Whether you’re receiving military, civilian, or VA health care, you’re in a stressed system that has undergone unprecedented changes to improve quality of care and patient safety over the last 20 years. Many of the issues resulting from these changes aren’t evident to patients – clinician burnout, for example, may be affecting providers’ health and well-being.
As patients, we at times tend to view ourselves as the victim of health system stressors like long wait times, provider shortages, insurance problems … the list goes on. Navigating these issues can be stressful and frustrating.
But imagine for a moment you are on the other side of the patient-provider relationship: A provider doing your best to deliver the high quality, timely care you know the patient expects and deserves. Try to think of some of the stressors and challenges providers face; a new report by the National Academy of Medicine outlines some of these challenges.
According to the report, 35% to 54% of nurses and physicians have substantial symptoms of burnout. They show evidence of high emotional exhaustion, a low sense of pride in their work, and high “depersonalization,” or cynicism, toward their jobs. Among medical students and residents, the percentages are even higher, ranging from 45% to 60%.
The report indicates burnout among all types of clinicians is a growing public health concern requiring major improvements in work and learning environments.
The causes are far-ranging, from overwork to technological issues to frequent ethical dilemmas, as well as limited resources and support structures. Such problems are "changing the landscape of the U.S. health care system and are having profound effects on clinicians, learners, patients, and their families," the report states.
It's no surprise such burnout equates to high personal costs to the individual worker and has significant social and economic costs to organizations and society at-large. For medical providers, residents or students, the personal costs are similar to other workers: occupational injury, alcohol abuse, and risk of suicide.
To patients, burnout can mean adverse effects on care – an increased risk of safety issues or malpractice claims, decreased patient satisfaction or patient-provider communication, and an overall drop in quality of care.
To health care organizations, increased clinician absenteeism – or more workers coming in while sick – impacts productivity and create an unhealthy work environment, as does an increase in turnover.
The report highlights specific issues that need to be addressed:
- Recognize burnout as an issue, and target it early in professional development.
- Reduce redundancies and consider staff effects on all decisions. This is especially critical among external stakeholders, who may not appreciate the scope of the problem.
- Make smart use of technology, which can reduce burnout when used well but can have unintended negative effects if not.
- Provide assistance for those in distress through medical societies, state licensing boards, specialty certification boards, and other groups.
Further, the report calls for more research on burnout, particularly among provider groups outside of nurses and physicians. Such research should include public-private partnerships between several federal organizations, including the Department of Veterans Affairs and professional societies, insurance companies, health care systems, and other stakeholders to look at the causes and implications of burnout. That should result in a research agenda by 2020 that would find the best measures for identifying occupational stress, burnout, and workplace well-being in a health care setting, the report recommends.
So consider the next time you (or I) go see a health care provider, maybe we can take a pause when we get frustrated or impatient with our care and try considering the challenges facing our providers. Maybe then our response could be a little kinder and more considerate than we might otherwise be inclined to give — it just may go a long way in making the day a little better for all of us.