New Data on Longstanding Burnout Phenomena
Burnout. Exhaustion. Overwhelm. Workload strain. Emotional fatigue. Occupational stress. Healthcare provider burnout is described in new and creative ways every year. What hasn’t changed is the trajectory of burnout in this setting.
Between 2021 and 2022, 145,000 healthcare professionals left the industry, with physicians accounting for nearly half of this mass exodus. Nurse practitioners weren’t far behind, clocking out at an estimated 34,834 quits.
One of the main drivers of quitting is burnout, fueled by long hours, high stress, and low pay. Burnout in healthcare has long been well-documented: in 2013, the Medscape Lifestyle Report found that 40% of physicians reported burnout, and just four years later, in 2017, the percentage had increased to 51%.
Physician burnout sharply increased in the first year of the pandemic, and studies suggest the rate continues to increase nationally. This ultimately leads to staff shortages and feeds the vicious cycle of burnout.
Burnout is a blend of exhaustion, cynicism, and perceived inefficacy from long-term job stress. While the causes of burnout are multifaceted, surveys consistently find too many administrative tasks (e.g., charting, paperwork), long hours, and increasing digital demands of practice (electronic health records) as top contributing factors.
Surprising Insights on Burnout in Healthcare
While our first thought may be to blame the U.S. for-profit healthcare systems and greedy insurance companies, the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians found that most physicians across ten high-income countries, including the U.S., were unsatisfied with their work. In fact, the U.S. falls middle of the road across survey responses.
So, what is to blame for this alarming trend in healthcare burnout and widespread healthcare workforce shortages?
Historically, patients went to the doctor for acute conditions. Since the latter half of the 20th century and the fast-growing rise in chronic diseases and treatment options, there has been an increased clinical demand for visits and treatments. This, coupled with record staffing shortages, chokes the healthcare system.
Healthcare providers are forced to see a revolving door of patients. The result is that healthcare professionals are more likely to experience “moral injury” or a lack of fulfillment. This adds to burnout and spirals into suboptimal care, decreased patient satisfaction, and greater risk for medical errors.
It’s going to take time to reverse the rise of chronic illness. At present, there are two clear pathways forward:
#1 Healthcare organizational change to attract and retain healthcare professionals through a more positive and supportive workplace.
#2 Learn and leverage behavioral science-based tools and strategies to address burnout and optimize outcomes.
Change Job Structure or Organization Culture with the Demand-Control-Support Model
Let’s address the elephant in the room: mediation and mindfulness training, wellness retreats, and other forms of “Band-Aid Therapy” won’t cut it.
Adam M. Grant, PhD, Wharton professor, organizational psychologist, and best-selling author, explains that “Burnout is not a problem in your head; it’s a problem in your circumstances. Stress may be inevitable, but burnout can be prevented and reduced — even in high-pressure jobs.” Grant’s favorite model for structural and cultural change is the Demand-Control-Support model.
Demand: Make structural changes that reduce work on the person doing the job or redistribute tasks. Examples: project management software or automation.
Control: For situations where you cannot eliminate demands, give people the autonomy and skills they need to manage them. For example, allow employees to set their own goals and decide how they will achieve them.
Support: Foster cultures that make it easy to ask for and receive help. For example, leaders can open up about struggles and ask for help to normalize struggles and get help.
Cleveland Clinic Case Study: Demand-Control-Supply Model
When Adrienne Boissy, MD, MA, started as Chief Experience Officer at Cleveland Clinic, she saw firsthand how healthcare professional burnout impacted the patient experience. Task forces were created to help identify sources of stressful work demands and ways to reduce them. As a result, electronic health records were streamlined to allow healthcare providers to spend more time with patients and less time inputting information. They also introduced new digital solutions to reduce the time calling pharmacies for refills and insurance companies for tests: automated refills and pre-authorizations.
Furthermore, Dr. Boissy trained 40,000 caregivers in empathy through role-playing scenarios. Teaching physicians to express empathy and concern in a way that the patient hears gave physicians a deeper sense of control and the effective, caring conversations they wanted to have.
Leverage Behavioral Science to Combat Burnout and Optimize Well-being
In a perfect world, we would reduce or eliminate the circumstances contributing to burnout for frontline clinicians. Sadly, there is no magic wand for organizational change, and it will take significant time. While you should continue to use your voice and push for structural and cultural change, it is of utmost importance that you prioritize your well-being today.
Drawing from behavioral science and evidence-based practice, we present three simple strategies that can be applied immediately to combat burnout and optimize your well-being:
Make A Bubble Of Love At Home: This strategy focuses on work-family support as a protector for burnout. It is rooted in your understanding of the value of your relationships with friends and family. This can extend to actively developing relationships with colleagues for a comprehensive support network of love and support.
Celebrate Small Wins: The power of small wins is especially effective in targeting “moral injury.” As a healthcare professional, you likely felt a calling to this career path. You embarked on a healthcare career to help people, and disillusionment may leave you feeling frustrated. Identify and enjoy the small wins throughout your day: your patient is discharged from the hospital. Your patient made significant lifestyle medications and reversed type 2 diabetes.
Create Your Own Heuristics: Heuristics are mental shortcuts, and as a favorite of psychologists, you can create your own set of heuristics to address burnout. For example, if you always say yes, create a hierarchy of support (family, friends, patients, colleagues) and recognize that you won’t be equally generous with everyone.
Restock Your Professional Toolkit at BRAINWeek 2024
Keep up the momentum and join us at BRAINWeek, GAPS IN BRAIN HEALTH: Putting Together the Pieces in Scottsdale, AZ, on May 9-11! Internationally recognized, award-winning behavioral science clinician, researcher, educator, speaker, and comedian Kristen Lee, Ed.D., LICSW, will discuss how to use the science of behavioral change and human potential to build positive mental health cultures.
Register now, and this May, you’ll be soaking up the expert insights and practical strategies of Dr. Kris’ keynote presentation, “How to Leverage Behavioral Science to Optimize Well-being!”
