Changing work conditions, more clerical data filing is robbing doctors of zeal for patient care
Unhappiness at work is leading to increased physician burnouts, an US study has found.
In just three years, physician burnout increased from 45.5 percent to 54.4 percent, according to a paper authored by doctors at the University of California, Riverside School of Medicine.
“Doctors aren’t depressed or less content at home,” write coauthors Dr Andrew G Alexander and Dr Kenneth A Ballou in the August 2018 issue of the American Journal of Medicine. “They’re less happy at work.”
The study noted: “Physician burnout is characterized by 1) a feeling of a lack of accomplishment; 2) feelings of cynicism; and 3) a loss of zeal, zest, and enthusiasm for work. Apart from the effects burnout has on individual physicians, there is evidence that relationships with patients and family also suffer. Although increased burnout has been found to be notably worse in primary care and emergency room physicians, it has also worsened in 18 of the 20 categories of specialist physicians sampled.”
Alexander and Ballou compared data from 2011-14 on physician burnout and satisfaction with work-life balance to arrive at their conclusions.
The doctor-patient relationship has been morphed into an insurance company-client relationship that imposes limitations upon the treatment doctors can provide to the insurance company’s member
Alexander, an associate clinical professor of family medicine, and Ballou, an assistant clinical professor of family medicine, list three factors that contribute to physician burnout:
• The doctor-patient relationship has been morphed into an insurance company-client relationship that imposes limitations upon the treatment doctors can provide to the insurance company’s members.
• Feelings of cynicism (resulting from patients no longer expecting continuity of care and routinely changing doctors).
• Lack of enthusiasm for work.
The authors found that physician burnout measures highest in emergency medicine, family medicine, internal medicine, and pediatrics. They also posit that five transformational medical practice events that occurred between 2011 and 2014 contributed to the increase in physician burnout.
Alexander said: “Doctors now spend more time with electronic health records than they do with patients. Electronic health records were pushed by the government at great expense and without regard to the effects upon patient or physician health. Go into any hospital and look for the nurses and the doctors. You will find them sitting in front of computers. They are not happy, and their patients are not healthier.”
Electronic health records (EHRs) snuck up on the medical community, Alexander noted. India is in advanced stages of planning a national level EHR initiative for its 1.25 billion population.
Alexander noted that physicians like him and Ballou are dedicated to educating medical students to be physicians that care.
“It should be a treat to care about another person, but I see that too many of our seasoned physicians are frustrated with medicine, and it rubs off onto the physicians in training,” Alexander said. “Doctors have a wonderful job, yet they are inundated with numerous extraneous burdens that collectively rob them of the joy of medicine.”