Physician burnout is a problem that needs to be addressed immediately. With the Covid-19 pandemic, society is facing a challenge known to us only in the stories of yesteryear. Faced with this, a group of citizens has come forward without a moment’s hesitation, responding with an astonishing show of generosity, fulfilling their tasks despite the risk of personal and family lethal damage. Healthcare workers.
The Effects of Physician Burnout
But this effort has not been free of harm. Just reading the social networks is enough to perceive in this group the feeling of extreme fatigue and “burnout” that is growing in their ranks. Physician burnout is a psychological syndrome characterized by “stressful and emotional conditions related to the work environment”.
This marked exhaustion is more than just being extremely tired. Medical burnout leads to deterioration in mental health, which can lead to depression, substance abuse and in the worst cases, even suicide.
Burnout has been simmering for years due to increasing changes in the healthcare system, the widespread implementation of electronic health records (EHR), and the roll-out of monitoring performance metrics. It only took one pandemic to reach the boiling point.
If there is one place that has resonated in the minds of all society, it is the intensive care units or ICUs. Working in an intensive care environment is very stressful due to high morbidity and mortality, patient overload, demanding schedules and the daily confrontation with challenging ethical situations. Since before the pandemic, specialists in the intensive care unit (ICU) experienced more than 50% of total burnout syndrome. Now, I can’t imagine what the percentages might be.
On the other hand, we hear that primary care workers are overwhelmed and do not have the necessary tools. Well, it is also proven that poor working conditions in primary care are associated with burnout in physicians and lower-quality care.
This is also an epidemic with a curve, which sadly continues to rise. In 2014, 54.4% of American physicians reported at least one symptom of burnout compared to 45.5% in 2011.
This represents a public health crisis with negative impacts on patient care, professionalism, healthcare, and safety. In cold numbers, burnout is costing the healthcare system approximately $4.6 billion a year.
Gagné and Deci postulate that there are three pillars that support the intrinsic motivation and psychological well-being of professionals: autonomy, competence and relationship. The problem of burnout will not be solved without addressing these elementary questions.
Steps to Prevent Burnout
But as always, there is hope. A Mayo Clinic study in Rochester, Minnesota, showed a statistically significant decrease in burnout rates after certain intervention measures.
The first step is clear, we have to look for it, measure it and diagnose it. There are several surveys available to measure clinician burnout. According to a recent systematic review, the Maslach Burnout Inventory (MBI) is the most widely used
After being diagnosed, there are 5 initiatives that we must implement:
- Schedule monthly meetings with healthcare workers, focused on work-life and personal challenges.
- Unload non-essential tasks to non-medical personnel, relying on the hiring of additional personnel.
- Flexibility in scheduling restroom schedules.
- Align the values of the healthcare system with those of doctors, nurses and other healthcare professionals.
- Limitations of working hours.
I don’t particularly like the comparison of the Coronavirus with a war. Still, I can’t help the following comparison. Ignoring the reality of burnout that is palpable in our healthcare system would be like ignoring the crisis of war veterans. Our healthcare workers have been exposed to situations beyond the line of duty, and many times they had to do so without the necessary “weapons”.
If we can go out every night to applaud their efforts, the least we can do is use social networks to nag our leaders with petitions to pay attention to this other epidemic that could leave us without anyone to take care of us in the next pandemic.