Practice Notes

What burnout interventions work best? Here's what the data says.

by Daniel Kuzmanovich

Editor's note: This blog post was updated on May 9, 2018.

Physician burnout is rampant in health care, with more than half of physicians experiencing symptoms.

The impacts of this epidemic sweep across the industry: While burned out physicians suffer feelings of apathy, indifference, and potential mental health concerns, their organizations and patients are also negatively affected. Physician burnout has been linked to decreased productivity and increased job turnover, while patients of burned out physicians are more likely to experience medical errors, reduced care quality, and less satisfaction with their care.

Recognizing burnout's importance, many health care executives are proactively taking steps to address it. But what's the best approach?

Insights from research

For a recent study published in JAMA, researchers conducted a meta-analysis evaluating existing randomized clinical trials and before-after studies of physician burnout interventions.

Specifically, they assessed the effectiveness of two types of burnout interventions:

  • Physician-directed interventions, or approaches that target individuals—such as mindfulness or cognitive behavioral techniques to improve coping, communication, and competence; and

  • Organization-directed interventions, or approaches that focus on improving the workplace environment—such as changes in scheduling, workload, practice operation, and decision-making.

The takeaway

It's common for organizations today to try to reduce burnout through physician-directed interventions, such as forming support groups or peer forums, providing physicians with mental health services, and implementing job training and wellness coaching.

These are valuable steps for reducing physician burnout and keeping physicians healthy and practicing medicine. But when it comes to actually beating and preventing physician burnout altogether, the hallmark takeaway from the JAMA study is that organization-directed interventions have a greater effect than physician-directed interventions.

This certainly doesn't diminish the value of physician-directed interventions. They're an important first step to reduce the burnout burden and support physicians. But physician-directed approaches alone are likely insufficient in the long run if the causes of burnout stem from organizational or health system factors.

The first step to overcoming burnout at the organization level is to listen and understand the root causes. Then, offer institutional support—which can take many forms, including optimizing physician workflows, reducing EHR burdens, and increasing physician time on direct patient care. These organization-directed interventions will have a greater effect on burnout among your physicians.

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preventing burnout

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