Physician Burnout Pervasive: 1 in 2 Internists Affected

Cheryl Clark, for HealthLeaders Media , August 21, 2012

He began thinking twice, he says, when a patient slapped him for not giving someone pain medication, and he was recently "punched and kicked" by a patient in the ED, a patient who he'd treated many times, but who had never paid his bills.

Asked if he wasn't trained to expect that in an emergency room setting, he said, no. "You were always taught that Medicare, Medicaid, and insurance companies would pay you a fair amount." Now regulations and insurance companies and legislation – "everyone seems to be coming down on us," he says.

David Bronson, MD, president of the American College of Physicians, says the study represents "a call to action to address the issues that are driving doctors away. Internal medicine is a great life and a great career."

"But the main reasons internists are dissatisfied and burned out has to do with reimbursement and limits on how much time they can see patients.

"Practice hassles and paperwork, are a lot greater than they were," Bronson says. But he sees a "glimmer of hope" in new payment models specified in the Patient Protection and Affordable Care Act.

"The patient-centered medical home model, if administered properly and done in the way it should, will bring rewards back to medicine," he says.

West says the study findings produced a kind of "fear factor" among himself and his co-authors. "None of us think it's acceptable that nearly half of the physicians across the country might be suffering from burnout. It can't be good for patient care or the health of the profession. And it's very concerning that these burnout problems could get worse.

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5 comments on "Physician Burnout Pervasive"

Jim E (7/4/2013 at 11:04 PM)
Our group has concerns that given the changes and requirements of EHR coupled with never-ending demands of seeing even more patients daily by our "overseers", then when will our first malpractice claim be served as a result of our evolving "operator fatigue"?

Dike Drummond MD (8/29/2012 at 12:15 PM)
The literature on burnout over the last 20 years is completely consistent with this study. 1 in 3 doctors on average are suffering from symptomatic burnout on any given office day. These statistics are worldwide, regardless of the docotor's specialty OR the type of healthcare delivery system. The biggest cause is the conditioning of our healthcare educational system which effectively installs a survival mechanism in all doctors that has four key components. Workaholic Superhero Emotion Free Lone Ranger This is a key set of skills we all must use to survive training and NOT a great way to live a life. It is this programming that is primarily responsible for the epidemic of burnout we see in medicine. The additional post-graduation stresses of "the business of medicine", our complete lack of functional leadership skills and the uncertainties of political "reform" and the changing practice landscape - 75% of doctors are projected to be employees by 2013 - not to mention raising a family with this #800 gorilla of a career. It is a recipe for this dysfunction. Where do we go from here? It is a multifactorial answer. The doctors need the skills to lower stress and prevent burnout as individuals. That is why I created my website. We know what works to create a more resilient doctor and prevent burnout and it is rarely taught in the standard medical school and residency curriculum. And organizations bear a large responsibility because it is so darn easy to focus on the patient .... and not see that - in healthcare especially - the health and wellbeing of the provider has a direct impact on the quality and healing at the level of the patient. We have a moral, ethical and business imperative to support the wellness of the providers and not treat doctors like piece workers on a production line. These are immensely important topics that deserve more than a blog comment to do them justice. If you REALLY want to explore this issue in a way that has a chance to create meaningful change. Please contact me through my website. The doctors are the canary in the coal mine of modern healthcare ... unfortunately that same canary is the one coordinating the care of everyone in your system... and we cannot afford to let them drop. My two cents, Dike Dike Drummond MD TheHappyMD (dot) com

Marc Boisvert (8/24/2012 at 9:50 AM)
This study brings to light in a formal way and validates what many of us have been feeling for a long time. Our professional representative organizations should be tasked to keep this information in the public eye and hammer it home in every discussion of health care reform.




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