Over 45 percent of resident physicians experience burnout, a condition linked to factors that include exposure to suffering and trauma, inefficiencies with electronic health records (EHRs) and paperwork, and—perhaps most of all—long work weeks that don’t allow clinicians time to recover from the stresses of the previous day. In fact, 75 percent of physicians work between 40 and 80 hours per week.
Symptoms of Burnout
Burnout is a reaction to chronic stress characterized by three dimensions: exhaustion, depersonalization, and low self-efficacy.
Exhaustion. Emotional, mental, and physical exhaustion all occur with burnout. Signs include lack of focus, insomnia, and chronic fatigue. One study found that over half of fatigued medical residents were involved in a car accident within a three-month period of being surveyed.
Depersonalization. Signs of depersonalization include feeling detached from work or relationships, cynicism or sarcasm, and negative or inappropriate attitudes towards colleagues or patients.
Low self-efficacy. Feeling insufficient, decreased productivity, low morale, and reduced personal accomplishment are common symptoms of burnout. Those with low self-efficacy may question their sense of purpose or why they entered the medical field to begin with.
These symptoms take a toll on individuals and may cause premature aging. A study took saliva samples from 250 first-year medical residents to examine the length of their telomeres, which help prevent DNA damage. Researchers found that the residents’ genes aged six times faster than normal, with this rate increasing with the number of hours worked per week.
When Burnout Gets Unmanageable
In a Medscape survey, 77 percent of physicians reported they had no plans to seek help for burnout or depression. Another study stated that about 40 percent of physicians would hesitate to seek help for mental health due to fear of impacting their job, credentials, or license.
This can mean that, for some, depression or suicidal ideation go unchecked until it’s too late. Every year, approximately 400 physicians die by suicide in the US. One radiologist shares a story about a colleague who closed her practice after working 16 to 20 hours a day, seven days a week, for years. But even with the stress of the practice was gone, the long-term effects of burnout were there, and the physician died by suicide shortly after.
How Burnout Affects Patient Care
Clinicians experiencing burnout can’t provide the best possible care for patients. In a 2018 meta-analysis of 47 studies, physician burnout was associated with an increased risk of patient safety incidents, reduced quality of care, and decreased patient satisfaction. Additionally, Mayo Clinic researchers have found that increased symptoms of burnout contribute to increased racial bias in medical residents.
Burnout can also cause severe injury and even death for patients due to medical errors. A study shows that burnout and mental quality of life are strongly associated with major medical errors reported by surgeons. Medical errors don’t just happen during surgical procedures either. Emergency medical technicians (EMTs) and other emergency physicians often face grueling 24 hour shifts, leading to severe fatigue and serious, if not fatal, mistakes.
Addressing and Treating Burnout
It’s estimated that the US spends $4.6 billion per year on burnout due to physician turnover and reduced clinical hours.
While there are certainly things individual clinicians can do to improve burnout symptoms or prevent burnout, some things may require leadership approval or organizational changes. For organizations, making changes to prevent burnout can save both lives and money.
- Deconstruct inherent and external stresses and rewards, and manage them accordingly
- Reduce alarm fatigue
- Find methods for optimizing documentation
- Create spaces that allow staff to decompress, as physicians and staff able to decompress are more likely to feel activated in their work
- Implement systems, like Collective’s platform that fuel collaboration and decrease unnecessary care
- Hire additional staff to help meet the social needs of patients
- Set boundaries and stick to them as much as possible
- Spend time with loved ones
- Allocate 20 percent of work hours to tasks that feel meaningful
- Schedule time for things like workouts, journaling, coffee with a loved one, reading, classes, date nights, etc.
- Turn to resources that help clinicians manage burnout
- Find ways to cope with the exposure to suffering and trauma
Most importantly, seek help from a trusted colleague, friend, family member, or medical professional—especially if you’re contemplating self-harm.