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March 1, 2019

Physician burnout is… down? Maybe—but it’s still a big problem, report finds.

Daily Briefing

    Read Advisory Board's take: Why rates may be declining— but why we still have a long way to go

    Rising rates of physician burnout have attracted considerable attention in recent years, but a new report published in Mayo Clinic Proceedings suggests that the share of physicians who are burned out may be declining.

    Report details

    The report, led by Tait Shanafelt at Stanford Medicine, as well as researchers from the American Medical Association (AMA) and the Mayo Clinic, analyzed data on more than 5,000 physicians.

    The researchers found that the share of physicians who said they were burned out increased from 45.5% in 2011 to 54.4% in 2014. But by 2017 that figure had fallen to 43.9%.

    When broken down by specialty, the ED physicians had the highest burnout rate in 2017 at 54.9%. But the researchers noted that figure was down from 71.6% in 2014.

    At the same time, overall satisfaction with work-life balance also improved. According to the report, 42.7% of physicians reported a positive work-life balance in 2017, up from 40.9% in 2014. However, the researchers noted satisfaction rates have not quite rebounded to 2011 levels, when 48.5% of physicians were satisfied with work-life balance.

    But while certain indicators of physician well-being may be improving, the rate of depression among physicians has slowly been climbing—from 38.2% in 2011, to 39.8% in 2014, to 41.9% in 2017.

    The researchers also found that, compared with the general population, physicians still had noticeably higher rates of burnout: 36.4% of physicians reported emotional exhaustion, while just 24.8% of the general workforce reported the same. Similarly, 18% of physicians reported depersonalization, compared with 13.5% of the general workforce.

    Why burnout rates improved in 2017

    The researchers offered five potential reasons for why burnout rates improved in 2017:

    1. 2014 could have been an outlier year, as many new regulations were implemented and there were high levels of hospital and health system consolidation, as well as increased administrative burdens;
    2. Physicians may be adapting to a new practice environment;
    3. Physicians who previously reported being burned out may be leaving the profession;
    4. Major initiatives by organizations to reduce burnout may be working; and
    5. Efforts to improve the overall efficiency of the practice environment could be putting less pressure on physicians.

    Burnout is still a major issue

    The researchers wrote that the decrease in physician burnout rate "is encouraging and suggests improvement is possible despite the numerous contributing factors and complexity of the problem." However, they added that "symptoms of burnout remain a pervasive problem, and its prevalence among physicians continues to be markedly higher than in the general U.S. working population."

    To address this problem, the researchers wrote that a "coordinated, systems-based approach at both the national and organizational levels that addresses the underlying drivers" is needed.

    Barbara McAneny, president of the AMA, said, "The progress demonstrated in today's research suggests that growing national efforts to address physician burnout are on the right track, but more work is needed to achieve meaningful change" (Cheney, HealthLeaders Media, 2/22; Castellucci, Modern Healthcare, 2/22).

    Advisory Board's take

    Rachel Woods, Senior Consultant, Medical Group Strategy Council

    As rates of physician burnout reached record highs in the past few years, physician leaders across the country have invested widely in strategies to identify and treat burnout. And it seems like these efforts have started to pay off. The difference seems to be that, after years of attempts to bring joy back to the practice of medicine, physician leaders have shifted their focus from strategies to mitigate burnout once it manifests to solutions that aim to prevent burnout from occurring in the first place.

    “Many physicians spend more than 15 hours per week online outside of shift hours.”

    It's no surprise that the rise in physician burnout has paralleled the rise in the administrative burden of medicine. Today's doctors spend far more time looking at screens than they spend in direct face time with their patients. And that so-called "desktop medicine" extends long past traditional office hours, with many physicians spending more than 15 hours per week online outside of shift hours.

    This misspent time is the primary cause of physician burnout today. And as physician leaders invest in reducing the administrative burden of medicine, they will start to see a corresponding reduction in the rate of physician burnout. That's why medical group leaders are investing in solutions to optimize the EMR, deploying new technologies and scribes to reduce documentation burden, and expanding care teams with codified roles and responsibilities.

    The good news is that many of the tactics that address the underlying causes of physician burnout can help groups achieve their broader strategic goals, like improving provider productivity and ensuring that each member of the care team is operating at top-of-impact.

    But of course, health systems and medical groups have a long way to go to engage their doctors, enfranchise them as leaders of change, and prepare physicians for the future of health care. It will require dedicated effort at scale to truly impact physician burnout in the years to come.

    To learn six key strategies to alleviate the EMR's burden on physician practice and reduce the administrative burden of medicine, download the Medical Group Leader's EMR Optimization Playbook. Then, to learn more about how to fight physician burnout as a whole, download our report on Combatting Physician Burnout.

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