.{{cite journal | vauthors = Shanafelt TD, Mungo M, Schmitgen J, Storz KA, Reeves D, Hayes SN, Sloan JA, Swensen SJ, Buskirk SJ | display-authors = 6 | title = Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort | journal = Mayo Clinic Proceedings | volume = 91 | issue = 4 | pages = 422–31 | date = April 2016 | pmid = 27046522 | doi = 10.1016/j.mayocp.2016.02.001 }} In 2008, the Healthcare Management Review suggested that healthcare settings that put programs in place to reduce physician burnout would see greater patient satisfaction and recovery.{{cite journal | vauthors = Halbesleben JR, Rathert C | title = Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients | journal = Health Care Management Review | volume = 33 | issue = 1 | pages = 29–39 | date = January 2008 | pmid = 18091442 | doi = 10.1097/01.HMR.0000304493.87898.72 | s2cid = 41671522 }} Resident interventions aimed to improve communication and role conflict have been shown to improve self-acceptance, acceptance of aggression and inner directedness in residents, interns, and nurses.{{cite journal | vauthors = Bair JP, Greenspan BK | title = TEAMS: teamwork training for interns, residents, and nurses | journal = Hospital & Community Psychiatry | volume = 37 | issue = 6 | pages = 633–5 | date = June 1986 | pmid = 3721426 | doi = 10.1176/ps.37.6.633 }}  Although burnout in resident physicians has become common knowledge in the medical community, few systems are in place to combat this issue. Some possible solutions are support groups, stress-management/coping training and self-care education.

An estimated 43-45% of medical student students report feelings of burnout.{{cite journal | vauthors = Dyrbye LN, Thomas MR, Huntington JL, Lawson KL, Novotny PJ, Sloan JA, Shanafelt TD | title = Personal life events and medical student burnout: a multicenter study | journal = Academic Medicine | volume = 81 | issue = 4 | pages = 374–84 | date = April 2006 | pmid = 16565189 | doi = 10.1097/00001888-200604000-00010 | s2cid = 19962588 | doi-access = free }} It has been proposed that physician burnout originates from physicians years' in medical school.{{cite journal | vauthors = Santen SA, Holt DB, Kemp JD, Hemphill RR | title = Burnout in medical students: examining the prevalence and associated factors | journal = Southern Medical Journal | volume = 103 | issue = 8 | pages = 758–63 | date = August 2010 | pmid = 20622724 | doi = 10.1097/SMJ.0b013e3181e6d6d4 | s2cid = 29804833 }} In 2010, a study was done by Emory School of Medicine and Vanderbilt School of Medicine to understand the prevalence and factors of burnout in medical students. Here, burnout was defined as emotional exhaustion, depersonalization and decreased physical exhaustion. The study administered the Maslach Burnout Inventory Human Services Survey to 249 medical students. This survey asked questions about stress levels, workload, relaxation habits, support systems and demographics. The study found that 21% of first-year students, 41% of second-year students, 43% of third-year, and 31% of fourth-year students felt symptoms of burnout. Factors associated with a higher rate of burnout include lower support, higher stress, and feelings of lack of control over one's life. There is no single solution to this issue, but easing student and physician workload and promoting wellness and resilience in the medical field has been shown to help.{{cite journal | vauthors = MacKinnon M, Murray S | title = Reframing Physician Burnout as an Organizational Problem: A Novel Pragmatic Approach to Physician Burnout | journal = Academic Psychiatry | volume = 42 | issue = 1 | pages = 123–128 | date = February 2018 | pmid = 28247366 | doi = 10.1007/s40596-017-0689-1 | s2cid = 42941512 }} Specifically in medical students, mindfulness-based meditation sessions have been shown to improve mood disturbance.{{cite journal | vauthors = Rosenzweig S, Reibel DK, Greeson JM, Brainard GC, Hojat M | title = Mindfulness-based stress reduction lowers psychological distress in medical students | journal = Teaching and Learning in Medicine | volume = 15 | issue = 2 | pages = 88–92 | date = 2003 | pmid = 12708065 | doi = 10.1207/S15328015TLM1502_03 | url = https://jdc.jefferson.edu/jmbcimfp/1 | s2cid = 30922233 }}

Friends and family often feel the burden when interacting with burned-out clinicians since most of these individuals will be disengaged and can exhibit symptoms of major depressive disorder. Coworkers are also likely to be impacted. For example, burnout initiated by a chaotic, unsupportive work environment results in higher rates of miscommunication and unresolved conflicts. It has also been shown that a workforce afflicted by burnout contributes to an overall greater hostile atmosphere.

