Why doctors are stressed, and what healthcare leaders can do to help

Doctors have been dealing with burnout even before the arrival of COVID-19, and the pandemic has only added to the stress on physicians.

There are a number of factors that contributing to the burnout of doctors, and some of those were highlighted in a session at the HIMSS 2022 Global Health Conference and Exhibition in Orlando. Two leaders from athenahealth led the discussion.

They explored some of the reasons doctors are getting stressed out, and they discussed ways healthcare leaders can ease some burdens on their physicians.

They cited one area that hasn’t received as much attention as some others: mergers and acquisitions.

Jessica Sweeney-Platt, vice president of research and education for athenahealth, didn’t describe mergers of healthcare organizations as good or bad. But when practices are absorbed or health systems merger, doctors face significant changes, and often a good amount of stress.

“Organizational upheaval … has a real impact on physician well-being,” Sweeney-Platt said.

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She pointed to survey results that said less than half (47%) of physicians who have been involved in a recent merger said they felt safe and supported, compared to 72% of doctors who haven’t been in a recent consolidation.

Doctors have cited a loss of autonomy as a contributing factor to burnout. (The story continues below the video.)

Doctors have typically relished autonomy, but that’s an increasingly rare luxury for many physicians today, said Nele Jessel, chief medical officer for athenahealth.

“Historically, physicians have been a very autonomous profession,” Jessel said. “Over the last decade or so, we’ve seen a gradual erosion of that autonomy.”

Beyond the pandemic, doctors have complained for years about the time they are spending on administrative tasks. Doctors cited administrative burdens (such as paperwork and charts) as the top cause of burnout in a Medscape survey in January. The survey found 60% of physician pointed to bureaucratic burdens as the leading cause of burnout.

“Physicians went into medicine to take care of patients,” Jessel said. “They did not go into medicine to do an administrative job.”

In addition to dealing with regulatory burdens, doctors are also handling varying payment models and quality control measures. A doctor could spend 15 minutes with a patient, and then 20-25 minutes on the documentation required for that case.

“The administrative component of the clinician’s job has really, really increased,” Sweeney-Platt said.

Of course, the pandemic has played a role in wearing out doctors as well. Roughly 1 in 5 doctors have said they are considering leaving the profession in the next two years due to the stress of the COVID-19 pandemic, according to a recent study.

Jessel and Sweeney-Platt outlined some steps healthcare leader can take if they want to help their doctors.

Promote autonomy

Sweeney-Platt stressed the importance of healthcare leaders finding ways to give doctors more autonomy.

“Physicians need a sense of control over their time, over their schedule,” she said.

In fact, she said if healthcare leaders took just one message home from the session, it should be the idea that doctors need more autonomy. Front-line workers need the latitude to take care of patients.

“We know from a lot of industrial research that individuals who feel like they have the latitude to do their jobs in the way that they think best, and the tools and resources they need to do their work, they tend to much more engaged, they tend to be much more willing to lean in, they’re much less likely to leave the organization,” Sweeney-Platt said.

Acknowledge and recognize clinicians

Healthcare leaders need to take the time to show appreciation and recognize the contributions of their doctors.

The more doctors feel safe and supported and recognized, the less frequently they feel burned out. “It sounds so simple,” Sweeney-Platt said.

Creating clinical communities

Some healthcare organizations are finding ways to bring doctors together.

“A number of organizations are thinking really hard about how to overcome this increasing sense of isolation physicians are feeling,” Sweeney-Platt said.

She pointed to a group of doctors who occasionally get together for meals to discuss successes and problems.

Healthcare organizations should also look at ways to give doctors more time to talk to and learn from each other. Doctors talking to colleagues has fallen by the wayside, Jessel said.

Scheduling time for administrative work

Healthcare organizations can help their doctors by protecting more time for documentation and other administrative duties during normal working hours. Doctors who spend less time on documentation outside work hours are less likely to report burnout, Sweeney-Platt said.

While doing such a step may help reduce stress, it could mean they would be seeing fewer patients, and potentially earning less under payment models that incentivize seeing as many patients as possible.

Invest in the right technology

Healthcare organizations need to invest in technology that improves the flow of information and provides actionable data at the point of care, Jessel said.

Most doctors agree getting easier access to critical data could save lives. Greater interoperability would also cut the time to diagnosis.

Team-based care

Another potential solution is facilitating team-based care, where a group of doctors and other healthcare professionals work together to improve patient care.

Most providers involved in team-based care report a deep sense of fulfillment, Sweeney-Platt said. Such teams can include doctors, nurses, assistants, and social workers. Doctors involved in team-based care also have said they are more likely to spot gaps in care during patient encounters.

Team-based care can reduce burnout of doctors, according to a 2018 report from the National Academy of Medicine.