Physician well-being and mental health requires constant care
By: Jennie Overton
For too long, physician well-being and mental health was seen as an acceptable, even necessary, sacrifice. Healthcare providers would work long hours, make themselves endlessly available, and take on the stresses of life and death. In exchange, they would receive good compensation and the satisfaction of knowing their work was meaningful.
But “do no harm” was never meant to apply only to others.
Burnout in healthcare has been creeping upward for decades, as recordkeeping demands, new financial pressures and other factors exacerbated an already stressful position. Then the COVID-19 pandemic hit, amplifying fears and putting pressure on the structural cracks.
From Triple Aim to Quadruple Aim: How health systems are taking responsibility for physician well-being and mental health
Many healthcare organizations are focused on the Institute for Healthcare Improvement’s Triple Aim. This framework is centered on patients: improving the patient experience of care, improving the health of populations and reducing the per capita cost of healthcare. All of those outcomes, however, can be enhanced by adding a fourth aim: improving physician well-being and mental health. The better doctors can take care of themselves, the better care patients will get in return.
A 2020 survey of caregiver stress amid COVID-19 by the American Medical Association showed odds of burnout were 40% lower in physicians and other workers who felt valued by their organizations. Institutional support is a crucial factor in keeping the rate of physician burnout low, especially during prolonged periods of stress like the COVID-19 pandemic.
Some of the ways that health systems can help their physicians feel valuable include:
Training leaders in behaviors that promote well-being, equity and inclusion
Helping managers to recognize burnout in physicians
Working to take away stigmas that can exist around using mental health resources
Strengthening protections for health professionals who report safety and ethical violations
Working to make your physicians feel valued will have positive ripple effects to every part of the health system.
Why is physician well-being important? It’s more than medical errors
Medical errors are certainly the most devastating impact of physician burnout, but they’re far from the only one. Roughly 400,000 hospital patients experience harm that could be prevented each year, according to one study. A shocking number, but only part of the $4.6 billion physician burnout is costing the healthcare system each year, per data from the New England Journal of Medicine.
Physician turnover and reduced clinical hours contribute dramatically to these billions. Burnout also erodes trust between patients and caregivers. If your physician is depressed or distracted, the patient experience suffers. And if physicians turn over regularly, patients miss the continuity of care that can be so critical to effective treatment.
It’s clear that programs to reduce physician burnout are well worth the costs — protecting the bottom line of health systems as much as it protects the outcomes for patients.
High engagement and low well-being create perfect conditions for burnout among healthcare professionals
To tackle physician burnout in a meaningful way, health systems need to identify and mitigate the contributing factors. Working as a physician is often seen as a calling. Doctors enter the field ready to engage deeply with their patients — they feel the positives of making a direct impact on the lives of others. Physicians are fully engaged in their work.
However, prolonged chronic stressors paired with low well-being creates an environment of exhaustion, cynicism and inefficiency. Physician stressors can include:
Overload — too much work and too much time spent doing that work
Role conflict or ambiguity
Lack of support from leadership
Lack of participation/input in decision making
Lack of fairness and equity
Without intervention, the downsides of practicing modern medicine will erode at the well-being of physicians and other caregivers. Add on rapidly increasing paperwork, and it’s easy to see how low well-being will turn into burnout for physicians — and turnover and costs for their employers.
How real fears for physical physician wellness impact well-being
Physician’s face abstract risks every day — the pressure of protecting their patients, the threat of increasing litigation, the politics within medical systems. But COVID-19 took those existential worries and turned them to a very real fear for their physical safety.
The pandemic exacerbated the stress doctors and caregivers were already feeling. In the AMA survey, 94% of physicians and other workers said they are somewhat, moderately or to a great extent worried about exposing themselves to COVID-19.
These unique concerns — not to mention the increased workloads involved with caring for COVID patients — join an already long list. And while worry over the pandemic may ebb over time, in the near-term it’s had a major negative impact on physician well-being.
To improve patient care, physician well-being programs have to deliver care
Physicians know all about how to get the best outcomes for their patients — show genuine care in them and their health. Reducing burnout in physicians requires a similar approach. Well-being programs for physicians need to deliver care, and to create space for caregivers to prevent burnout.
4 steps to improve caregiver and doctor well-being
1. Provide recovery time
Everyone needs time to recover, even doctors who seem to be used to working long days. Continued long hours can only lead to burnout. Taking breaks and time away is important, and health systems should consider making vacation days mandatory. It’s also crucial that leadership focus on root causes. Weekly meetings with doctors, even for a few minutes, where well-being is discussed and prioritized can help address issues before they become too big to manage.
2. Foster a well-being mindset
The ways people think about stressors has an impact on their ability to handle and recover from them. Help physicians find their “sweet spot” of stress. Acute (good) stress keeps you on your toes, ready to rise to a challenge. Chronic (bad) stress can lead to health problems and burnout.
3. Build social connections
People are wired to be social. The more doctors can rely on each other for support, the better off they will be. Encourage taking time to reach out to close friends and family and time to meet with other physicians to discuss how they are feeling. An increase in social support, supportive communication and connection can help ease the burden of the stressful healthcare environment.
4. Consider a well-being platform
Healthcare professionals are in the business of creating wellness for patients — less so for themselves and their colleagues. Consider implementing a customized well-being solution to address mental health, burnout and turnover across your organization.
Though health systems are laser-focused on patient care, they must embrace employee care as well. Improving physician well-being is critical to delivering the best medical care and ensuring the overall health of your organization.