Other impacted populations include the patients and healthcare industry seeing as burnout results in decreased quality of care.{{cite journal | vauthors = Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P | title = How does burnout affect physician productivity? A systematic literature review | journal = BMC Health Services Research | volume = 14 | issue = | pages = 325 | date = July 2014 | pmid = 25066375 | pmc = 4119057 | doi = 10.1186/1472-6963-14-325 | doi-access = free }} Research has generated evidence supporting an inverse correlation between burnout and productivity. Thus the shift in decreased productivity sometimes ends in decreased physician retention due to low job satisfaction and decreased mental health. Since successful medical interactions are based on trust between providers and patients, this constant staff turnover can go on to reflect poorly upon the institution.

Physician burnout significantly contributes to decreased quality of care, primarily due to its impact on clinical decision-making, which can lead to increased medical errors.{{Cite web |last=ChenMed |title=The Impact of Physician Burnout on Patient Trust |url=https://www.chenmed.com/blog/impact-physician-burnout-patient-trust#:~:text=Physician%20burnout%20has%20significant%20impacts,the%20well-being%20of%20physicians |access-date=2025-03-24 |website=ChenMed |language=en}} Burnout leads to mental and physical exhaustion, which in turn impairs cognitive function.{{Cite journal |last=Michel |first=Alexandra |date=2016-01-29 |title=Burnout and the Brain |url=https://www.psychologicalscience.org/observer/burnout-and-the-brain#:~:text=Just%20as%20the%20impact%20of,neuroendocrine%20systems%20%E2%80%94%20eventually%20leading%20to |journal=APS Observer |language=en |volume=29}} Physicians suffering from burnout are less able to critically analyze clinical information, making them more likely to overlook important details or make poor decisions under pressure.{{Citation |last1=National Academies of Sciences |first1=Engineering |title=Factors Contributing to Clinician Burnout and Professional Well-Being |date=2019-10-23 |work=Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being |url=https://www.ncbi.nlm.nih.gov/books/NBK552615/ |access-date=2025-03-24 |publisher=National Academies Press (US) |language=en |last2=Medicine |first2=National Academy of |last3=Well-Being |first3=Committee on Systems Approaches to Improve Patient Care by Supporting Clinician}} Burned-out physicians are more likely to miss small but important clinical signs or fail to adhere to clinical guidelines.{{Cite journal |last1=Panagioti |first1=Maria |last2=Geraghty |first2=Keith |last3=Johnson |first3=Judith |last4=Zhou |first4=Anli |last5=Panagopoulou |first5=Efharis |last6=Chew-Graham |first6=Carolyn |last7=Peters |first7=David |last8=Hodkinson |first8=Alexander |last9=Riley |first9=Ruth |last10=Esmail |first10=Aneez |date=2018-10-01 |title=Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis |journal=JAMA Internal Medicine |volume=178 |issue=10 |pages=1317–1331 |doi=10.1001/jamainternmed.2018.3713 |issn=2168-6114 |pmc=6233757 |pmid=30193239}}{{Retracted|doi=10.1001/jamainternmed.2020.1755|pmid=32421149|http://retractionwatch.com/2020/05/21/jama-journal-retracts-well-publicized-paper-linking-doctor-burnout-to-patient-safety/ Retraction Watch}} When physicians are tired and disengaged, they may not engage deeply with patient histories or may be less likely to question diagnostic hypotheses, which contributes to errors.{{Cite journal |last1=Garcia |first1=Cíntia de Lima |last2=Abreu |first2=Luiz Carlos de |last3=Ramos |first3=José Lucas Souza |last4=Castro |first4=Caroline Feitosa Dibai de |last5=Smiderle |first5=Fabiana Rosa Neves |last6=Santos |first6=Jaçamar Aldenora Dos |last7=Bezerra |first7=Italla Maria Pinheiro |date=2019-08-30 |title=Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis |journal=Medicina (Kaunas, Lithuania) |volume=55 |issue=9 |pages=553 |doi=10.3390/medicina55090553 |doi-access=free |issn=1648-9144 |pmc=6780563 |pmid=31480365}} Burnout affects a physician's ability to communicate effectively with colleagues and patients. Poor communication leads to errors in the exchange of critical patient information, which can exacerbate diagnostic mistakes, incorrect treatments, or delayed interventions.{{Cite journal |last1=Howick |first1=Jeremy |last2=Bennett-Weston |first2=Amber |last3=Solomon |first3=Josie |last4=Nockels |first4=Keith |last5=Bostock |first5=Jennifer |last6=Keshtkar |first6=Leila |date=2024-05-27 |title=How does communication affect patient safety? Protocol for a systematic review and logic model |journal=BMJ Open |volume=14 |issue=5 |pages=e085312 |doi=10.1136/bmjopen-2024-085312 |issn=2044-6055 |pmc=11131125 |pmid=38802275}} When physicians are exhausted and emotionally drained, they may not engage in collaborative decision-making, and may make errors in interpreting or sharing patient data.{{Cite journal |last1=Shin |first1=Philip |last2=Desai |first2=Vimal |last3=Conte |first3=Antonio Hernandez |last4=Qiu |first4=Chunyuan |date=2023-06-15 |title=Time Out: The Impact of Physician Burnout on Patient Care Quality and Safety in Perioperative Medicine |journal=The Permanente Journal |volume=27 |issue=2 |pages=160–168 |doi=10.7812/TPP/23.015 |issn=1552-5775 |pmc=10266854 |pmid=37278062}}

