Physician Stress Having Effect on Patients, Future Docs: Survey
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Physician burnout, which has worsened during the COVID-19 crisis, doesn’t just affect doctors ― it also affects their patients, according to a new survey.
The research, published by virtual healthcare technology company Wheel and independent research firm Pure Spectrum, found that 80% of the 2000 patients surveyed noticed during a healthcare visit in the past year that their doctor or nurse was burned out. Those respondents saw that their healthcare professional was highly stressed and exhausted; 70% of them said they were alarmed by it. One in three respondents said physician burnout negatively affected the quality of the care they received.
“Our healthcare workers are reeling from an incomprehensible amount of trauma, burnout, and grief,” said Michelle Davey, CEO and co-founder of Wheel. The survey, she said, demonstrates that failure to provide support and relief for physicians and others in medicine is “harming the overall health of our country.”
Better Understanding the Symptoms and Risks of Physician Burnout
Wheel conducted the survey to understand the costs of physician burnout on patients. The researchers came to the conclusion that it indeed negatively affects patient health and satisfaction. Mark Greenawald, MD, who runs the online physician peer support process PeerRxMed, said he is not surprised patients are picking up on the fact that something’s wrong with their doctor. “They may not label it as burnout ― rather, something like, ‘my physician doesn’t listen to me,’ ” said Greenawald, a family physician with the Carilion Clinic, in Roanoke, Virginia.
Confirming his suspicions, Wheel’s survey found that 1 in 4 respondents said that their healthcare visit felt rushed and that their healthcare professional did not have the time or energy to listen to their inquiries.
Rushed visits and doctors’ lack of energy could result in medical error, which, according to a study conducted over 8 years ago by the Johns Hopkins University School of Medicine, causes 250,000 deaths annually in the United States. Misdiagnoses cause an estimated 40,000 to 80,000 deaths annually nationwide, and an estimated 12 million Americans receive diagnostic errors in primary care settings annually. One third of those errors result in serious or permanent damage or death.
Physicians who are burned out are also at increased health risk. Although burnout is not a medical diagnosis, it has stark ramifications for one’s physical and emotional health ― it can lead to insomnia, substance abuse, heart disease, high blood pressure, type 2 diabetes, and increased vulnerability to illnesses. Doctors are not being proactive about seeking relief from burnout, as evidenced by the Medscape Physician Lifestyle and Happiness Report 2021, which found that only about 1 in 3 physicians said that they spent time on their own health and wellness.
“Part of our professional training and socialization is to soldier on and suck it up,” says Greenawald. “We do that because we don’t want patients to be impacted.”
COVID-19 Adding to Physicians’ Already Stressed Daily Work
The Medscape Physician Lifestyle and Happiness Report 2021, which surveyed over 12,000 physicians, found that about 80% of physicians were happy outside of work before the start of COVID-19. Now, only about half of physicians say that they’re happy outside of work, reflecting the increased stress that they’re under because of the pandemic.
Public resistance to COVID-19 safety measures, such as wearing masks, as well as conspiracy theories that dissuade many from getting vaccinated and a general refusal to believe scientific fact all contribute to a public health crisis distinct from COVID-19 itself ― one that may be taking a toll on doctors’ energy to battle the pandemic each day. In the Wheel survey, 2 of 3 respondents thought that the general public’s resistance to taking basic precautions could be contributing to clinician burnout.
Another factor may be waning public appreciation of doctors’ efforts during the pandemic. In the beginning months, there were public displays nationwide celebrating physician efforts to tackle COVID-19 head on ― people put signs in their windows and on their yards and cheered from their apartment balconies. Now, public enthusiasm has largely decreased. Three in five survey respondents said they noticed an increase in the lack of recognition for healthcare workers.
General practice physicians are being called upon to serve as mental health professionals for patients, although that is not their area of expertise. Nearly 1 in 3 patients who responded to the Wheel survey admitted that they’ve relied on their primary care clinicians for help with mental health problems instead of discussing them with a trained mental health specialist. However, some doctors have met patient discussions about mental health problems with openness about their own, disregarding the stigma associated with discussing mental health as a healthcare professional. Nearly 1 in 8 respondents said their doctor or nurse disclosed that they were personally struggling with mental health problems during their healthcare visit.
Public Perception of the Medical Careers Decline
Early on in the pandemic, the “Fauci effect” drove young people to medicine. Now it seems that the sustained effects of COVID-19 and the strain on medical professionals are having a less positive impact.
Forty percent of survey respondents said that they would not want their children to enter the healthcare profession as a physician today, and 1 in 3 respondents said that medical school is not worth the investment. One in four respondents shared that they personally knew a doctor who would switch careers if they could, confirming widespread reports that doctors are fed up with their work.
“We train to care for people, but we didn’t necessarily train for this,” says Greenawald. “It has exceeded our threshold, for many of us, to control it, to manage it. It’s started to come out more.”
The nation’s healthcare system is already suffering from a shortage of doctors and nurses. “If rates of medical school applications begin to decline, the healthcare industry will need to take a hard look in the mirror and acknowledge we’re overdue for prioritizing the clinician experience,” Wheel noted in the study.
Mitigating Physician Burnout
Greenawald’s recommendation for physicians who feel burned out is simple: Get help. That help could come in many forms: through a therapist, a professional coach, a friend, or a family member.
“Don’t try to do it on your own, because if you could, you would have,” he says. “From a professional standpoint, it’s almost an obligation to get help.” Being proactive about one’s mental health is key. Greenawald encourages physicians to identify the things that drag them down and to draw up a plan for how to feel better ― it may be exercise, meditation, or family time.
“There’s not been a lot out there from the patients’ perspective,” Greenawald says. “Now that it’s being heard, on a personal note, I hope this provides an additional impetus for leaders in healthcare to not just accept what’s going on as the price of the practice of medicine.”
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