Specialists offer advice for navigating physician burnout
Key takeaways:
- Lack of autonomy, poor leadership and poor work-life balance are just some of the drivers of burnout.
- The use of scribes and having staff work to the top of their license may ease some burdens.
Burnout among physicians and residents continues to grow, with six out of 10 reporting these feelings, along with continued stigma about seeking treatment, according to a survey by The Physicians Foundation.
“Burnout arises when individuals are experiencing high and continuous levels of stress,” Theresa Bingemann, MD, FACAAI, FAAAAI, allergy and immunology fellowship program director, University of Rochester Medical Center, told Healio.
Time pressures, lack of autonomy and control over processes, and role conflicts all contribute to stress, said Bingemann, who also is a member of the Healio Women in Allergy Peer Perspective Board.
Bingemann also blamed stress on poor leadership and a lack of value alignment with leadership, in addition to excessive insurance hassles, increasing work productivity expectations, paperwork and documentation burdens, and the emotional intensity of the work.
Aikaterini (Katherine) Anagnostou, MD, MSc, PhD, FACAAI, professor of pediatric allergy at Texas Children’s Hospital and Baylor College of Medicine, sees similar obstacles for health care professionals.
“A large number of commitments and daily tasks, elevated work-related stress, dissatisfaction with a current job, too many hours of work every week, lack of dedicated time for routine tasks and increasing demands from employers can all drive physician burnout,” Anagnostou, who also is a member of Healio’s Allergy/Asthma Peer Perspective Board, told Healio.
Michael S. Blaiss, MD, FACAAI, FAAAAI, clinical professor of pediatrics, Medical College of Georgia at Augusta University, agreed that there are numerous causes of burnout.
“A few include excessive workload, erosion of the meaning of work, poor work-life integration and loss of control over patient care,” Blaiss, who is a member of Healio’s Allergy/Asthma Peer Perspective Board as well, told Healio.
“[Electronic medical records] have added to physician burden, leading to more time in the clinic to chart and less time with family,” he continued.
Professionals in allergy and asthma care are not immune to these pressures.
“As most allergists are employees now, I believe excessive workload and control over patient care are two of the main issues,” Blaiss said.
“Most drivers are more likely shared by different specialties,” Anagnostou agreed.
The biggest dangers to professionals, Blaiss said, are substance abuse disorder, increased depression, suicidal ideation and suicide.
In addition to depression and suicide, Bingemann said anxiety is another danger, along with negative impacts on personal relationships including divorce. Anagnostou noted effects on physical well-being too.
All three specialists agreed that burnout could drive physicians to switch jobs, retire early or otherwise leave the profession, increasing the shortage of allergists that already exists for patient care, with further negative impacts on patients.
“Burnout is associated with increased medical errors, poorer care quality and less patient satisfaction,” Bingemann said.
Physicians can take steps to mitigate burnout, these specialists said.
“Getting sufficient exercise, sleep and rest can be helpful,” Bingemann said, adding that eating well and gratitude practice also can help, in addition to “addressing pain points, like getting rid of stupid stuff — things that a physician does not need to see, they should not be getting.”
Bingemann also called for team-based care where everyone works to the top of their license, including team documentation.
“Scribes and AI scribes are also showing some promise,” she said.
Blaiss agreed with these strategies.
“In the office, use scribes or AI to do charting on patients. Delegate more responsibilities to mid-levels in the office. Get control of your patient schedule. Work for a supportive management team. Work to strive for the meaning of work,” he said.
Physicians can take better care of themselves outside of the office too, Blaiss continued.
“Take all your vacation. Make sure work does not interfere with family activities. Create barriers between work and home. Take care of yourself: exercise, eat right, get proper sleep, have hobbies and have a strong support system,” he said. “Outsource as much as possible in your life.”
“Ultimately, there is not a one-size-fits-all approach,” Bingemann said. “Looking and addressing the pain points where possible can be a step in the right direction.”
Anagnostou recommended a similar approach.
“Choose your place of work wisely,” she said. “Ensure you have good admin support where you work, and leaders that support flexible working. Make time to reflect and de-stress. Prioritize family and activities that give you pleasure. Exercise.”
Blaiss agreed that a change of scene may help.
“If all else fails for the allergist, change practices. Go from clinical to academic or vice versa,” he said. “Or leave clinical practice. There are numerous nonclinical jobs allergists can do.”
“Identify your own needs, priorities and desires and work to design your job in a way that allows you to thrive,” Bingemann said.
Physicians should not shoulder the burden of reducing the risks of burnout alone, these specialists agreed, as organizations and policies also bear responsibility.
“First, it is important to recognize that burnout is a systems issue, and the most effective interventions and strategies occur at the systems level,” Bingemann said. “This is not a resilience problem either.”
Bingemann said that organizations need to reduce the administrative burdens in health care.
“More specifically, simplify the health care system and insurance hassle. Make documentation and payment easier,” she said. “Reduce the multitude of requirements/trainings. Remove questions regarding seeking mental health care from licensing and appointment questionnaires.”
Blaiss said that organization leadership needs to recognize that burnout is an issue and develop well-being programs for their physicians and staff.
“Make sure that physicians and staff are not bothered during their non-clinic time,” he said. “Have scribes or AI to take the burden off physicians for charting. Give physicians time to develop something they are passionate about in the health care arena.”
“Organizations need to understand that exhausted, unhappy workers will produce much less than healthy, happy ones and should provide support to alleviate unnecessary work tasks, encourage a balance of well-being/work, and compensate/reward workers accordingly for additional contributions they may make to the working environment,” Anagnostou said.
Anagnostou also noted the complexity surrounding burnout, which requires significant time and financial investment to mitigate.
“Often, organizations miss the big picture, or the individuals making key workforce decisions are too distanced from daily reality to pick up warning signs for burnout,” she said.
Help is available for physicians who are struggling as well, Bingemann said. The American Academy of Allergy, Asthma & Immunology offers online resources for physician wellness including its Physician Wellness Toolkit.
“The AMA Steps Forward program also has multiple helpful resources,” Bingemann continued.
Bingemann noted the National Suicide Prevention Lifeline, available by dialing 988, and the Crisis Text Line, which can be accessed by texting HOME to 741741, as well.
“If you are struggling, please ask for help. Reach out to a trusted colleague or friend. Don’t hesitate to get professional help if needed,” she said. “While the system is slow to change, we can control how we treat each other.”
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For more information:
Aikaterini (Katherine) Anagnostou, MD, MSc, PhD, FACAAI, can be reached at katherine.anagnostou@gmail.com. Theresa Bingemann, MD, FACAAI, FAAAAI, can be reached at theresa_bingemann@URMC.Rochester.edu. Michael S. Blaiss, MD, FACAAI, FAAAAI, can be reached at michael.blaiss@gmail.com.