Physician burnout can lead to reduced patient satisfaction as exhausted and emotionally drained doctors may become detached or less empathetic in their interactions.{{Cite journal |last1=Underdahl |first1=Louise |last2=Ditri |first2=Mary |last3=Duthely |first3=Lunthita M. |date=2024 |title=Physician Burnout: Evidence-Based Roadmaps to Prioritizing and Supporting Personal Wellbeing |journal=Journal of Healthcare Leadership |volume=16 |pages=15–27 |doi=10.2147/JHL.S389245 |doi-access=free |issn=1179-3201 |pmc=10773242 |pmid=38192639}} When clinicians experience burnout, they may struggle to engage meaningfully with patients, leading to rushed consultations, diminished communication, and a perceived lack of compassion. This disengagement can erode patient trust and weaken the doctor-patient relationship, making patients feel unheard or undervalued.

Physician burnout significantly increases healthcare costs by driving inefficiencies in patient care and contributing to medical errors, malpractice claims, and prolonged hospital stays. Burned-out clinicians are more prone to making mistakes, leading to costly complications, additional treatments, and readmissions.{{Cite web |last=Cross Country Search |date=January 28, 2025 |title=The Hidden Costs of Understaffing in Healthcare: A Critical Call for Hospitals and Medical Facilities |url=https://www.crosscountrysearch.com/blogs/a-critical-call-for-hospitals-and-medical-facilities#:~:text=Overworked%20staff%20are%20more%20prone,diagnosing%20conditions%20or%20providing%20treatments |website=Cross Country Search}} Studies have shown that hospitals with high levels of burnout experience greater rates of diagnostic errors, unnecessary testing, and procedural mistakes, all of which inflate healthcare expenditures.{{Cite journal |last1=Ryu |first1=I. Seul |last2=Shim |first2=JaeLan |date=2021-11-20 |title=The Influence of Burnout on Patient Safety Management Activities of Shift Nurses: The Mediating Effect of Compassion Satisfaction |journal=International Journal of Environmental Research and Public Health |volume=18 |issue=22 |pages=12210 |doi=10.3390/ijerph182212210 |doi-access=free |issn=1660-4601 |pmc=8621116 |pmid=34831966}} Additionally, burnout-related malpractice claims place a financial burden on healthcare systems through legal fees and settlements. Increased staff turnover due to burnout further exacerbates costs, as recruiting and training new healthcare professionals require substantial investment.

Treatment strategies first focused on addressing the individual. Physician-oriented approaches ranged from cognitive behavioral techniques (CBT) such as meditation and coping strategies to professional coaching which aimed at reinforcing individual resilience. Because of the high incidence of physician burnout, the field of physician coaching{{Cite web |last=Gazelle |first=Gail |date=2023-02-22 |title=Physician Burnout - The ULTIMATE Guide {{!}} Gail Gazelle MD, MCC |url=https://gailgazelle.com/the-ultimate-guide-to-physician-burnout/ |access-date=2023-03-17 |website=Gail Gazelle MD |language=en-US}} has emerged. Physician coaching involves the implementation of mentors, usually former physicians, that would guide physicians out of burnout. Gazelle, Liebschutz, and Riess discussed the benefits of physician coaching as being able to cater to each provider using his or her own previous experiences therefore personalizing the intervention as opposed to CBT which delivers treatment in a standardized manner. On the other hand, Dr. Kelly speaks of how altering perception of patients from chores and potential litigation sources to opportunities to heal is key to the reversal of burnout.

