WORCESTER MEDICINE
The Elephant in the Room
Carolyn H. Kreinsen, MD, MSc Susan G. Krantz, MD, ScM
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eing a physician has always been difficult, fraught with responsibility, intellectual challenges and stress. Physicians often enter the profession with altruistic goals to help other human beings and to lessen the burden of illness and pain. They may pursue medicine to address complex diagnostic challenges, to make contributions through education or research or to serve the greater good through volunteerism. Given the nature of the work, no one embarks on a career in medicine expecting routine hours and predictable work days; however, for many physicians, the current realities of the job barely resemble the profession for which they trained. Burnout is widely defined as a long-term occupational stress reaction characterized by depersonalization, emotional exhaustion and a sense of low personal accomplishment. Burnout is not a new concept, having been described over the past several decades in physicians, other healthcare professionals and other individuals in myriad work environments. In 2019, the National Academy of Medicine reported burnout had reached “crisis levels” among the U.S. health workforce, with 35-54% of nurses and physicians and 4560% of medical students and residents reporting symptoms of burnout [1]. Since then, mounting pressures in the U.S. healthcare environment, in addition to severe stressors and staffing shortages associated with the COVID pandemic, have only exacerbated problematic imbalances. Demands on physicians consistently exceed the available resources to support their efforts within the existing infrastructure [1]. Burnout not only results in high personal cost for individual physicians, but also negatively impacts patient care with substantial economic and societal costs. It has been estimated that burnout costs the U.S. healthcare system at least 4.6 billion dollars per year, with the greatest burden attributed to physician turnover and work hour reduction [2]. A recent Massachusetts Medical Society (MMS) survey reported an alarming level
Workforce Vitality
of physician burnout currently impacting the physician workforce in Massachusetts, with overall 55% of physician survey respondents experiencing symptoms consistent with burnout. Their data indicated that a large number of Massachusetts physicians have already reduced or intend to reduce their clinical effort, with approximately 1 in 4 respondents planning to leave medicine in the next 2 years [3]. These alarming statistics may actually underestimate the true scope of the crisis; many physicians do not reveal their symptoms of burnout due to personal and professional reasons, and often suffer in silence.
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While many different contributors to burnout have been described…often ill-conceived performance metrics have been consistently identified as underlying drivers. While many different contributors to burnout have been described, the widespread implementation of the electronic health record (EHR) and often ill-conceived performance metrics have been consistently identified as underlying drivers [4]. Rather than supporting clinicians in delivering care more effectively and efficiently, existing EHR designs essentially
Fall 2023
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