News of employee burnout seems to dominate headlines today, particularly concerning physicians and clinical staff. A recent and historic healthcare labor dispute, marked by tens of thousands of nurses, ER technicians, and pharmacists participating in a 3-day strike over under-staffing, sheds light on the prevalent issue. While a 21% raise in pay over the next four years is part of the brokered deal, Kaiser has also committed to investing in job training programs, referral bonuses, mass job fairs, restricting subcontractors, and renewing efforts to fill vacant positions (currently at 11% for the system).
This unprecedented event highlights the severe burnout and conditions some healthcare workers endure, a problem felt across the country in systems and practices of all sizes.
Burnout is especially pronounced for OBGYNs. Medscape’s annual report, based on physician survey data, places OBGYN as the fourth specialty in 2023 for burnout, with a staggering 58% of OBGYNs experiencing it. What’s more troubling is that this isn’t just a temporary problem.
Which Physicians Are Most Burned Out?
So, what makes burnout so pervasive? OBGYNs cite several reasons, for the significant increase in burnout related to working too many hours, rising from 39% in 2022 to 47% in 2023.
Stepping back to assess the broader situation, burnout isn’t solely about the hours worked. Many doctors feel overwhelmed by their work environment and the continuous demands placed on them. Issues such as inadequate staffing, a lack of respect from co-workers or the administrative team, and a decline in the quality of patient care contribute to the problem.
Practice owners or lead physicians often experience even more significant burnout. While managing a full panel of patients, they also juggle responsibilities as business managers and chief executives, dealing with administrative tasks on top of clinical duties. This situation has far-reaching consequences, negatively impacting women’s health and the practice of medicine.
Recent data from the Association of American Medical College reveals a decline in active OB/Gyns, with 24 fewer in 2020 than in 2012. Additionally, the number of active OB/GYNs over the age of 60 increased from 27% in 2012 to 37% in 2020. The field is attracting fewer professionals despite the growing need for care.
Recognizing that burnout is a pervasive issue prompts us to ask honest questions:
“Are you energized to go work each day? If not, how do we fix that as fast as you can and the others you work with at your practice?”
Reflections from the Clinic Frontlines
Ten years ago, I worked at a large health system managing teams and departments across various specialties. At that time, the system had just launched a $170 million campaign to convert their electronic medical record (EMR) to EPIC. It was a big project, and I was in the trenches as an operator. For my part, I oversaw several primary care clinics at Phase 0 (beta testing) and subsequent phases. As part of the conversion, I supported providers as they onboarded to the new system. This meant different things depending on the physician or nurse practitioner. Some never needed my support; they jumped in on the first day and never looked back. Others found it incredibly difficult, and their workload doubled overnight.
I remember one doctor, in particular, whom I was quite fond of. He struggled to keep pace with his daily caseload in this new environment. Pre-EPIC, he could see 30+ patients per day in the legacy system without trouble. That number was halved after the EMR conversion, even months later. I recall visiting the clinic late in the day and seeing him alone punching away at the computer.
He once told me,
“Marc, do you realize that I had to make 85 clicks for only 1 patient to open and close their visit today?”
Because of that experience, he retired early.
From experiences like this, burnout is not just about the increasing number of daily tasks or patients to see but also about the environment in which physicians operate. Tools, supporting teams, and the overall environment can have an enormous impact on a physician’s success in thriving in their practice, particularly if they are a new team member.
5 Little Things to Lessen Your Team’s Burnout
Much to no surprise, it’s easy to say that there is no single answer to solving burnout in a practice. I think many leaders think that if you marginally raise salaries or employee incentives, the problem will subside. While no one would object to more money, it usually won’t prevent good employees from leaving the practice if they are truly unhappy and burned out.
Without suggesting a complete overhaul of your HR policies or office culture, I might suggest that you start simple and experiment. Here are a few ideas to find small wins in the daily struggle with keeping things manageable for you and your staff:
- Cut chit-chat during clinic hours. As cruel as it sounds, I’ve seen a lot of friendly physicians spend precious time talking with coworkers and patients on non-work related matters. Acknowledging that the average physician spends 1.84 hours per day beyond work hours or 9.2 hours per week on completing EHR documentation according to a recent JAMA article, reclaim that time. Catchup at lunch; plan social events after work; catchup at administrative meetings. Don’t freely give up time at night to work if you can avoid it.
- Buy everyone a second computer screen. I know it sounds simple and may be an investment for your practice but it makes life better and more efficient. The ability to toggle between screens can provide you quick access to all relevant information (open EMR record, coding instructions, email) and shave off precious minutes on every patient chart. Adding an extra screen in the patient rooms and at provider stations can have an ROI in saving time and sanity.
- Get more sleep. This may be obvious to most physicians and working adults, and frequently cited as a coping mechanism for OBGYNs (43% cite it as such), but often still ignored or thought unattainable by high-achieving professionals. Yet, lots of recent research continues to press the importance of being your best self. I’ve shifted my thinking to see this as a business need and not just a personal need (e.g. required to be a leader). It may be that you need to start with a simple goal – can you get 7 hours of sleep for 7 conservative days? You can build from there.
- Find ways to increase physician autonomy. Increasing salaries and staff are not the only ways to structurally address burnout. From the latest Medscape Report in 2023, 32% of physicians thought that increasing their control and autonomy would have a big impact on their burnout. This could be done easier than think. Here are some ideas to explore: try giving more flexibility on weekly schedules; offering “mental health” days when they need them; providing opportunities outside the daily grind to offer input on strategic initiatives or practice growth; or a more active role in recruitment.
- Boast training with your EMR. Unsurprisingly, if you struggle with charting and documentation, you’re likely not enjoying your job. Recent research proves this. As a practice, find ways to continually support physicians and staff on how to optimize their experience with their EMR. This can be broken out in early training as they onboard, creating “super users” who can be fully trained on all functions to help everyone and provide continual support – whether online or remotely. Knowing how to better navigate your EMR the more productive your staff will be and time they’ll save on the backend.
Good Resources to Revitalize Your Practice’s Team
There is a surprising amount of resources out there, although not always found easily on the web if you don’t know what to search for. Here are some of the ones that I have found useful. I thank Dr. Tina Shah, a dear friend and a leading physician burnout expert, for pointing me to some of them:
- The American Medical Association (AMA) put together great resources including a toolkit on physician burnout. https://edhub.ama-assn.org/steps-forward/pages/physician-burnout.
- The National Academy of Medicine has also done a lot of work into it: https://nam.edu/systems-approaches-to-improve-patient-care-by-supporting-clinician-well-being/.
- A recent journal article that includes a lit review of burnout articles as well as tools for tackling it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404708/
- TED has put together a great playlist to boost your creativity and find your passions: https://www.ted.com/playlists/689/how_to_protect_your_passions_from_burnout
- Healthcare isn’t the only area facing employee burnout. Here is a good 20-minute podcast from Reid Hoffman’s “Masters of Scale” on burnout for all companies: https://www.youtube.com/watch?v=l5LJ6J6G2VQ.
Burnout shouldn’t be a reason why care should stop for patients that need it. But it shouldn’t be ignored and be expected that things will get better by themselves as time passes or certain events transpire.
It’s important to recognize what may be going wrong in your own world as it relates to your working environment. Then start small, and seek to reclaim some of the things that can make you and fellow team members feel more energized and excited to come to work each day.