However, some research suggests that a combination of individual, team, and organization approaches is the only way to address all levels of burnout and successfully put an end to this epidemic.{{cite journal | vauthors = Wuest TK, Goldberg MJ, Kelly JD | title = Clinical Faceoff: Physician Burnout-Fact, Fantasy, or the Fourth Component of the Triple Aim? | journal = Clinical Orthopaedics and Related Research | volume = 475 | issue = 5 | pages = 1309–1314 | date = May 2017 | pmid = 27933444 | pmc = 5384921 | doi = 10.1007/s11999-016-5193-5 }} The entire health care system requires transformational change{{Cite book |url=https://www.nap.edu/catalog/25521|title=Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being |date=2019-12-02|publisher=National Academies Press|isbn=978-0-309-49547-9|location=Washington, D.C.|doi=10.17226/25521|pmid=31940160|s2cid=243168431 }}{{cite journal | vauthors = Thomas LR, Ripp JA, West CP | title = Charter on Physician Well-being | journal = JAMA | volume = 319 | issue = 15 | pages = 1541–1542 | date = April 2018 | pmid = 29596592 | doi = 10.1001/jama.2018.1331 }}{{cite journal | vauthors = Shanafelt T, Goh J, Sinsky C | title = The Business Case for Investing in Physician Well-being | journal = JAMA Internal Medicine | volume = 177 | issue = 12 | pages = 1826–1832 | date = December 2017 | pmid = 28973070 | doi = 10.1001/jamainternmed.2017.4340 | s2cid = 25824027 }} and organizational approaches have shown much promise as successful treatment options by reducing workloads and distributing more flexible schedules among employees. A shift to realign goals between physicians and executive administrators could also contribute to reducing the risk of burnout. A systematic review analyzing individual and organizational strategies found that organization-oriented approaches were more effective.{{cite journal | vauthors = Panagioti M, Panagopoulou E, Bower P, Lewith G, Kontopantelis E, Chew-Graham C, Dawson S, van Marwijk H, Geraghty K, Esmail A | title = Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis | journal = JAMA Internal Medicine | volume = 177 | issue = 2 | pages = 195–205 | date = February 2017 | pmid = 27918798 | doi = 10.1001/jamainternmed.2016.7674 | s2cid = 15052065 | url = http://eprints.keele.ac.uk/2676/1/C%20Chew%20Graham%20-%20Controlled%20Interventions%20to%20reduce%20burnout%20in%20physicians.pdf }} Other examples of team approaches are the implementation of honest discussions between caregivers to emphasize compassion as well as organization-wide events to enhance workforce well-being. While Gazelle and Panagioti concluded that organizational approaches were superior to individualized interventions, the final verdict has not yet been reached as Wuest's combined intervention addressing burnout at the individual, team, and organizational levels might be the key. Institutions across the nation are coming up with various innovative ways of reducing the EHR and technology induced physician burnout. One of the approaches carried out was by the Mount Sinai hospital New York in a project called beyond getting rid of stupid stuff in the EHR(Beyond-GROSS). Beyond-GROSS project seeks to get direct feedback from physicians about aspects of EHR that need improvement. This project was modelled after the Hawaii Pacific hospital's getting rid of stupid stuff in the EHR(GROSS){{cite journal | vauthors = Ashton M | title = Getting Rid of Stupid Stuff | journal = The New England Journal of Medicine | volume = 379 | issue = 19 | pages = 1789–1791 | date = November 2018 | pmid = 30403948 | doi = 10.1056/NEJMp1809698 | s2cid = 53208363 }} Some organizations are outsourcing services, like medical scribing, to relieve the documentation burden on physicians and free up time.{{Cite web |last=Management |first=HealthData |date=2022-03-31 |title=Scribe support may help alleviate documentation, trim physician burnout |url=https://aquitysolutions.com/articles/scribing/scribe-support-may-help-alleviate-documentation-trim-physician-burnout/ |access-date=2023-02-21 |website=AQuity Solutions |language=en-US}}

Due to the fact that physician burnout can impact overall quality of care, many regulatory bodies are also trying to reduce the adverse effect of burnout by putting forward regulations to counter its identified etiologies like unnecessary physician documentations. Centers for Medicare and Medicaid Services (CMS) initiated the "patient over paperwork" initiative to reduce the burden of unnecessary documentations on clinicians.{{Cite web|title=CMS Finalizes Changes to Advance Innovation, Restore Focus on Patients {{!}} CMS|url=https://www.cms.gov/newsroom/press-releases/cms-finalizes-changes-advance-innovation-restore-focus-patients|access-date=2021-03-20|website=www.cms.gov}}

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Category:Physicians

Category:Occupational stress