The World Health Organization’s recent move to classify burnout as an official medical diagnosis couldn’t have come at a more critical time for the healthcare industry. I’ve written before that between 40 to 50 percent of physicians are currently experiencing symptoms of burnout. This is also occurring as we undergo a nationwide physician shortage. And, we already have an immediate need for nearly 100,000 doctors across the country, which is impacting millions of Americans and their access to quality healthcare.
This new classification points to just how common burnout is, which has the potential of finally removing the stigma from physicians admitting to burnout and seeking help. As burnout becomes destigmatized, physicians won’t look at burnout as a personal failing, but as a failing of a system that hasn’t given them the support, resources, autonomy, or tools they need to succeed. Together, we can improve that system.
Physicians aren’t encouraged to seek help
As a physician, I recognize that doctors celebrate one another for each other’s Herculean efforts, but rarely celebrate one another for acts of humility, guilt or insecurity. It is our responsibility to create a culture where we can disclose our failures and our fears without ridicule or risking career suicide. But issues with burnout begin long before doctors receive their medical license. The first place where aspiring physicians experience signs of burnout begins in medical school.
In medical school, we are taught that anything less than “resilient” makes us a failure. But admitting that we’re not superhuman is exactly what makes us able to empathize, listen, and understand our patients and the problems or stresses they encounter. Our own anxiety around burnout is what makes our patient’s fear of burnout so relatable.
The cost of moral injury on physicians and patients
A fellow physician friend of mine has written extensively about how doctors first experience “moral injury” in medical school. How? Physicians are trained to overcome obstacles and stare our worst fears like death in the face. To then admit that you are experiencing burnout is to admit that you can’t always bounce back. For care providers, especially as students, we never ask: who is taking care of us? When really, not only should care providers take care of ourselves, but our colleagues, healthcare administrators, and professors need to do everything in their power to protect us from the stresses of the job. They also need to provide us with resources on how we can best cope with these issues as they arise.
For most physicians, we got into the medical field to help people. But as we began our careers in medical school, we were taught to make compromises in the name of efficiency that also made us compromise our morals. That is where moral injury begins; being forced to see more patients than we really have time for, not spending enough time away from our residencies in order to recharge, bottling up our trauma or negative experiences we’ve had on the job because we’re taught to “push through it.” What this leads to is a culture of burnout, and a culture where doctors feel afraid to admit they need help.
But it’s not only the physicians who suffer, it’s also our patients. When we aren’t given the proper amount of time on our schedule per patient, we can miss details and opportunities to ask follow-up questions to find out what our patients aren’t telling us. This is how misdiagnosis occur, or how a doctor can mistakenly prescribe a medication that counters the effects of another.
So how can we correct the system which is leading to physician burnout and poor patient outcomes?
Returning to Dr. Pink’s principles and building a supportive community of physicians
Daniel Pink popularized three basic principles of what every physician needs in order to feel empowered and to succeed: purpose, autonomy, and mastery. As a physician, when you feel frustrated, you need to ask yourself, what outside influences are impacting one of these three principles? For doctors, one of the best ways that we can recognize burnout in ourselves and help prevent it is by acknowledging when we don’t feel like you have equilibrium of those three components.
You can also never underestimate the power of fellowship and gathering with other doctors to problem-solve, share grievances, and commiserate. I have never experienced a moment when fellowship didn’t recharge a group of doctors. I was once asked what was the purpose of the American Medical Association. The AMA was created to give doctors who didn’t have opportunities for fellowship, like physicians who had their own private practices, and bring them together, discuss ideas, and develop comradery. If you just have your private practice, you can feel isolated and alone, and you’re more at risk for burnout. Knowledge sharing really is key to helping prevent and recognize burnout.
How to create a supportive work environment for physicians
Beyond how doctors can support each other and take care of themselves, healthcare organizations can do much more to support their doctors. At the virtual care company where I currently lead our team of physicians, our virtual care practice focuses on something called relationship-centered care. This means we are patient-focused, but we also acknowledge the physician and the community or context in which they are practicing.
Additionally, when it comes to how we train our physicians, our application and model were designed with physician input and our peer review and growth mindset focuses on life-long learning. Our physicians get to develop a sense of fellowship with each other so they never feel isolated, and they feel safe to approach their peers with any questions they may have.
We are also invested in cutting down on the time doctors spend on administrative tasks and have developed tech platforms so that patient records and information are available at our doctor’s fingertips. Our technology gives our physicians autonomy, efficiency, and productivity.
The World Health Organization’s recent classification of burnout as a medical diagnosis is helping physicians recognize the burnout they are experiencing, and take a proactive approach to caring for themselves. At the same time, medical school and the healthcare industry need to do a better job of preventing moral injury and mitigating the circumstances that lead to physicians making compromises that impact their patients’ health. By fostering a sense of fellowship, providing doctors with integrative training, and utilizing tech to eliminate stresses of the job like additional administrative tasks, you are creating an ideal environment for doctors and stopping burnout before it starts.
Dr. Ian Tong is the Chief Medical Officer at Doctor On Demand
