A Review on Strategies to Manage Physician Burnout

Abstract

Physician burnout is an emerging condition that can adversely affect the performance of modern-day medicine. Its three domains are emotional exhaustion, depersonalization, and a sense of reduced accomplishment among physicians, with the Maslach Burnout Inventory (MBI) being the gold standard questionnaire used to scale physician burnout. This concern not only impacts physicians but the entire healthcare system in general. There is growing awareness regarding the mental health of physicians and the consequences faced by the healthcare system as a result of burnout. According to a recent study, more than 50% of physicians reported suffering from at least one burnout symptom. In this review article, we aim to identify the causes leading to burnout, its impact on physicians, and hospital management as well as interventions to reduce this work-related syndrome. Some contributing factors leading to burnout are poor working conditions with long work shifts, stressful on-call duties, lack of appreciation, and poor social interactions. Burnout can lead to adverse consequences, such as depression, substance use, and suicidal ideation in physicians and residents. This can result in poor patient care increasing total length of stay, re-admissions, and major medical errors. Due to increased scrutiny of patient and healthcare costs, along with increased lawsuits as a result of major medical errors, it is crucial for both the hospital management and physicians to recognize and address burnout among physicians. Comprehensive professional training such as Cognitive behavioral therapy (CBT), stress-reducing activities such as mindfulness and group activities, and strict implementation of work-hour limitations recommended by Accreditation Council for Graduate Medical Education (ACGME) for residents are a few methods that may help to manage burnout and increase productivity in hospitals.

Pediatric Resident’s Perception of Night Float System Compared to 24 Hours System, a Prospective Study

“…Another study was done on neurosurgery residents showed that long and multiple shifts associated with burnout risk [4]. Another research emphasized the effect of stressful on-call duties, and long duty hours on the increase in the incidence of burnout [5]. In addition, a study suggested minimizing work hours and assigning health care workers to speci c rules in order to prevent physician burnout [16].…”

“…The questionnaire was composed of Likert items which measured the extent to which respondents agreed or disagreed with statements relating to the three major domains of the senior residents' wellness (16 items), ability to deliver quality health care (17 items), and medical education experience (16 items) (Appendix 2). The responses to each item were coded as strongly disagree (1), disagree (2), neither agree nor disagree (3) agree (4) and strongly agree (5).…”

“…Furthermore, an increase in burnout and suicide attempt among physicians. As a result, several countries have established the Night Float (NF) shifts system [2][3][4][5][6].…”

Wellness Review 2019, Part 1

“…A summary of burnout literature appeared in Cureus (an "open access medical journal for a new generation of doctors and patients' appeal to the cross-disciplinary nature of medicine") [23]. We highlight this thorough review of the literature for its content, but also to draw our readers to the journal Cureus, which like JWellness, appears too good to be true.…”

Multidisciplinary Approach to Enhancing Provider Well-Being in a Metropolitan Medical Group in the United States

“…Approximately $4.6 billion in costs related to physician turnover and reduced clinical hours is attributable to burnout annually in the United States which represents approximately $7600 per employed physician each year [16]. In addition to the signi cant nancial burden, the overwhelming administrative duties in part due to the electronic health record (EHR), sti ing oversight by employers, loss of autonomy and control, and lack of colleague and organizational support contribute to provider burnout [7,11,14,[17][18][19].…”