By Christopher Cheney
A new sentiment survey gauges physician burnout and other challenges.
Burnout is one of the top challenges facing clinicians and other healthcare workers nationwide. In a September 2020 report published by The Physicians Foundation, 30% of more than 2,300 physicians surveyed cited feelings of hopelessness or having no purpose due to changes in their practices related to the coronavirus pandemic. Research published in September 2018 indicated that nearly half of physicians across the country were experiencing burnout symptoms.
The new sentiment survey, which was published by Watertown, Massachusetts-based athenahealth, is based on information collected from nearly 800 physicians. Most of the respondents (64%) worked at independent practices, with 22% of respondents working at hospital-affiliated practices. Most of the respondents (75%) were primary care physicians and 25% were specialty physicians.
The sentiment survey includes several key data points:
- 39% of respondents said their practices had taken concrete steps to address burnout in the prior 12 months
- More female physicians (32%) reported feeling burned out at least once a week compared to male physicians (26%)
- 52% of physicians 65 years and older reported their burnout frequency was “never” or “a few times a year or less”
- 37% of physicians 18 to 44 years old and 37% of physicians 44 to 65 years old reported their burnout frequency was “never” or “a few times a year or less”
- On average, physicians spent 64% of their weekly working hours on direct patient care, 23% of their weekly working hours on work-related activities other than direct patient care, and 14% of their weekly working hours performed at home outside business hours
- 50% of respondents said they had all of the information they needed to quickly come up to speed on a patient’s story during a patient visit
- 23% of respondents said that they had difficulty focusing on patient care because of time consuming administrative tasks
Interpreting the data
The finding that only 39% of practices had taken concrete steps to address burnout in the prior 12 months is troubling, Jessica Sweeney-Platt, vice president of research and editorial strategy at athenahealth, told HealthLeaders.
“Only a little more than a third of physicians said their practices have taken concrete steps to address burnout, which means more than 60% have not taken concrete steps. That is contributing to the sense that the pace of practice is something that the physicians are struggling to maintain. One of the most troubling aspects of that finding was that if you answered that your practice has not taken concrete steps to decrease burnout, you were much more likely to report feeling rushed in your interactions with patients. It is that sense of time pressure and the out-of-control nature of the physician’s schedule that we think is a big input into levels of burnout,” she said.
The sentiment survey provides insight into the gender gap in physician burnout, Sweeney-Platt said. “There were some very clear differences between female physicians and male physicians. Female physicians are feeling much more burned out than their male counterparts. They also report spending more time working outside of normal work hours. There is a connection between those two findings.”
The relationship between age and physician burnout points to a potential way to help address burnout, she said. “It is interesting that older physicians are reporting burnout less frequently in our survey. There may be some insights that older physicians can share with their younger colleagues in terms of how they have learned to manage and balance the conflicting requirements on their time.”
More research is needed to assess the impact of hours spent on work-related activities other than direct patient care and weekly working hours performed at home outside business hours, Sweeney-Platt said.
“It depends a lot on what they are doing. For example, if a physician is spending two hours at home every night diving deep into the journals and thinking hard about the clinical conditions for specific patients that they have seen during the day and using their training and their intellect trying to get to better answers, then that would feel satisfying. However, if that two hours is spent finishing up paperwork or finishing up the documentation burden, that is not going to feel optimal,” she said.
Physician practices should make it easier for clinicians to come up to speed on a patient’s story, Sweeney-Platt said. “We can do better for the physicians who do not have all the information they need to quickly come up to speed on a patient’s story during a patient visit. Even if you end up feeling that you have all of the information you need to come up to speed on a patient’s story, sometimes the work required to get to that information is too much.”
Burdensome administrative tasks are a serious problem for many physicians, she said. “The administrative tasks that take physicians’ focus away from their direct patient care is the most concerning element of the distribution of their work effort. Most physicians I have talked with would say that they did not get into the practice of medicine to get on the phone with insurance companies, for example. That is a deeply unsatisfying.”
Physician practices that are successful at shifting administrative work away from their clinicians have focused on creating clear roles and responsibilities for the members of the care team, Sweeney-Platt said. “They have carefully thought about the way that they want work to flow across the care team so that the physicians and the clinical team members are doing the work that only they can do. As much as possible, these practices ensure that non-clinical team members are enabled and capable of taking on administrative tasks.
Christopher Cheney is the senior clinical care editor at HealthLeaders.