What Is Practitioner Burnout and How Can You Help?
Patients can turn to healthcare practitioners when they experience symptoms of burnout: emotional exhaustion, depersonalization, and a sense of reduced accomplishment at work. But many clinicians cite barriers that make them feel alone in coping with the same conditions. New approaches can help hospitals stem the tide of practitioner burnout and avoid its cascading effects: injury to patients or providers themselves, increased risk of malpractice, reduction in overall quality of care and patient outcomes, high provider turnover rates, and the like.
Studies and online forums reflect the widespread and serious nature of practitioner burnout, including these direct quotes: “I dread coming to work,” and “I’m drinking more and have become less active.” In organizations that don't have an outreach program to support burned out providers, credentialing professionals and MSPs can suggest or implement small steps to help, says Joni Orand, Senior Solution Consultant at symplr. Orand recently hosted a symplr webinar on the topic of provider burnout, which explored innovative approaches helping practitioners nationwide.
First, it’s worth taking a closer look at the reasons why practitioners avoid seeking help with burnout symptoms, before crafting or expanding your organization’s strategy to support healthcare professionals.
Communicate to practitioners that burnout is not a taboo topic
Although physician burnout—or burnout among advanced practice professionals (APPs) such as nurses or CRNAs—may be equal to or greater than that of other professions, one survey found:
- 64% of practitioners have never shared their feelings or reached out to anyone about them
- 81% fear risk of disclosure and the impact on their license to practice, or worry about the perceptions of co-workers/patients and the community
- 97% feel their symptoms are not bad enough to warrant help
Other common responses practitioners cite for why they won’t seek help are that they have no time to do so, feel that they can handle/get over the feelings, or they simply don’t want colleagues or administrators to know they’re struggling. Only 10% said they would share their feelings with a colleague.
Left untreated, provider burnout could reach crisis levels that endanger our healthcare providers and undermine patient safety. Therefore, if messages of support and other communication can aid even one practitioner in overcoming the taboo around the subject, the efforts will have been worth it. Often, it takes just one provider or administrator to set a tone of support and encouragement in the organization to see positive effects.
Learn where your organization stands in its physician burnout response
According to Mark Smith, MD, MBA, FACS, who also participated in the webinar, healthcare organizations collectively have made progress in addressing the problem of practitioner burnout. His timeline shows how some organizations have gone from little or no recognition or practitioner support, to a current state of managing it proactively when providers vocalize a need for assistance.
Prior to 2005: You’re on your own
- There was typically no official or structured outreach or response by the organized medical staff.
- If help was sought, it was likely outside the healthcare organization where the practitioner was affiliated or employed.
- Often, the individual physician who experienced burnout would consider retirement if economically feasible.
- The practitioner would undergo peer review for any associated negative clinical outcomes.
2006–2018: Referral to a physician wellness committee
- Physician wellness committees (PWC) began appearing (the positive spin on those formerly referred to as “impaired physician committees”).
- PWCs mainly addressed practitioners who presented with alcohol or drug dependencies
- Due to a lack of alternatives, PWCs became the go-to source for medical staff leaders attempting to assist physicians with symptoms of burnout.
2018–present: Proactive measures
- Today, medical staffs and hospitals are realizing that burnout is a condition to be managed.
- We now understand that the effects of burnout can destroy careers and lives, negatively affect quality and safety, inviting exposure to malpractice, negligence, or medical error based lawsuits.
- A two-pronged response using treatment and prevention has seen some success in hospitals and healthcare systems.
Encourage practitioners to take self-preservation actions
A major factor contributing to providers’ feelings of burnout and career dissatisfaction is a lack of time. In fact, one study listed “too many bureaucratic tasks” and “spending too much time at work” as the top two reasons for providers’ unhappiness. As a result, adding mandatory training about burnout prevention is often seen as unsuitable and creating just another demand.
