While studies validate that physician burnout is real and that burnout is increasing faster among doctors than other professionals in the U.S., relatively little research has assessed interventions aimed at ameliorating the problem. With many questions remaining and more fixes needed, 32 experts gathered at the Joy in Medicine Research Summit last year to develop a national agenda for research in the field.
The summit, sponsored by the AMA, included the Association’s vice president of professional satisfaction, Christine A. Sinsky, MD. Experts at the meeting discussed suggestions for discovering and disseminating effective strategies to promote physician well-being. The group’s six recommendations to accomplish that goal were published in Annals of Internal Medicine.
Here is what the experts recommend.
Further establishing the links among physician burnout, well-being and health care outcomes. “Studies assessing the degree to which interventions to reduce physician burnout also improve patient outcomes might have a transformative effect.”
Estimating the economic cost of physician burnout. “Research is needed to explore the relationship between physician burnout and behaviors that influence health care costs, such as referral patterns, test ordering and prescribing practices. Economic models estimating the costs of burnout may lead to greater financial support for intervention research.”
Building alliances to address physician burnout. “New alliances among researcher and health care delivery systems, foundations and funding agencies are needed to develop and test interventions. … Partnering with other stakeholders may help in disseminating successful strategies.”
Using common metrics. This will help facilitate meta-analysis and allow for more cost-effective research and a deeper understanding of research findings.
Developing a comprehensive framework for intervention with individual and organizational components. “Solutions must be directed at how organizations evaluate and improve the work environment, help individuals promote their well-being and support those who experience distress.”
Sharing the best available evidence. A toolkit could be developed and disseminated that “might include a common set of metrics and several actions for organizational leaders, core unit leaders and individuals to consider adopting.” Also, if large national organizations track their best practices and the effectiveness of interventions, it could be particularly effective in helping individual disciplines improve work life and reduce burnout.
“Improving the wellness of the physician workforce and bolstering the joy of working in medicine are essential to advancing health,” Dr. Sinsky and her co-authors wrote. “Methodologically rigorous and robust research on these six dimensions will help us achieve that goal.”
These recommendations come on the heels of AMA CEO and Executive Vice President James L. Madara, MD, and CEOs from 10 prominent health care delivery organizations calling on their peers to address the root causes of burnout and make changes to restore the joy of working in medicine. Their call to action lays out 11 commitments for the health care executives to make, including raising awareness about physician well-being, tracking the impact burnout has on medicine and looking for ways to reduce burdens that drive burnout in physicians and other health care professionals.
In a related article published in NEJM Catalyst, Dr. Sinsky and colleagues from the Mayo Clinic, Stanford, Yale, Hennepin County Medical Center, and the University of Virginia wrote that three domains of physician well-being must be addressed. These are practice efficiency, a culture of wellness and personal resilience.
“Health care organizations must embrace their responsibility to build an efficient practice environment and to foster a culture of wellness while also supporting physicians’ efforts to improve their own resilience. This model in no way relieves physicians of their own professional obligation,” they wrote.
