Physician burnout has been classified as a psychological syndrome that can be expressed as a prolonged response to due chronic occupational stressors. It is sometimes referred to as moral injury. But it doesn’t only affect physicians. Nurse practitioners, physician assistants and all clinical staff can be affected by burnout. Clinician burnout is a serious problem for health professionals nationwide.

COVID-19 has made it much worse. Based off of two studies in the US and globally,  which included nurses, physicians, respiratory therapists, advanced practice providers and others showed a rate of 51% in April of 2020. In the U.S. the rate was even higher at 62%.

Burnout was already an issue, per the Medscape National Physician Burnout & Suicide Report 2021, 79% of surveyed physicians indicated their burnout started before the pandemic, and other reports indicate a burnout rate of 43% prior to COVID.

As the title of the Medscape report indicates, in extreme cases clinician burnout can be linked to suicide. It can also be associated with high turnover, self-medication with alcohol or prescription drugs, high divorce rates, and mental health issues.

So, what is causing these high rates of burnout, and how can we get them down?

Causes of Clinician Burnout

Clinician burnout has been a recognized issue for years, although not nearly enough has been done about it. The causes of burnouts that are cited include:

1. Overwork, often related to low staffing levels. Needless to say, the burden placed on healthcare systems by the COVID-19 pandemic and the high rate of illness amongst healthcare workers has only made work loads worse. Burnout gets worse when work loads start to impact the ability to handle one’s own household and selfcare.
2. Shift work and schedule changes. Rotating shifts are well known to contribute to fatigue, which then contributes to burnout.
3. Lack of support and access to personal protective equipment (PPE). During COVID-19, many healthcare workers had insufficient access to proper PPE, and have overall felt as if they did not have support either from hospitals or from the general public. The cavalier attitudes towards public health measures in some areas have also contributed.
4. Feelings of powerlessness. In general, clinicians take on these jobs with the goal of helping people. The inability to help their patients often leads to burnout, and many clinicians have felt powerless in the face of the virus, especially at the start when they were not sure how to treat patients.
5. Time pressure when treating patients and conducting examinations (which also goes back to overwork). Short visits lead to poor patient outcomes and can affect the relationship between healthcare professionals and patients, and can leave clinicians feeling as if they have to see as many patients as possible.
6. Poor, or unfavorable organizational culture. A toxic environment can result in a cascade of burnout, and sometimes particular units may be hot spots of it.

As clinician burnout often leads to staff leaving the profession (or at least their workplace), burnout can become a cycle where it causes people to leave, the remaining staff are overburdened, and things rapidly spiral out of control.

So, how can clinics, hospitals and other organizations address clinician burnout?

Reducing Clinician Burnout and Turnover

There are a number of things clinics, hospitals and other organizations can do to reduce burnout and, thus turnover.

1. Reducing the burden of charting and paperwork. When clinicians are overwhelmed and still have to spend hours completing their notes, they suffer. Chartnote can help with this by expediting medical documentation. It allows you to edit and create your own dot phrases and templates, saving clinicians time that can then be spent with patients, or allowing them to leave on time at the end of their shifts and have a etter work-life balance. By using a tool such as Chartnote, patient records and documentation can be completed faster and with higher accuracy, supporting a better environment for doctors and patients alike.
2. Developing a support system so that clinicians can talk about their problems with their peers. While many are reluctant to do so, even knowing somebody is willing to talk can be enough to help relieve some of the stress on them. The use of Balint groups, which apply psychological principles in a group setting, can also be helpful. It’s worth remembering that burnout can be contagious, and administrators should be watching for units which have high levels of burnout so that they can intervene and provide extra support as needed.
3. Improved communication, which allows clinicians to get more accurate and consistent information, which can help them feel less powerless. As things continue to rapidly change during what is hopefully the last part of the pandemic, it will be even more important to keep your staff informed and be honest about uncertain decision-making and unknown factors which can impact hospital or clinic policy as we move out of this difficult time.
4. Resources for mindfulness and self-compassion exercises, which can also help lessen feelings of helplessness and isolation. And, of course, easy access to properly trained therapists as needed. Healthcare professionals are often unwilling to accept help, especially physicians, so it’s important to build a culture in which it is not stigmatized.
5. Reducing other administrative burdens so clinicians are not worrying about compliance problems, insurance issues, etc. Helping doctors and advance practice providers understand these things better can also help. Using tools to make regulatory burdens easier also saves time and reduces the tendency to rush patient care.
6. Encourage clinicians to engage in habits that reduce burnout such as getting enough sleep and exercising regularly. As the pandemic winds down, it will also be safer and easier to hang out with friends and family and schedule time with others.
7. When possible, keep staffing levels stable and avoid scheduling clinicians for rotating shifts unless it can’t be avoided. Encourage staff not to stay late unless it’s needed in order to improve work-life balance and help them support their domestic relationships.
8. Train staff to watch for the signs of burnout, including irritability, increased interpersonal conflict, changes in appetite and sleep, and increased mood changes.
9. Avoid tying compensation, bonuses, etc, to the number of patients a healthcare professional sees so as to discourage rushing and remove the time pressure often put on them. This can be a particular problem in clinicians that are on a productivity-based compensation model.
10. Clinicians that work in fast-paced environments, like the emergency department or urgent care, may also feel that they have to see patients to reduce waiting times. Sufficient staffing is particularly vital in acute care settings.

Clinician burnout is a very real problem that can lead to high levels of turnover and thus to staffing shortages (which can then trigger more burnout). Preventing it helps improve patient outcomes and support your staff through these difficult times. One key way to do so is to reduce the documentation burden associated with patient care. To find out how we can help with this, visit Chartnote today.

Interested in sharing your story? How do you deal with burnout? Tell us more about what works for you and what doesn’t.

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About Chartnote

Chartnote is revolutionizing medical documentation one note at a time by making voice-recognition and thousands of templates available to any clinician. We know first-hand that completing notes while treating patients is time-consuming and an epic challenge. Chartnote was developed as a complementary EHR solution to write your SOAP notes faster. Focus on what matters most. Sign up for a free account: chartnote.com

Posted on: May 19, 2021, by : Gerardo Guerra Bonilla