Are physicians being asked to do too much? How different is the workload today than it was 40 years ago? What contributes to physicians getting burned out? These types of questions are being asked across the United States by medical practices and hospitals small and large. How do we acknowledge and reduce physician burnout?
Younger physicians seem to have a different view on what their work day looks like than they did 40 years ago. Young doctors often have one or both parents who may have been a physician or practitioner and grew up having very little contact with them because their work was their life. Although they have a passion for medicine, they do not want their kids and family to grow up the way they did. Younger physicians are negotiating and taking less and less on-call duty, and when they are on-call they expect to be heavily compensated for that time away from their friends and family.
According to a November 7, 2016 New York Times Article “A Doctor Shortage?” The overall shortage of physicians is getting worse each year. The AMA is projecting that by 2025 there will be a shortfall of between 46,100 and 90,400 doctors. This scenario is putting more pressure on the existing workforce and making it extremely more difficult to create and maintain the physician on-call and in-office schedule. In fact, for many specialty practices creating the physician schedule has become so complicated that it requires a Doctor to do the work. You can read more about that topic in my blog post “ Went to medical school to create on-call schedules, Eh?” Work, office, and the growing number of small satellite locations have providers spending up to 1 hour in their car each way to see patients. Many physicians spend their day’s off catching up on “charting” or updating ERM systems, training and some even spend it creating schedules for their partners.
Because of just a few of the things we mentioned above, we see a direct correlation between how physicians are scheduled and burnout. According to a 2016 Medscape Lifestyle Report, the top five specialties that are most burned out are Critical Care, Urology, Emergency Medicine, Family Medicine and Internal Medicine.
On a scale of 1-6 the average severity of the burnout is about 4.1 and the study shows no noticeable difference between men and women. There is no surprise that there is a noticeable difference between happiness outside of work and at work. There is also no big surprises when looking at which specialities have the happiest doctors, they are primarily the areas that have the least on-call duty requirement, Dermatology and Ophthalmology. In addition to on-call the causes of burnout also include too many bureaucratic tasks, increasing computerization (EMR), too many patient appointments in a day and dealing with difficult colleagues.
It seems clear that on-call directly contributes to physician burnout and happiness. Is there anything that can be done? I think that all the companies that work directly in the physician scheduling industry would agree that yes, there are things that can be done to immediately reduce the burden that on-call places on doctors.
Here is Call Scheduler’s top list:
- Ensure that the provider schedule is fair and balanced. There is enough stress taking call on nights, weekends and holidays without the feeling of unfairness. This is easy to achieve and even easier to prove.
- Ensure that your providers have easy tools to access information when and where they need.
- Ensure that your providers have tools to make vacation and other day-off requests when and where it is most convenient.
- Ensure that whoever creates and maintains the physician schedule has all of the available tools to automate and systematize as much of the process as possible.
- Ensure that your providers are not creating scheduling rules and scenarios that are so complex that they are unable to be automated.
- Train your providers to be open to change and to persist in the face of resilience to change.
Image courtesy of Stuart Miles at FreeDigitalPhotos.net
Image Source: Medscape Lifestyle Report 2016: Bias and Burnout.
Carol Peckham | January 11, 2017