While healthcare can be an incredibly rewarding field, it’s also one of the most challenging careers. Physicians, in particular, are subjected to high stress, thanks to the long hours and high expectations. Emergency room doctors have to make split-second decisions every day. But many other doctors have to make diagnoses and act quickly in emergencies.
Doctors form emotional bonds with patients, too, and feel the impact of every life-altering diagnosis. When all of these stressors add up, the resulting burnout can interfere with doctors’ ability to focus and communicate with patients. The effects of burnout on physicians are complex. Best practices for countering burnout are not as well-researched as they should be.
However, physicians need to learn to recognize the signs of burnout and do what they can to manage burnout as soon as it appears. The potential consequences are high and can even cause physicians to leave the medical field entirely. In a worst-case scenario, medical errors caused by burnout can result in patient deaths.
Although every physician has bad days, burned-out physicians will have more bad days than good ones. They may struggle to connect with patients and may be more impatient and cynical than they used to be. Usual stress-management techniques like mindfulness can help somewhat but are challenging to implement when cynicism has taken its toll on a doctor’s morale.
Primary care doctors, in particular, may struggle with depersonalization due to high patient volume and the relative simplicity of most diagnoses. However, ER doctors may also find that they are subconsciously disconnecting from their work as a coping mechanism due to trauma. In any case, doctors struggling with depersonalization may struggle to maintain open and honest communication with patients.
Physicians who are overtired and overworked may struggle to listen carefully to patients’ symptoms. Even if they’re trying to stay emotionally engaged with their work. A 2018 Stanford University study showed that physician burnout could be causing more errors than unsafe working conditions. While healthcare providers are actively taking steps to deal with hazardous working conditions, they aren’t doing as much to combat burnout.
Medical errors are estimated to cause over 100,000 deaths per year in the United States. While it’s challenging to determine precisely how many are caused by burnout, it’s very likely that this number could decrease if burnout among doctors is reduced.
Although depression and anxiety are not always caused by work-related stress, they can be. ER doctors, in particular, are prone to Post-Traumatic Stress Disorder. But other doctors can experience similar combinations of anxiety and depression. These feelings can quickly intensify if a doctor makes a serious medical error or has other feelings of guilt.
Depression and anxiety can also have their own effects on physician memory and decision-making. They can exacerbate fatigue-related inattention and mistakes. Since the symptoms of depression can vary somewhat, it’s important for doctors to consult with a psychiatrist as soon as they start feeling general symptoms like hopelessness, excessive fatigue, and lack of interest in usual hobbies.
The long work hours take a noticeable toll on a physician’s family life, but there can be less direct effects as well. Doctors could end up emotionally distant, especially if they dealt with a difficult decision or diagnosis during the workday. It can be challenging for spouses to understand the reasons for this, especially if the spouse does not work in healthcare.
As a result, some doctors drink alcohol or abuse prescription drugs to cope. This can further wear on family life. The societal stigma against substance abuse makes it difficult for doctors to get help. Employers have taken steps to combat substance abuse among doctors. But unless the root cause of burnout is addressed, the trend will likely continue.
Physician turnover at individual facilities is often linked to burnout. In serious cases of burnout, doctors may leave the profession entirely, or at least switch to a specialty that isn’t as demanding. Some head into academia or consulting, where they can work fewer hours overall. Although adjunct teaching at universities generally has low pay, for some, it’s well worth the change.
When a doctor leaves a practice, patient care can be negatively impacted if care is not taken to transition the patient to their next doctor. If a doctor is burned-out when they leave the practice, they might not take all the steps necessary to ensure a smooth transition. Finding a replacement doctor can be especially difficult in rural areas or high-poverty urban areas. So patients might wait months for their next appointment.
One of the best ways to counter burnout is to allow doctors to take more time off. However, in some areas, a shortage of doctors makes this almost impossible. Under-served communities and busy hospitals struggle to attract and retain doctors, especially in family medicine and other specializations that pay less.
Reducing burnout for a physician further will require years of gradual changes. Until then, the impacts of burnout will be far-reaching.
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