But there are ways to get the message out using meetings where practitioners are already gathered (Credentials Committee or MEC) or communication vehicles they already attend to (newsletters, staff room postings). Some basic recommendations for practitioners include:
- Establish professional boundaries by setting clear parameters that ensure space and time for yourself.
- Use your paid time off and take vacations. Even stay-cations help.
- Engage support from family, friends, and professional organizations.
- Use existing resources such as Employee Assistance Programs where staff can access free support.
- Look into health plans’ offerings for a certain number of free mental health visits/year
- Take an advocacy role within your institution or practice.
- Push for an environment that provide physicians with increased control over workplace issues.
- Push leadership to respect work-life balance by demonstrating the long-term costs associated with not doing so.
Take organization approaches to help with practitioner burnout
It shouldn’t be up to providers alone to advocate for measures that support their health and well-being to avoid professional burnout. Unfortunately, that remains the case in some organizations. Take a cue from systems and hospitals finding positive results when offering these innovative approaches to their physicians:
- Provide scheduled, mandated quiet or meditation times for 10-15 minutes.
- Always include solicitation from providers about burnout in evaluations.
- Encourage, acknowledge and appreciate the commendable things that practitioners are doing and include them in FPPE. (Don’t focus on only issues requiring correction.)
- Have fellow providers or administrators offer unobtrusive, scheduled times with providers to inquire how they are. (Attend to nonverbal communication when they practitioner says they are “fine” but their demeanor sends a different message.) Have a policy for follow up when concerns are raised.
- Provide internal or external sources for help with burnout and post them.
- Form a wellness committee with “sponsors” as well as proctors.
- Place a box where patients can drop a thank you or note of appreciation.
- Openly talk about stressors and burnout in the medical profession.
- Offer topics on burnout prevention and coping mechanisms in meetings that carry continuing medical education credits for physicians or continuing education units for nurses.
- Offer “real talk” forums in 5- 15-minute segments where a leader does all the talking (cases/stories) or where practitioners can listen or share about a personal or patient experience, ensuring that what’s shared is confidential and not questioned.
- Break into small groups during already scheduled committee or departmental meetings and create open ended discussion questions around the topic of burnout to encourage opening up and sharing.
Provide contacts of organizations that support providers feeling burned out
Gregory Nawalanic, Psy.D., Clinical Director of Psychology Services at The University of Kansas Health System's Strawberry Hill Campus, also participated in the recent symplr webinar. He discussed organizations such as Carl’s Cause, which are working to remove the stigma associated with seeking help for mental health issues. Other resources for practitioners experiencing burnout include:
The APA Workgroup on Psychiatrist Well-Being and Burnout created a PowerPoint slide deck and companion manual to help advocate for systemic reform in healthcare organizations. The slide deck can be modified to match the needs of an organization as individual practitioners spread awareness of physician burnout.
- Download the Toolkit for Well-being Ambassadors
- Download the Manual for Well-being Ambassadors
- Download the Well-being and Burnout Handout/Flyer
The ACGME is focusing on five key areas to support its ongoing commitment to physician well-being: Resources, Education, Influence, Research, and Collaboration. Resources here include webinars on combating burnout and inventories to keep track of various elements in a program’s well-being plan.
An online resource from the Agency for Healthcare Research and Quality details the leading causes and promising interventions for clinician burnout.
STEPS Forward™ is a practice-based initiative by the American Medical Association to provide practitioners with strategies to improve practice efficiency and help reach the Quadruple Aim: better patient experience, better population health, and lower overall costs with improved professional satisfaction.
About Joni Orand
Joni Orand has worked in the healthcare industry for twenty eight years’, in both managed care and hospital environments, working with providers and staff gaining unparalleled experience in all aspects of provider management and quality improvement initiatives. She holds a degree in Corporate Communications, with minors in Interpersonal Communication and International Studies in Communications. Joni is a certified trainer, speaker and coach, and is known for helping, educating, and supporting clients as they develop quality improvement plans. Currently working as a Senior Solution Consultant for symplr, Joni speaks as a Subject Matter Expert at industry events.