By David Geier, MD
While “the flame burns brightest just before it goes out,” may be a cliché, there is truth in the saying—especially when referring to the healthcare profession.
Orthopedic surgeon, sports medicine specialist, media medical expert, and Symposia Medicus speaker Dr. David Geier addresses facts and symptoms of burnout that healthcare leaders need to be aware of in order to prevent damaging healthcare teams, practices, and providers’ lives.
It’s easy to hear all the talk about burnout today and blow it off as something that doesn’t apply to you or to your team. If you are going to lead a team, whether it’s in your practice or at your hospital, you must recognize just how pervasive of a problem burnout is and take steps to overcome and prevent it.
In the months before the COVID-19 pandemic set in, I was hired by three medical organizations to speak to their members about burnout. When I contacted the leader of each group to discuss the talk, all three of them told me that they didn’t have an issue with burnout in their groups, but they just wanted to know about it in case it became a problem in the future.
As we will see with some of the data below, the rates of burnout symptoms are at higher-than-ever levels. It’s almost impossible for these organizations, with memberships of 30, 150 and 400, to not have a single provider experiencing burnout symptoms.
I’m not suggesting that these leaders are ignoring the problem. Often, we just don’t know what to look for. Burnout often creeps up on you slowly, over a long period of time. You don’t often recognize it or see it coming.
As healthcare professionals, we need to be able to not only recognize burnout in our patients, but also recognize burnout in ourselves so we can be at our best for our teams and those we care for. We also need to take steps to help all the people who work with us overcome and prevent burnout in their work and lives.
Here are some facts about burnout and its symptoms that we need to recognize if we want to come to grips with this problem and prevent it from damaging our teams, our practices, and our lives.
The Definition & Three Components of Burnout
The World Health Organization recently added burnout to its International Classification of Diseases, recognizing it as a legitimate medical syndrome. The IDC-11 refers to burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed. It has three elements: feelings of exhaustion or energy depletion; increased mental distance from one’s job, or feelings of negativity or cynicism related to the job; and reduced professional efficacy.
Rates of Burnout in the Workplace Are Increasing
A survey done by Gallup found that among 7,500 full-time employees, 23% claimed to feel burned out at work always or very often. A staggering 67% said they experience burnout sometimes. Essentially, two-thirds of all full-time workers experience burnout on the job.
Similarly, a Deloitte survey of 1,000 full-time professionals found that 77% claimed to have experienced burnout at their current job. More than half of the professionals stated that they had experienced more than one occurrence of burnout.
Americans Are At a Higher Risk for Workplace Burnout
In healthcare, over half of physicians in the U.S. experience symptoms of burnout. Harvard’s School of Public Health calls burnout a public health crisis among our nation’s physicians.
Burnout Isn’t Just Bad for the Healthcare Providers—It’s Bad for Everyone.
Burnout erodes the patient-provider relationship and leads to lower quality patient care. Burnout increases the risk of medical errors and malpractice. Burned out physicians make more mistakes.
Burnout is causing physicians to leave medicine. By 2025, we’re going to have a huge shortage—nearly 90,000 physicians—driven away from medicine because of burnout.
It’s costing the healthcare system in this country an enormous amount—$4.6 billion a year. And that only takes into account lost work hours and physician turnover. It doesn’t factor in less satisfied patients, medical errors, and malpractice.
Workplace Stress & Burnout Have Enormous Health Costs
In a 2016 study, researchers at Harvard Business School and Stanford University’s Graduate School of Business estimated that workplace stress contributes to 120,000 deaths each year. This stress costs American businesses up to $190 billion in healthcare costs alone.
Authors of a 2017 study published in the journal PLoS One found that burnout is associated with a number of health risks, including cardiovascular disease, type 2 diabetes, high cholesterol, bone and joint pain, fatigue, headaches, gastrointestinal and respiratory issues, and death before age 45.
