August 21, 2012
Already Overworked US Physicians Face Upcoming Work Increase
John Neumann for redOrbit.com - Your Universe Online
The Mayo Clinic reports today that 45.8 percent of the nation´s doctors already suffer from symptoms of burnout and overwork. This is before millions of newly insured patients under the upcoming Affordable Care Act begin entering doctors´ offices.
“The rates are higher than expected,” says lead author and physician Tait Shanafelt. “We expected maybe 1 out of 3. Before health care reform takes hold, it´s a concern that those docs are already operating at the margins.”
Being asked to see more patients and not getting enough time with them creates an atmosphere of “being on a hamster wheel,” physician Jeff Cain, president-elect of the American Academy of Family Physicians, which is not associated with the study, told Janice Lloyd for USA Today. “We know when enough time is spent with patients that outcomes improve and costs are down.”
The study´s results indicate a lot of stress in the profession, with 37.9 percent of US physicians claiming high emotional exhaustion, 29.4 percent complain of high depersonalization and 12.4 percent had a low sense of personal accomplishment.
These numbers compare with 3,442 working US adults, physicians were more likely to have symptoms of burnout (37.9 percent vs. 27.8 percent) and to be dissatisfied with their work-life balance (40.2 percent vs. 23.2 percent), the study found.
Differences in burnout also varied by specialty with emergency medicine, general internal medicine, neurology and family medicine having the highest rates, while pathology, dermatology, general pediatrics and preventive medicine had the lowest rates, according to the study.
Physicians participated in the study by completing a 22-item Maslach Burnout Inventory questionnaire, considered the gold standard for measuring burnout.
“The study advances our knowledge by, for the first time, comparing to the general population and showing that physicians are at higher risk of burnout,” said James Wright, chief surgeon at The Hospital for Sick Children in Toronto.
“It´s very clear that when physicians are becoming burned-out it begins to affect their relationships with other healthcare workers and with patient families.”
Other reasons for professional burnout include too much paperwork, loss of professional autonomy and a higher patient load to make up for declining reimbursement rates.
“There is a sense that the volume of patients that need to be seen is increasing and it´s taking away some of the time needed to build a relationship and give the best care possible,” Shanafelt said. “That starts to build cynicism, I think.”
Mark Linzer, director of the Hennepin Healthcare System in Minneapolis, suggests that team-oriented approaches could help ease the pressure: “It used to be all about the clinician caring for the patient. Now it needs to be the clinician, nurse, care coordinator and others.“
“When you start expanding the numbers of types of people who are caring for a patient, that helps a doctor and patient a lot.”
Bottom line, says Linzer, “The Affordable Care Act is going to put more pressure on the front lines. This new study could be an important wake-up call the country needs to hear to build health care teams to meet the need.”