How to Avoid Physician Burnout: Signs, Symptoms, Prevention

What Is Physician Burnout?

Physician burnout is described as a response to chronic occupational stress, manifesting as feelings of cynicism, detachment or lack of empathy toward patients, and physical or emotional exhaustion. 

These stressors can come from several pain points in the workplace. The role of a physician is a physically and emotionally demanding role, the job does not always set physicians up for success, which is why many leave the profession altogether. Understanding how to help doctors prevent burnout will improve retention rates and overall patient outcomes. 

Impact of Doctor Burnout

Doctor burnout has a direct impact on the doctors themselves as well as their patients. Doctors work closely as a team with other healthcare providers, like nurses, physician assistants, technicians, pharmacists, and many other roles in the medical ecosystem. Burnout results in low morale, reduced staff retention rates and ultimately poorer patient outcomes. 

External Causes of Burnout Among Physicians

There are many causes of burnout in healthcare, with many outside the control of doctors, identifying possible issues early will help with intervention and prevention.

High Emotional Demands

Any profession that revolves around the service of aiding others is emotionally demanding roles. The role of a physician at its core is to assist patients through diagnosis, treatment, or therapy, and address maintenance of health through preventative measures. Positive or negative, a physician has the knowledge and power to recommend courses of treatment that can alter the well-being of their patients. This responsibility is no light matter and can be taxing when physicians are not set up to succeed. 

Time Pressure and Clinical Workload

Despite the heavy responsibility of the role of a physician, time pressures and clinical work have to be balanced in their day. Doctors often have to address multiple patients at a time and offer expert advice with limited interfacing with patients. Additionally, hospitals and institutions require in-depth write-ups and paperwork to provide each patient with a detailed history of their health for records and insurance purposes. This leaves little room for mistakes and compounds the likelihood of error on the side of the physician. 

Constraints on Decision Making

When it comes to making the best decision for your patients, the ideal option is not always available. This can be either due to resources at the particular hospital, cost on the side of the insurer, or more increasingly political constraints. These factors are outside the control of the physician and their patients meaning doctors have to recommend courses of treatment that may not be in the best interest of the patient. 

Internal Factors Leading to Physician Burnout

Having high self-expectations or perfectionism is not a direct indicator of burnout, but doctors who hold high metrics of success for themselves and their work are predisposed to burnout. 

High Self Expectations

Holding high self-expectations for oneself is not an inherently flawed trait to have as an individual. When it comes to working in healthcare, however, there are factors and systems in play that will ultimately fail at some point. Holding oneself responsible for decisions made for patients outside the realm of control can quickly lead to feelings of inadequacy and burnout. 

Perfectionism

Perfectionism is important to strive for but ultimately is unachievable. Even the most skilled and well-trained physicians fail and make mistakes. Perfectionism in healthcare, though an honest endeavor, is not attainable, and expecting perfect outcomes in patients, and exact support from administrators is not healthy for continued work in the healthcare sector and will result in burnout. Medical care is about mitigating risk and improving the overall well-being of patients. No two cases will be the same, providing the best options for patients is an inherently imperfect job. 

Signs of Physician Burnout Among Doctors

There are three external signs of healthcare burnout, and showing one or all three of these symptoms causes to evaluate whether it should be addressed.

Cynical and Negative Outlook on Career

Not all physician specialties are created equal when it comes to the emotional toll of caring for patients. Inherently oncologists and emergency medicine deal with issues like death and pain regularly. The key is recognizing that any doctor has the potential to feel cynical about their work. More mundane specialties are just as susceptible to perceiving their career through a cynical lens. When self-identifying or spotting it in others, it is important to notice patterns of negativity, as this can be independent of any one difficult event. 

Lack of Empathy Toward Patients

Showing reduced interest or empathy for patients and their outcomes can be very harmful and actually decrease the efficacy of care. Doctors who notice prolonged disinterest in their patient’s feelings and needs should consider burnout as an issue. Lacking empathy toward patients can mean a miscommunication in an exam, an improper diagnosis, and even result in patient death. 

Physical and Emotional Exhaustion

Working as a physician can be very physically and emotionally demanding. There is much to be accredited to doctors who regularly work long and atypical work hours, often on weekends and holidays away from their families. The temporal aspect of the work can be remarkably taxing and does not leave time for mental and physical recuperation. Additionally, the job requires emotional investment in patients and their outcomes. 

Doctors who feel unable to recover and sustain their workload are likely exhausted, which is a key indicator of burnout and it is often the first symptom to look out for. 

Which Types of Doctors Are Most Likely to Experience Burnout

Certain medical specialties are more predisposed to burnout compared to others. Emergency medicine, family medicine, urology, and nephrology are known specialties with increased rates of physician burnout. For example, family and emergency medicine see high numbers of patients with significant constraints on their decision-making either due to funding issues or inadequate staffing. 

How to Prevent Physician Burnout

The goals in preventing physician burnout are threefold: improve workplace morale, encourage better retention rates, and strive for better patient outcomes. There are a few ways to achieve these aims. 

Reduce Workload

A key pain-point for physicians is their workload. Doctors do not spend the majority of their time with patients, in fact, they are spending an increasing amount of time doing administrative tasks. These are tasks that are time consuming, repetitive, and are seen as not entirely necessary for a doctor to be doing. 

Support in the area of administrative tasks allows physicians to spend more face time with their patients. Which in turn results in better patient outcomes and stronger doctor-patient relationships. 

Keeping Open Communication

Working in the medical field is a team affair, often doctors need to work collaboratively to share expertise. Communication between physicians and the administration of their hospital or workplace is not always held up to such importance. When it comes to meeting the needs of doctors, opening these lines of communication, and allowing space for growth and improvement is essential. 

Often doctors work difficult hours outside of typical business hours, this means time and space to communicate their needs are essential to reinforce. Creating a culture of communication, and voicing concerns can give physicians a way to feel supported. Not only should they be able to reach out for assistance, but they should feel their extension for assistance is being met. Hospitals or medical institutions are hierarchical and require all levels and positions to be allowed to utilize communication as a means of support.

Promote Well-Being

The promotion of well-being is easier said than done. Well-being is setting a tone in the workplace and shifting the culture of a work environment, which does not happen overnight. Promoting well-being must be genuine and requires the implementation of preventative measures that come from the top down. The healthcare system is remarkably hierarchical and the tone is set by the most senior of an institution.

Offering Support Resources

Tangible resources are a great means of support for individuals in the medical profession. Resources that allow them rest, and assistance with managing their causes of burnout allows for a healthier relationship with their work and patients. External factors are critical to focus on. These help physicians by alleviating stringent timing and pressure, as well as removing barriers that facilitate better decision making. Tools that make their workload less invasive allow doctors to allocate more time with their patients, and room to make better decisions. This in turn will result in better patient outcomes, higher workplace morale, and higher retention rates.