Maryam S. Hamidi, PhD, was working as a nutritionist with late-stage cancer patients at a research hospital in Toronto when she learned firsthand what it was like to experience professional burnout.
"I felt tremendous pressure to help my patients, but nothing was working," she said. "I began to feel hopeless, useless. Then I lost a few patients and felt like a failure." Her colleagues told her to accept the losses; that patients die and health care providers simply have to soldier on. That only made her feel worse.
"I just felt like I shouldn't be falling apart," she said. As a result, she decided to do something about burnout among medical professionals.
Now Hamidi is working as a researcher at Stanford's WellMD Center and Department of Psychiatry and Behavioral Sciences investigating physician burnout. She's the lead author of a study published today in BMC Health Services Research that shows that in addition to the high human costs of burnout, the financial costs to medical institutions are significant as well. Mickey Trockel, MD, PhD, clinical associate professor of psychiatry and behavioral science is the senior author.
"Our study shows that physicians who are experiencing burnout are more than twice as likely to leave their organization within two years," Hamidi said. "This results in significant financial burden to academic medical centers and health care organizations."
In the United States, physician burnout levels have reached epidemic proportions at nearly 50 percent. Research on burnout has shown negative effects on health care quality as well as positive effects of institutional prevention programs to reduce burnout. By showing the financial cost to institutions from physician burnout, researchers in this study hoped to provide an additional motivation for implementation of prevention programs.
"For the business community, health care affects their bottom line," Trockel told me. "Our study suggests effective efforts to prevent physician burnout could render a cost benefit."
Using the two Stanford hospitals as a case study, researchers distributed a wellness survey to a random sample of physicians in 2013. The survey included questions on burnout, work hours, anxiety, depression and sleep-related impairment.
Among the 472 physicians who completed the survey, 26 percent reported experiencing burnout and 28 percent reported "intent to leave" within the next two years. Two years later, 13 percent of surveyed physicians had actually left, a total of 61 physicians out of 472.
After adjusting for surgical specialty, work hours, sleep-related impairment, anxiety and depression, researchers found that the 61 physicians who reported experiencing burnout in 2013 had a 168 percent greater chance of leaving their jobs by 2015 than those who didn't. Next, they estimated that the recruitment costs used to hire replacements for those physicians who left their jobs due to burnout ran between $15.5 million and $55.5 million, the study said. Those costs were based on estimates from the chief financial officers of the institutions.
"Aside from our humanistic motivations, we're trying to emphasize that organizations should invest into preventing burnout," Hamidi said. "From a purely financial perspective, burnout prevention has the potential for significant return on investment."
As for herself, Hamidi said her burnout symptoms disappeared due to the new career shift in which she feels she is able to make a difference. "Working on ways to reduce burnout among medical professionals is the most meaningful work I've ever done," she said.
Image by StanfordMedicineStaff
