Burnout is what happens when you avoid being a human for too long. If there is one profession where being superhuman and beyond is expected, it is that of a physician. Doctors are not just expected to diagnose, treat, and cure, but they must also achieve these expectations quickly and accurately, and in addition, do all these with ease and compassion towards patients. There is just a lot expected from our physicians. Long hours are the norm, and stressful situations and challenging decisions are plenty. Notwithstanding, the healthcare system isn’t helping as it remains ancient and inefficient, simply aggravating an already existing crisis. According to the recent 2019 Physician Burnout, Depression & Suicide Report conducted by Medscape National, 44% of physicians reported feeling burned out. Not to mention, 11% admitted to feeling depressed. That is a staggering number representing almost half of our highly regarded medical professionals. Previously called burnout and more recently referred to as doctor moral injury, what causes this strain? The three most prevalent causes are: the nature of the job, lack of work-life balance, and the conditioning of our medical education.
The healthcare system isn’t helping as it remains ancient and inefficient, simply aggravating an already existing crisis.
The job of a physician will always be stressful. Dealing with injured, sick, and dying patients and their families is no small feat. It is a job of enormous responsibility coupled with little control. Some of us who do not work with human lives may joke that when a work-related mistake is made that nobody was killed. Well, a doctor deals with this reality and fear on a regular basis. To sum it up, the job is stressful. Second, despite being specialized at caring for others, most physicians do not practice taking care of themselves, and nurturing their own happiness and needs. Long and irregular hours, unhealthy eating habits, lack of a proper exercise routine, and insufficient sleep, can be damaging to the mind and body. This is unfortunately another sad reality. To add to the already existing pressure, doctors are trained to avoid showing any signs of weakness.
We want to take care of our physician’s well-being, and for many reasons. Firstly, compassion is a two-way street. Just as a patient is cared for and thoughtfully communicated with, we owe it to our doctors to show empathy back. Physician suicide is on the steady rise, with 1 physician per day committing suicide from burnout in the US alone, making this the profession with the highest suicide rate. In addition, did you know that the third cause of death in the US is medical errors? It is further frightening to know that 65% of medical errors are partly or fully related to caregiver fatigue. This means that from more than 500,000 Americans that die each year from medical errors, about 300,000 are close to avoidable, and our healthcare workers are not really to blame. Taking care of our physicians is also taking care of our patients. With medical moral injury comes a decline in the quality of patient care and increased medical care costs due to a higher staff and physician turnover.
Worse, the number of physician drug and alcohol abuse incidents continue to increase, with some physicians committing suicide. Despite the staggering numbers, there is a way out. According to HBR’s article ‘Why Doctors need Leadership Training, medicine almost always, requires a strong leadership and management skill set. Unfortunately, this is not always an integral and enforced part of the training medical doctors receive in their residency, nor on the job. Such skills would provide physicians with the know-how of how to interact more effectively with one another and other attending physicians, lead junior and senior resident staff, direct nurses and administrative staff, manage employee conflict, and also, better guide patients and their loved ones through their care. This systemic issue of lack of leadership training, further ensues stress to doctors as they try to skillfully navigate and manage a patient's medical problems while also managing other staff involved in the care of the patient. Enforcing appropriate and continuous management and leadership training as a physician climbs the ranks in his or her profession, can help minimize the daily stresses in the job.
Despite the challenging reality facing our physicians, there are further options and tools out there aimed to improve these circumstances. Firstly, encouraging and helping physicians to find ways to reduce “work-life balance conflicts” will go a long way. There needs to be a systematic approach supported by the governments, health leadership, and unions among others. Does urging our physicians to take vacation help? The fact of the matter is that the work-load, lack of institutional support, and stress are still going to be waiting upon returning to work. The ideal solution is to create an environment and work culture that supports physicians in their everyday dealings of the job. In addition to the aforementioned example of additional training, reducing administrative burden or allowing more fairly distributed working hours and the option for physicians to decide when they would like to work could add to the relief. Allowing for preferences and building in flexibility into the job may benefit more than just a break or two a year. So, yes, there are short-term and quicker solutions but more importantly, there is also a dire need to shift the healthcare provider ‘culture’.
Given the rudimentary or not-so-user-friendly scheduling tools out there and the increasingly complicated task of managing medical staff shifts, the healthcare system and its providers have felt helpless for too long. There is now some good news. Cutting-edge technology for healthcare providers can help if designed well. Recent research has indicated that despite very good intentions, the proliferation of EMR/EHR (electronic medical/health records) systems has actually increased the load on providers. Using advanced software tools, algorithms, and artificial intelligence (AI), a particular SaaS platform, MeshAI, is a one-of-a-kind staff scheduling platform available for healthcare workers today; it can be a game-changer. The sophisticated ‘augmented-intelligence’ algorithms of this platform are behind a simple and user-friendly interface that magically finds ways to give staff the work hours they want while ensuring all shifts continue to get covered efficiently and fairly. MeshAI can provide more control over time at work which in turn provides better planning opportunities for eating, resting, and taking vacations. This can surely help our overburdened physicians. Finally, we need to encourage our physicians to speak to trusted colleagues and other licensed professionals such as therapists, to assist with the daily stresses of the job. We need to eliminate the stigma and expectations set on our physicians that they be superhumans. We want our physicians at their optimum in order to provide optimum care!
Doctors are not superhuman; they are superheroes. Albeit, we need to understand that these life-saving superheroes are still humans requiring self-care and compassion. If we can provide additional moral support, continuous training, and better working tools for our physicians, we also stand to exponentially enhance and improve our healthcare system, and most importantly, not just save more patient lives, but also save the lives of our trusted doctors. Primum non nocere. First do no harm must apply to all, both the caregiver and cared for. We owe it to our medical staff, and really to ourselves too.