COMMENTARY

Physician Burnout Is a Public Health Crisis, Ethicist Says

Arthur L. Caplan, PhD

Disclosures

March 04, 2016

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Hi. I'm Art Caplan from the Division of Medical Ethics at New York University Langone Medical Center. We've got a problem in this country with doctors. It's kind of an epidemic, but no one is talking about it. It is burnout. A recent study from the Mayo Clinic showed that in 2011, 45.5% of doctors reported that they felt burned out, and that number has now risen to 54.4% in 2014.[1] More than half of all doctors in this country are saying, "I really feel that some aspect of my work as a doctor is making me feel burned out."

This is really trouble. It's trouble because a doctor who feels this way can commit more errors. They suffer from compassion fatigue, or just not being able to empathize with others because they have their own emotional issues. They may retire early, thereby reducing the workforce. They may have problems managing their own lives; 400 doctors committed suicide last year, which is double the rate of the population average.[2] There's trouble for patients in having a workforce that's burned out. There's trouble for doctors in terms of their own health and well-being. We don't talk about it much. We like to think that doctors can handle everything, but it's clearly not true. It's a problem and there ought to be some solutions.

One type of fix is to make sure that hospitals and other healthcare environments try to create better conditions for a happy workforce and for happier doctors. This might include yoga, mindfulness training, having more therapists to talk to, encouraging people to come forward when they feel this way, peer groups, and better mentoring. There are a lot of tactics that we could pursue and try to engage in. I'm not sure what's best, and maybe one size does not fit all, but it's time to really build a safety net so that we keep our workforce functioning and we keep physicians at their careers and doing a good job—not making mistakes, not being indifferent to patients, and not harming themselves. This really is a problem we've got to attend to in the workplace. It's just as important as any other aspect of workplace safety.

When we institute new software or when we have new bureaucratic regulations, I think somebody ought to ask what this does to the workforce. If one more doctor complains to me about Epic and other types of electronic recordkeeping and billing forms, it'll be one doctor too many. It takes a lot of energy. It makes people unhappy. A lot of the software and computer assistance that's out there doesn't seem to help the doctor; it makes more work or makes them frustrated. It also seems to me that if you look at what's going on with respect to regulations and administrative or bureaucratic requirements, nobody is saying, "Hey, is this user-friendly? What's the burden that it's putting on the doctor?" It's just done to save money or allow people to collect bills more reliably, but it's not asking what it's taking out of our workforce.

I believe that, morally, we've got to make sure that a highly trained workforce that takes a very long time to get the ability to practice medicine is a resource that we preserve and really take seriously. I don't think we are doing that as part of employee or workplace safety. I think it's crucial, but it's being ignored. We also have to view it as part of patient safety, and I think we should start spending some resources to figure out how we can make the physician workplace more user-friendly. How can we make it a happier place to be? What can we do when we institute regulations, guidelines, software, and bureaucracy to try it out on the workforce for a while to make sure that they're satisfied and that it's not making their lives more miserable?

I'm Art Caplan from the Division of Medical Ethics at the New York University Langone Medical Center. Thank you very much for watching.

Editor's Note: Medscape's annual Physician Lifestyle Report has been following the physician-burnout story for the past few years. Read the 2016 report here.

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