Prioritizing physician well-being is more important than ever

Physicians choose careers in medicine because we are driven to help others, but ever-increasing demands on our time and our attention resulting from excessive administrative burdens and dwindling autonomy create barriers to patient care that are inescapable.

The truth is, providing the best possible care to our patients begins with taking time to care for ourselves—a fact often overlooked in a fast-paced clinical environment that grows more complex and time-constrained by the day.

The seemingly good news is that, according to data culled from the 2023 AMA Organizational Biopsy (PDF), physician burnout has fallen below the 50% mark. The bad news, of course, is that a staggering 48.2% of responding physicians reported experiencing at least one symptom of burnout last year, which reflects the ongoing need for comprehensive solutions to a persistent problem. Worse still is that more than one-third of physicians indicated they are considering reducing their hours or leaving medicine altogether—including an alarming number of young physicians and those in midcareer.

While the overall physician burnout figure is lower than it was during the height of the pandemic, it’s clear from these latest survey findings that there is much work ahead of us to address the underlying problems within our healthcare system that are so pervasive and damaging to the medical profession and to facilitate the current mental health needs of physicians.

The AMA has made improving physician well-being and professional satisfaction a cornerstone of its state and federal advocacy priorities for more than a decade, and we continue to develop the tools, support and resources physicians need to create practice efficiencies, streamline workflow, and address the common frustrations we all face.

The AMA is working every day at both the state and national levels to reduce physician burnout through a comprehensive approach that encompasses model legislative solutions, policy changes and advocacy to reduce administrative burdens that interfere with patient care.

AMA surveys make it clear that prior authorization is high on the list of frustration for physicians. While the AMA achieved a significant victory for physicians and our patients earlier this year by advocating directly to CMS for reform of prior authorization processes in federal funded plans, we continue to support the updated version of the Improving Seniors’ Timely Access to Care Act (H.R. 8702, S. 4532) now pending in Congress.

This measure, which overhauls the use of prior authorization in Medicare Advantage plans, enjoys bipartisan support and is endorsed by more than 500 organizations, including the AMA and state and specialty medical societies. Physicians can add their voices to the call for its passage by contacting their representatives in Congress through the Physicians Grassroots Network.

Like so many physicians, I deal with prior authorization hassles constantly. Initiating treatment plans for the patients I see through my private otolaryngology practice is a complex process that includes listening to their histories, examining them, reviewing lab results and imaging studies, and only then making shared decisions with them on the best path forward.

But typically, my patient and I can’t take a single step down that path until I’ve secured prior authorization from an insurance company employee who knows neither my patient nor the course of treatment I am prescribing—but who nonetheless holds the power to issue a blanket denial without explanation. Resolving issues surrounding prior authorization takes physicians away from patients and remains a major driver of burnout, which is why the AMA remains firmly committed to reforming this onerous problem.

Physician burnout triggers a host of wide-ranging and thoroughly insidious effects that drive physicians away from practice and impose greater stress on a health care system that struggles to meet patient needs. Creating and sustaining a culture of wellness that prioritizes professional fulfillment is the driving force behind the AMA Joy in Medicine™ Health System Recognition Program.

This effort highlights the work of health care organizations nationwide that are promoting physician wellness and job satisfaction through programs and policies that emphasize teamwork and operational efficiency as well as dismantling obstacles physicians face in delivering quality care. A full list of 2024 Joy in Medicine recognized organizations will be available soon. In the meantime, health system leaders are encouraged to review eligibility criteria, case studies and sample submissions here (PDF) and consider applying for recognition next year.

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Following passage of the Dr. Lorna Breen Health Care Provider Act in 2022, a bill we strongly supported, AMA continues to push for regulatory, legislative and other solutions to direct more funding and resources to support the mental health needs of physicians. We are also seeking reauthorization of this legislation in 2024.

AMA has supported legislative victories in multiple states to help create confidential physician wellness programs so that physicians who need coaching, counseling or other services to better address burnout, stress or similar situations, can have a confidential place to go.

The AMA is also active at the state and national levels to identify and eliminate outdated and stigmatizing language that can still be found on some medical licensing board, health system credentialing, and medical employment applications. Our advocacy has led to the National Association of Medical Staff Services revising its Ideal Credentialing Standards to follow AMA policy. The AMA also successfully advocated for the National Center for Quality Assurance to align with AMA policy for credentialing applications to ask only about current impairment and not past diagnosis or treatment of a mental illness or substance use disorder.

Already, 27 state medical boards have audited and changed their licensure applications—benefiting more than 700,000 physicians. Nineteen health systems have also audited and changed the intrusive language from their credentialing applications—benefiting more than 200,000 physicians and other health care professionals. AMA advocacy and policy have been a part of nearly every one of these efforts. Also, the AMA partnered with medical societies and hospital associations in Massachusetts, Oregon and Virginia to successfully advocate for statewide changes to credentialing applications.

I invite you to follow our progress (PDF) in overhauling prior authorization procedures, reforming Medicare physician payment and fighting burnout.  

Achieving the Quadruple Aim of health care—boosting patient care, cutting costs, improving population health outcomes and promoting the well-being of the health care workforce—cannot be attained without a work environment that promotes professional satisfaction and self-care.

The AMA remains committed to giving physicians every opportunity to deliver quality, evidence-based care and reap the rich rewards of professional job satisfaction in the challenging careers they have chosen based on their drive to help others.