Doctors and Burnout

Doctors and Burnout August 23, 2012

From USA Today, where you can read the whole article:

While the medical profession prepares for treating millions of patients who will be newly insured under the health care law, the Mayo Clinic (Rochester, Minn.) reports nearly 1 in 2 (45.8%) of the nation’s doctors already suffer a symptom of burnout.

“The rates are higher than expected,” says lead author and physician Tait Shanafelt. “We expected maybe 1 out of 3. Before health care reform takes hold, it’s a concern that those docs are already operating at the margins.”

Being asked to see more patients and not getting enough time with them create an atmosphere of “being on a hamster wheel,” says physician Jeff Cain, president-elect of the American Academy of Family Physicians, which is not associated with the study. “We know when enough time is spent with patients that outcomes improve and costs are down.”

Differences varied by specialty: Emergency medicine, general internal medicine, neurology and family medicine reported the highest rates. The authors note other studies show burnout can decrease the quality of care, lead to increased risk for errors and push doctors into early retirement, as well as cause problems in their personal lives.

“There have been other studies done on doctor burnout, but we assumed it was the surgical specialties who would be at primary risk,” says Shanafelt. “Instead we found out it’s the physicians on the front line of care who are at the greatest risk.”

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  • Fish

    Burnout happens in all fields, but it’s harder to feel sorry for those in fields where you can become very wealthy.

    I’d make medical school free if the doctors would become civil service employees and be satisfied with a couple hundred thou per year.

  • Vicki

    While this article speaks to burnout among doctors, I would say the stats should reveal similar things about nurses. As a registered nurse, I feel like my job is more about how many tasks I complete than to how well I care for the person and their more “human” needs.

    @Fish, while some doctors make a lot of money, my doctor friends work very long hours and endure a lot of stress. For many, I can’t deny that they earn what they make. In turn, do you really want to be the patient of a doctor who is burned out? I don’t think I would want that to be my experience.

  • See it happen again and again – the problem is where the doctors put their career and their patients as their top priority, above all else. Doctors are not taught how to set limits or how to say no. I’ve learnt to always put my family first above my job, and whenever I’ve felt the job getting to me, I’ve made changes. Patients do not benefit from having burned out, unhealthy doctors. Fortunately I can do that in private general practice but salaried hospital doctors in the early part of their careers don’t have that flexibility.

    @Fish I don’t appreciate the caricature of doctors being rich and greedy. Although doctors are usually earning above the average income there are only a few who I would describe as wealthy. Considering the rigorous study and training, the long hours, and then the degree of responsibility doctors hold, I would suggest that for the most part the pay is commensurate.

  • Mike M

    @Fish: that’s just an insult to me and thousands of primary care docs who are not rich and who (along with their families) have to suffer because of the intense work and long hours and pay that is essentially less than what our counterparts received 20 years ago. And as for the snarky “civil service” remark, that also belittles us independent physicians who choose this path precisely because we can care for patients how we want instead of how we’re told.
    Personally, I think all lawyers should become civil servants and get paid an hourly rate instead. THAT is true reform.

  • Ron Spross

    Once upon a time I worried about physicians’ bloated incomes. Nowadays, I worry much more about the distortions that are introduced into the medical care industry by the domination of for profit “health” insurance companies, which victimize both patients and doctors.

  • Lord Valiant

    We -need- far more physicians and medical staff trained up with less focus on specialty care and the like. A single payer system or an NHS with salaried physicians would go a long way. Also, a 40 hour work week for our medical staff. We would need more doctors but we need more doctors anyhow and it seems insane to work the doctors we have 80 hours a week just to meet, insufficiently, our medical needs.

  • Tim Atwater

    There is a longer article on the same study at NY Times that makes the connection more clear re the money — the systemic money of the insurance industry and implicitly all the others caught up in the logic of dollar-driven definitions of value and efficiency that are driving the system — I empathize with the doctors. And the patients even more. And as a pastor trying to preach the Sabbath on the Sabbath (ok on the Christian version of the Sabbath) I don’t think I am making up the Sabbath message underlying this report… The logic of the Sabbath is meant to infuse all the working week….
    thanks for this post.

  • Mike M

    Tim: thanks for the Sabbath affirmation. But I think the blame needs to be spread around a bit. The implicity driving the current system involves not only the insurance companies (which stands to gain trillions of taxpayer dollars under Obamacare), but also drug companies, hospital systems (which bear little resemblence to our grandparent’s hospitals), the AMA, AARP, specialists, hospice companies, nursing homes, and assisted living facilities. Trust me, no hospital CEO is working harder nor making less money than his counterpart 20 years ago.

  • Dianne P.

    As an aging 🙂 RN, I can see how this is true… For physicians as well as the other medical professionals. With the increased need for primary care, I see the same burnout extending to PAs and nurses. Crank ’em out. Treat ’em and street ’em.

    Anyone who thinks the average primary care doc is wealthy is living in another decade… Or another planetary system. Yes, the specialists are, and that’s related to our totally crazed reimbursement system. But the pediatricians and other primary care docs… Well, IMHO no sane person would sign on for these jobs. Truly a vocation of love… And/or burnout.

    There’s lots of praise about the efficiencies in such systems as Mayo and the Cleveland clinic, where doctors are staff, but I sure don’t see anyone else putting their money where their mouth is. Far more profitable to stay with the status quo.

    Since I’m retired, I have the pleasure of volunteering in a free clinic where we nurses spend as much time as necessary with each patient. Wow! Though we are religiously based (yep, the good old Catholics) and privately funded, we are able to do what’s needed for each patient. Ironically, I think we give far better care to the chronically ill… Diabetes, hypertension … Than many private medical offices.

  • Mike M

    God bless you, Dianne.

  • Tim Atwater

    thanks Mike #8, and i agree… It is the whole system that is bent, badly…
    Thanks Dianne for your witness as volunteer not in a rush, modeling the Alternative.

    and rather than beat on (or try to exonerate) any one group (i tend to think, paraphrasing Heschel, that we are all guilty and all responsible, though not of course all equally so in each arena…) and there is the usual reminder of our fight not being against enemies of flesh and blood… but powers, rulers authorities etc… (eph 6)

    the spiritual fight is to rehumanize and redivinize the fallen systems without demonizing each other in the process…

    simple, right?


  • DRT

    While at my GP the other day I asked her how many hours she needed to work a week, 70.