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The most sustainable solution to overcoming physician burnout is industry-wide change, and the transition to a value-based system could lead us there
Physician burnout has increasingly become a pain point in the health care industry, affecting not only doctors' well-being but potentially the quality of care they provide as well. As a primary care physician with vast health care experience, I have witnessed firsthand the profound impact that overwork and insufficient support can have on physicians, as well as ways to mitigate and altogether prevent burnout.
The challenge of excessive work hours
Physician burnout often stems from prolonged exposure to stressors such as excessive workload, administrative burdens and a lack of control over work processes. Some physicians may find themselves in roles that demand long hours, primarily in health care organizations prioritizing high patient volumes. In some fee-for-service clinics, providers are expected to see upwards of 20 patients a day, many of whom have multiple comorbid conditions.
According to Statista, the average physician works 50 hours per week. A University of Chicago study further emphasizes the unrealistic expectations, suggesting that doctors would need nearly 27 hours each day to provide guideline-recommended primary care.
This relentless schedule leads to physical and mental exhaustion, and it can reduce physicians' ability to engage empathetically with patients and colleagues. The implications of burnout extend beyond the individual. It can contribute to patient dissatisfaction, increased risk of medical errors and high turnover rates among health care professionals.
Support systems and work-life balance
Robust support systems are crucial in managing workloads and reducing burnout. My colleagues have become a second family, offering invaluable support during personal and professional challenges. When I needed to take leave to care for a family member, my colleagues and practice leaders stepped in, enabling me to balance my responsibilities effectively.
Physician longevity and retention are best achieved through a proper work-life balance. The value-based care model at my current practice has smaller patient panels; providers see around 10 patients per day and have greater autonomy, which translates into more personalized patient care and more rewarding patient-physician relationships. This is the essence of why many of us choose to practice medicine.
My prior role in recruiting, hiring and training providers has given me unique perspective in evaluating health care organizations. I have consistently found that flexible scheduling and wellness resources help promote a culture committed to providing physicians with a quality work-life balance. This approach should be a priority across all organizations.
The impact of bringing work home
Many physicians, including myself, have experienced the detrimental effects of bringing work home. This practice perpetuates a cycle of stress and intrudes on personal lives, often causing strain on familial relationships. In the fee-for-service model, where providers earn their income based on the volume and type of services delivered, the pressure to take work home is even greater.
Transitioning to a value-based care model has been transformative. With smaller patient panels and fewer daily appointments, facilitated by the robust care team and advanced electronic health record capabilities, I have more control over my work and do not feel pressure to bring administrative tasks home. This shift has allowed me to build enriching relationships with my patients and enjoy more quality time with my family.
Preventing physician burnout
Preventing physician burnout involves both individual and systemic strategies. At the individual level, promoting self-care practices such as regular physical activity, mindfulness and adequate rest is important. Physicians should be encouraged to seek support from peers, mentors or mental health professionals when needed.
Organizational changes are equally important. Implementing efficient EHR systems can reduce administrative burdens and significantly alleviate stress. In addition, fostering a supportive work environment where physicians feel valued and heard can enhance job satisfaction and reduce the risk of burnout.
To me, the most sustainable solution to overcoming physician burnout is industry-wide change, and the transition to a value-based system could lead us there. Value-based care, which prioritizes patient outcomes over service volume, has the potential to transform the health care landscape. In comparison to the fee-for-service model, value-based care shifts the focus to delivering high-quality, coordinated care. When effectively implemented, value-based care systems can mitigate some of the primary drivers of burnout, such as administrative burden and poor patient engagement.
However, not all value-based care models are created equal. Physicians must look beyond the label and truly grasp the company’s culture, patient panel sizes, number of patients seen daily and room for growth. In the right setting, these factors can empower physicians to determine the frequency and timing of patient visits, ensuring that they have ample time to address patient questions and manage workflow without feeling overwhelmed.
Moving forward
Physician burnout is not just a personal issue; it is a systemic problem that affects the entire health care ecosystem. By implementing sustainable practices and supportive environments, we can ensure that physicians remain healthy, fulfilled and capable of providing the high-quality care that our patients deserve. Health care organizations must make a concerted effort to provide flexible scheduling and comprehensive wellness resources, in addition to fostering a culture that prioritizes physician well-being. With my company, we have made significant strides in this direction, and I encourage other organizations to follow suit.
Reginald Ross, M.D., is an internal medicine specialist at CenterWell Senior Primary Care