Surgeon general: Burnout has many health care workers ‘in crisis’
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CHICAGO — The escalating prevalence of burnout among U.S. health care providers poses “a real threat” to public health, the U.S. surgeon general told ASCO Annual Meeting attendees.
“Many of our health care workers are in crisis,” Vice Admiral Vivek H. Murthy, MD, MBA, said during the meeting’s opening ceremony. “We have burnout rates that have gone through the roof. We have people in medicine and nursing who are talking about leaving the profession in greater numbers than they ever have. It presents a real threat to public health of our country.”
Marcella Nunez Smith, MD, MHS, associate dean for health equity research at Yale School of Medicine and associate cancer center director for community outreach and engagement at Yale Cancer Center, led a 30-minute fireside chat with Murthy.
The wide-ranging discussion addressed topics such as loneliness, the risks of social media for youth and the pursuit of happiness.
The first half, however, focused on clinician health and well-being, including burnout — a subject on which Murthy issued a surgeon general’s advisory last year.
Murthy highlighted multiple strategies he believes are essential to address the problem.
“Number one, when people in health care need help, that help should be available,” he said. “Mental health services should not be hard to access. There shouldn’t be insurance barriers. We should use technology to bring that care to where our health care workers are instead of expecting them to wait 3 months and drive 30 miles to get an appointment.”
The nature of the work health care providers do also must be evaluated, Murthy said.
“No doctor or nurse I know went into their profession saying, ‘You know, one day I want to grow up and be able to chart’ ... or ‘I can’t wait to get on the phone about that prior authorization,’” Murthy said. “These are things that get in the way of patient care. It’s not to say you shouldn’t chart. We need to use technology and safe systems to be able to deliver care, but far too often we’re finding people are spending more time with tasks that take them away from the bedside ...
“The system we have built, for all of its strengths and all of the ways it has advanced care, I think has had the unfortunate effect of taking us further and further away from the patients we’re seeking to serve,” Murthy added. “That actually does impact burnout because so many of us get sustenance from interactions with our patients. When we don’t have enough time with them, we can’t deliver the quality of care we want.”
Although kindness, compassion and bedside manner are valued, that isn’t always underscored for trainees or signaled to others in the profession, Murthy said.
“When was the last time you heard about somebody being promoted because they were a compassionate clinician at the bedside?” he said. “More often they’re promoted because of their publications and their research funding and other traditional accolades. It’s not that those aren’t important, but there’s such a disparity in the message we send trainees about what is valued in the profession. Things like kindness and compassion almost come to be seen as afterthoughts.”
Murthy suggested a “rebalance” for the profession may be necessary.
“That starts with who we lift up and hold up as role models, how we lead in our own care — especially when others are watching — and who we promote,” he said. “I would love to see some of the more human elements around care delivery ... valued more as we think about promotions and who to bring in to our faculties.”
Addressing burnout offers a chance to re-examine the values that motivated so many providers to enter the profession, Murthy said.
“We need to double down on [those values] and ensure the fact we came to do this work because of our head and our heart — because we wanted to use our intellect and our compassion — is not lost in our efforts to provide care,” Murthy said.
“This falls to all of us, not just policymakers or hospital leaders,” he added. “It’s everyone. What you say matters. How you lead matters. The values you speak to and demonstrate in your care of patients help shape the next generation of care providers.”
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A discussion with the U.S. Surgeon General on Health Worker Well-Being. Presented at: ASCO Annual Meeting; June 2-6, 2023; Chicago.
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