Physicians discuss and document their patients’ health throughout their day, but when it comes to communicating about their own mental health, they are often silent. Stoicism in physicians is not necessarily harmful if practiced correctly. However, when feelings of burnout are simply ignored or disregarded, but symptoms persist, it becomes a significant risk to patients, physicians and the healthcare organization itself.
That means it is up to other clinicians, leadership and administrative colleagues to recognize the symptoms of burnout, intervene and offer solutions. The following are some indicators of burnout leadership and colleagues can watch for based on physicians’ behavior and performance and the experience of their patients.
The best indicator of burnout across an organization is high physician turnover. Research has shown that burnout can lead to resignations, which can cost a healthcare organization anywhere from $500,000 to more than $1 million per doctor. These expenses include recruitment, sign-on bonuses, lost billings and onboarding costs for replacement physicians.
Preceding the resignation may be excessive absenteeism and lower morale, the latter of which is sometimes difficult to identify. A good indicator of low morale is a physician exhibiting signs of depersonalization, such as a negative, cynical or impersonal attitude toward patients, family, staff members and colleagues.
This behavior is likely a sign of emotional exhaustion, which is feeling worn-out and drained from an accumulation of stress contributed by work or personal life (or a combination of both) and a leading sign of burnout. Although there are many contributors to emotional exhaustion, the frustrations and excessive time spent with electronic health records (EHRs) and outdated technology increase the chances.
Physician Performance Indicators
Other than changes in interpersonal behaviors and bedside manner, physicians’ colleagues should consider worsening professional performance as an indicator of burnout. Multiple studies have found that physicians with burnout are more likely to fail on critical aspects of professionalism that determine the quality of patient care, such as adherence to treatment guidelines, quality of communication and empathy.
An increase in avoidable readmissions or medical errors, for example, can indicate the physician is struggling with burnout. These incidents double a physician’s odds of involvement in patient safety incidents and increase his or her employer’s risk of costly medical malpractice claims, litigation and damage to institutional reputation.
Patient Reaction and Experience
Apart from colleagues’ observations and input, patients’ direct and indirect feedback can indicate potential physician burnout. In research on the link between physician burnout and patient satisfaction, patients of doctors with high levels of exhaustion and depersonalization had significantly lower satisfaction scores and longer post-discharge recovery time.
The most obvious sign of trouble is an increase in patient complaints about their physicians’ behavior or care plan. This feedback can be unsolicited, such as a complaint letter or email, or provided through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys distributed after a hospital stay.
Patients also will indicate their dissatisfaction with their physicians by simply abandoning that doctor and seeking care from another physician or asking for a referral. Either way, an increasing trend of negative patient feedback about a physician, regardless of the reason, is the biggest red flag that an intervention needs to occur.
Confronting the Challenge
Technology often is—but shouldn't be—contributing to physician stress burnout. Rather, it should aid in reducing the stress and burdens on physicians and staff. A fully integrated and interoperable, end-to-end healthcare access solution, for example, can reduce the average 45 minutes per day physicians spend using outdated communication technologies and increase the time they have for direct clinical care.
Even if all of these signs of burnout are not present, effective leadership must have an active program in place to address this issue before serious consequences to patients and physicians occur. Successful interventions—those that take into account the broad range of causes, including technology and many others, and incorporate a variety of different therapeutic tools—have been found to decrease overall burnout symptoms by 10 percent, emotional exhaustion by 14 percent and depersonalization by four percent.
Burnout is not a problem that goes away on its own, and it affects much more than an individual physician. Rather, burnout is an institutional and foundational challenge that needs to be recognized and remedied promptly using multiple methods to enable meaningful results.
One of those methods should be to decrease the time physicians spend managing technology instead of delivering care. To learn more about how to improve physicians’ experience by simplifying their technology-related workflows, contact Epion Health.