25 Feb 2020 //

Are health workers prone to burnout?

In the US, over one-half of physicians and one-third of nurses experiencing symptoms. The burnout epidemic is detrimental to patient care and may exacerbate the impending physician shortage. Our country does not have the data, yet we still have to look out for the symptoms of burnout and try to find a way to prevent or treat it.

Burnout was first described in 1974 by the clinical psychologist Herbert Freudenberger, who often volunteered at a free clinic in the then drug-ridden East Village of New York City. Over time, Freudenberger observed emotional depletion and accompanying psychosomatic symptoms among the clinic’s volunteer staff. He called the phenomenon “burnout,” borrowing the term from drug-addict slang. Freudenberger defined burnout as exhaustion resulting from “excessive demands on energy, strength, or resources” in the workplace, characterizing it by a set of symptoms including malaise, fatigue, frustration, cynicism, and inefficacy.

The consequences of burnout are not limited to the personal well-being of healthcare workers; many studies have demonstrated that provider burnout is detrimental to patient care. For example, the number of major medical errors committed by a surgeon is correlated with the surgeon’s degree of burnout and likelihood of being involved in a malpractice suit. Among nurses, higher levels of burnout are associated with higher rates of both patient mortality and dissemination of hospital-transmitted infections. In medical students, burnout has been linked to dishonest clinical behaviors, a decreased sense of altruism, and alcohol abuse. High rates of physician burnout also correlate with lower patient satisfaction ratings.

As part of its annual Physician Lifestyle Report, Medscape gives physicians a list of possible burnout causes and asks them to rank their significance. Over the last five years, “too many bureaucratic tasks (e.g., charting, paperwork),” “spending too many hours at work,” and “increasing computerization of practice (electronic health records (EHRs)),” have consistently been ranked as three of the top four factors.

Last year, the Mayo Clinic described nine strategies that, when implemented, resulted in a 7% decrease in burnout over a two-year period. Some suggestions for combating burnout are listed below:

1. Adequate and better leadership quality

2. Choose incentives wisely, like performance-independent salary models or offer alternative rewards such as greater schedule flexibility or time off

3. Encourage a work-life balance, e.g. work fewer hours in exchange for reduced compensation, or by granting them greater flexibility

4. Encourage peer support by promoting relaxed interactions between health workers

5. Furnish resources for self-care and mental health

6. Target burnout from day one of merical school

1. Reith TP. Burnout in United States Healthcare Professionals: A Narrative Review. Cureus. 2018 Dec; 10(12): e3681.
2. Medscape Lifestyle Report 2017: race and ethnicity, bias and burnout. [May;2018 ];Peckham C. Medscape Lifestyle Report 2017. https://www.medscape.com/features/slideshow/lifestyle/2017/overview Accessed February 12th, 2020.