Shockingly, 400 physicians in the United States take their own lives each year. That’s more than one physician a day. That’s the highest suicide rate of any profession.
Recognize the Numerous Signs & Symptoms of Burnout
- Chronic fatigue
- Frequent irritability
- Difficulty sleeping
- Brain fog and forgetfulness
- Poor immune system
- Loss of appetite
- Frustration in your job
- Anxiety or depression
- Decreased motivation
- Reduced efficiency in your work
- More mistakes in your work
- Dreading going to work most days
- Rolling your eyes internally (or externally) when patients or co-workers complain
- Mentally checking out during meetings
- Sarcasm or spreading negativity in the workplace
- Dreaming of retirement because you don’t want to work
The Lack of Work-Life Balance Contributes To Burnout
If work takes up so much time and effort that physicians can’t spend time with their families or friends, or don’t have the energy to do it, they might burn out quickly. A Deloitte survey of working professionals observed that 91% of respondents noted an unmanageable amount of stress or frustration that negatively impacts the quality of their work. Worse, 83 percent felt that this stress, frustration, and burnout negatively impacted their personal relationships.
The Job & Workplace Environment Plays a Large Role in Employee Burnout
Employees who feel that they have no control over their work, such as a lack of input on the workload or their schedule, are more likely to suffer burnout. Leaders who offer too little feedback or encouragement or who overly micromanage can also play a role.
Purpose-Driven Work Might Not Be the Answer
While it is conventional wisdom that finding work you find personally meaningful can increase job satisfaction, it might not prevent burnout.
A study of over 3,700 professionals performed by Plasticity Labs found that employees driven by purpose are significantly more stressed. Compared to employees not driven by purpose, these workers score lower for well-being, resilience, and self-efficacy. While there are benefits to being connected to your work, there are challenges that can impact your risk of burnout.
People who work in helping professions, such as physicians, mid-level providers, and nurses are at the highest risk of burnout among professionals in the U.S. In fact, working in a “helping” profession is one of six risks for burnout, according to the Mayo Clinic.
Because these workers feel so strongly about their work, they often devote much larger amounts of their time and lives to their work at the expense of their personal lives.
Technology Might Worsen the Burnout Problem
Technology keeps us constantly connected to work. The lack of boundaries perpetuates an “always on” mindset. Each night, thousands of physicians log on to complete their medical records for the patients they saw that day. Over half of U.S. employees feel like they have to check their email at night just to keep up at work. As a result, burnout is on the rise and engagement is decreasing, according to Amy Blankson, founder and CEO of Positive Digital Culture.
A Lack of Social Support, Isolation, and Loneliness Impact Our Work & Health
If physicians feel isolated at work and in their personal lives, they might feel more stressed and burned out.
Over 40% of adults in this country claim to feel lonely. The percentage of people who have a close confidant in their lives has been dropping in recent decades. Many employees—and half of CEOs—claim to feel lonely in their professional lives.
Loneliness and weak social connections have a huge impact on our work and our health. They are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day, and an even greater reduction in lifespan than that associated with obesity. Loneliness is also associated with the risk of cardiovascular disease, dementia, depression, and anxiety.
Loneliness can lead to stress. Chronic stress leads to elevations of cortisol and increased inflammation in the body. These changes over time can increase the risk of heart disease, diabetes, obesity, joint disease, depression, and premature death.
At work, loneliness reduces task performance and impairs reasoning and decision making. The resulting chronic stress can depress the brain’s prefrontal cortex, impacting the ability to regulate emotions, decision making, planning, and abstract thinking.
Healthcare Leaders Need To Do More
Nearly 70% of professionals believe their employers are not doing enough to prevent or overcome burnout within the organization. And many–21%–claim their organization does not offer programs to address the problem.
Dr. Geier is an orthopedic surgeon, sports medicine specialist, keynote speaker, and media medical expert. He lives in Mount Pleasant, South Carolina.