Healers in Need of Healing Cannot Heal

Herdley O. Paolini, PhD; Mark H. Greenawald, MD


May 20, 2016

In This Article

The Burn-Out Epidemic

All of this leads to the question: Why are physicians generally so ill prepared for the expanded role they need to play in this transformation of healthcare? As alluded to above, the majority of physicians today are burned out, cynical, and overwhelmed. The recent Medscape Physician Lifestyle Report places physician burnout at a higher prevalence and greater severity than just a year ago, with the highest prevalence at 53% and greatest severity of 4.3 on a 5-point scale, depending on specialty.[13] This is consistent with a recently published article that placed mean physician burnout in 2014 at 54%, with a specialty-specific range between 39% and 71% and with every specialty's prevalence increasing since 2011.[14] The consensus is that physician burnout has reached a critical, if not epidemic, crisis level. In addition, in a recent survey in the United States, 60% of physicians reported that they were considering leaving their practice, and 70% reported knowing at least one colleague who left their practice due to low morale.[2]

Why is physician wellness of crucial importance as we face this unprecedented change in healthcare? For starters, physicians have tremendous influence, and they are often looked upon as de facto team leaders. They possess the ability to collaborate in essential teamwork or to undermine those essential processes. Indeed, physicians are more than just cogs in the healthcare machine. They are the key influencers for good or bad. Just think of the power of the physician's pen, order entry on an electronic health record (EHR), or the reality that they are on the front lines and responsible for critical points in the care of the patient. Therefore, they have the ability to undermine an initiative because they are emotionally and physically maxed out, do not understand the meaning of it, do not experientially see how it will be helpful, or have not been meaningfully enlisted so they are too detached.

Without addressing the issue of burnout and all of its causes and working toward a culture of wellness for caregivers and patients alike, we are not going to have the foundation we need to achieve the much needed triple aim. After all, what could be more patient-centered than ensuring that those who provide care are not only clinically competent but emotionally well? But let's be clear: Addressing burnout is not just a matter of addressing how many hours one works, how many bureaucratic tasks one has to weed through, how many barriers one has to jump through in order to care for patients, reducing the number of clicks on an EHR, or providing better pay. While these are necessary components, any comprehensive approach must include addressing the damage that may have been done by physician training and the ongoing effects of medical and organizational culture.


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