Finding Fulfillment in the Era of Physician Burnout

Every professional should be energized and excited by their work, most of all physicians who spend day in and day out saving lives and improving the health of their communities. While the worst of COVID might be behind us, one problem continues to hover over the healthcare system like a thick dark cloud: burnout in healthcare workers. And from the looks of jam-packed emergency waiting rooms, scarce hospital beds, and impending physician shortages on the horizon, there seems to be no end in sight for the World-Health-Organization-dubbed occupational phenomenon.

What is Physician Burnout?

Emotional exhaustion, depersonalization—or lack of empathy for or negative attitudes toward patients—and feelings of decreased personal achievement are just a few symptoms the American Medical Association attributes to physician burnout. With nearly 63% of physicians reporting symptoms of burnout and a significant increase in medical errors attributed to the burnout frontline, it’s no wonder burnout is no longer just a workplace challenge but an all-out crisis.

According to The American Academy of Physicians, burnout is directly linked to unfavorable consequences, including:

• Lower patient satisfaction and care quality,
• Higher medical error rates and malpractice risk,
• Higher physician and staff turnover,
• Physician alcohol and drug abuse and addiction,
• Physician suicide.

Dr. Tim Hoff, a professor of management and author of the book, Searching for the Family Doctor: Primary Care on the Brink, has made it his life’s work to improve healthcare delivery. But one challenge, he admits, is that doctors are just too exhausted to do more than the bare minimum, leaving innovation and advocacy off the table for many overworked, overscheduled physicians. He likens family medicine in its current state to a death spiral.

“[Doctors] want career sustainability. We’re all in industries that are moving fast and changing quickly. The pandemic has worn us out, and doctors have terrible afflictions with burnout— however, the [worst case scenario] for the field as a whole is not not to have family doctors turn off and say, ‘Well, I’m not going to get involved in the business of medicine, I’m not going to open my own practice, I’m not going to engage more than being a 9-5 employee.’ If they do that, they're [essentially] giving themselves over to a corporation. It’s still about autonomy. It’s still about control. As an elite professional, you want to feel some control over your work. If you say, ‘I don’t want to deal with the business side, I’m happy for the hospitals to take it over, you lose control.”

This abdication of family medicine is partly why primary care has become so transactional, impersonal, and increasingly run by hospital systems. Overhauling the entire system is too great for most physicians to bear, especially on the heels of COVID, where physician leadership development has been nonexistent, and burnout has siphoned any energy and excitement about healthcare innovation or invention.

But can physicians, despite increasing burnout, reclaim family medicine and steer it in the right direction?

How to Overcome Burnout and Find Fulfillment in Family Medicine Again

Delegate and Innovate: Leveraging delegation and technology to balance workloads

One silver lining of the pandemic is the ubiquitous use of telemedicine. For some, it was a welcomed change. For the most underserved senior populations who typically lack access to a smartphone or the internet, their children and grandchildren came to the rescue, ushering in the adoption of telehealth in a unique demographic during an unprecedented and challenging time for doctors and patients alike. This enabled doctors to get an up-close-and-personal look at patients’ home lives who are adversely affected by healthcare disparities. They were able to get a glimpse into their living quarters and pantries and even check on those patients with previous substance abuse diagnoses who couldn’t get into an office for help.

As burnout in the physician population persists, Dr. Hoff suggests leaning on technology—telehealth visits, for example—and delegating responsibilities to your trusted care teams to lighten your load and bring some balance back to your workday.

Embrace new communication methods

Advances in technology are moving full speed ahead, whether physicians or patients like it or not. This means breakthroughs like AI (artificial intelligence) are changing how we communicate and interact. Building relationships with patients means meeting them where they are and communicating in ways that feel safest and most supportive to them. Often, this means text messaging is superior to an inconvenient and lengthy doctor’s visit.

Dr. Hoff explains, “You should want to be able to text your patients and use an app to communicate—this can help build your relationships. That’s the way people want to connect with you now. They don’t want to come into an office and wait two hours a day. For my young students, the phone is embedded in their hands, and it’s embedded in my hand—so family doctors need to embrace that and realize that could actually bring the patient closer.” 

Burnt-out Physicians Should Consider a Career in the Full-Risk (or Value-Based) Model

Addressing burnout means addressing workloads. In the legacy fee-for-service model, doctors have patient panels that are impossible to maintain, much less build trust-based relationships with patients. Plus, their income hinges largely on services provided, including writing prescriptions, referring patients to specialists, or prescribing tests or procedures that are often unnecessary. Because there are no RVUs for “building trust with a patient” or “keeping a patient from being readmitted to the hospital”—both value-based metrics that hold weight in the full-risk model—the fee-for-service world, with its impractical patient panels and impossible expectations, undoubtedly contribute to physicians feeling overburdened and unfulfilled by their work.

With access to care being one of the biggest problems with healthcare today, Hoff points out that limited patient panels make or break future success. “If you’re going to make yourself more accessible in real-time, there are limits to how many patients you can have on your panel.”