In my last blog post, we explored the definition of burnout, some common symptoms of burnout, and the reasons why it is imperative that we address physician burnout. Today, I want to talk about contributors to physician burnout.
Physician burnout is outrageously common. A 2021 Medscape survey of more than 13,000 physicians showed that 47% have experienced symptoms of burnout (up from 42% pre-pandemic). There are gender disparities in burnout; in the same survey, 56% of female physicians (vs 41% of male) reported symptoms.
This table highlights the factors that physicians feel contribute to their burnout:
Physicians were asked to comment on these contributors. Their quotes may sound familiar:
"I barely spend enough time with most patients, just running from one to the next, and then after work, I spend hours documenting, charting, dealing with reports. I feel like an overpaid clerk”.
“Where’s the relationships with patients that use to make this worthwhile? Everyone is in a foul mood.”
"Home is just as busy and chaotic as work; I can never relax.”
The findings of this Medscape survey are confirmed by other research; the primary contributors to physician burnout are system-level factors rather than individual factors. Increased productivity requirements that lead to less time with our patients, documentation regulations that create a higher clerical burden (much of which ends up occurring on nights and weekends), quality and productivity metrics that imperfectly capture the nature of our work, a medical culture that expects perfection and rewards overworking and personal sacrifice.
You may be wondering – if physician burnout arises from system-level factors rather than individual ones, what is the role of coaching in preventing and reducing physician burnout?
The traditional framework has been that physicians are somehow to blame for experiencing burnout; that burnout is the result of a personality defect or individual “frailty”. Accordingly, many antidotes for burnout have been individual level interventions – “mental health” days off, massages, yoga classes. And these things can help – but alone, they do not solve the problem of physician burnout.
It is clear that the system must change. And we, as physicians, are perfectly poised to lead that change. But when we experience burnout, our creativity, self-efficacy, and resolve are affected. We feel frustrated and powerless. The filter of burnout does not allow us to identify the things that are within our individual control to change OR the things that we must collectively advocate for.
With skills learned through coaching, two shifts occur – as the filter of burnout lifts, you start to appreciate the power of your mindset (which – good news - is entirely within your control) AND you can more clearly identify system-level problems, build collaborations, and explore creative solutions.
11% of the physicians in the Medscape survey reported that they have worked with groups or individuals (including coaches!) who offer programs to reduce burnout, and an additional 46% said that they were considering doing so. Physician coaching is evidence-based and rapidly-expanding; I am so grateful to be part of this movement.
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Physician Burnout & Depression Report 2022: Stress, Anxiety & Anger. Medscape. January 21, 2022.