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Causes of physician burnout and way to address it

The president of the Association of American Medical Colleges details factors that contribute to physician burnout and broad cultural changes that can help.

More than 50 percent of physicians experience symptoms of burnout, and significant shares report depression and suicidal thoughts.

These numbers signal a problem that should be considered a national health emergency, Darrell Kirch, MD, president of the Association of American Medical Colleges, said in a recent speech. As reported by MD Magazine, Kirch told the audience at the American Psychiatric Association's annual meeting:

If you woke up one morning and the New York Times had a headline that said, '6.4% of airline pilots reported that they were suicidal in the prior year,' we would ground the fleet. We would say that this is a crisis, and we can't afford to have these people doing high-risk tasks jeopardizing other lives because they themselves are thinking of taking their own lives.

Kirch outlined a constellation of factors that can contribute to physician burnout, from excessive workloads to regulatory burdens, from lack of control to lack of satisfaction. He also listed five "great disruptions" in health care that add to the stress: increasing drug labor and supply costs, new clinical partnerships, actions from lawmakers, changing demographics, and tightening of reimbursement.

Health care leaders are the ones navigating these issues, he said, but they often don't come from a medicine background and therefore don't always tailor solutions to fit physicians' needs.

"We have leaders who know how to drive down costs, but aren't focused on the clinical care," Kirch said.

Though problems can be unique to individual institutions, many factors generally affect the wellbeing of physicians, he said, including diversity and inclusion, team structures and functionality, and support both inside and outside the workplace.

To address burnout, Kirch called for a wide-spanning change in the culture of medicine to emphasize physician wellbeing. He recommended a shift from hierarchal, competitive and expert-centered to collaborative, team-based and patient-centered:

This is a heavy lift. It's not an easy solution. It's an issue of culture change. To err is human. But I say, to care is human.

Photo by Luis Melendez

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