Lauren Vogel | CMAJ | June 14, 2018
Dissatisfaction, burnout, depression and suicide in medicine are everyone’s problem, say physician health experts.
Reducing high rates of burnout in medicine is the shared responsibility of health systems, medical organizations and individual physicians, according to the Charter on Physician Well-Being, which was recently endorsed by the American Medical Association (AMA) and the Association of American Medical Colleges.
Created by a group of medical educators, academic leaders and wellness research experts, the charter outlines principles and best practices to improve physician health. These include societal, organizational and individual commitments to support “meaningful work, strong relationships with patients, positive team structures, and social connection at work.”
Medicine is facing an “epidemic of burnout,” said Dr. Jonathan Ripp, coauthor of the charter. Nearly two-thirds of American physicians report feeling burned out, depressed, or both. One in three say those feelings negatively impact their work. At the end of the line, suicide is the most tragic outcome. It’s estimated that one doctor dies by suicide every day in the United States, the highest rate of any profession and double that of the general population.
Ripp attributes these problems to the “overwhelming demands” of caring for patients in constantly changing and often inefficient health systems. “The providers themselves also need to be supported in their mission with adequate resources and effective tools to promote wellbeing,” he said. “Ultimately, they and the patient will benefit.”
The charter cites evidence that physicians who spend even one day per week on the aspect of their work they find most meaningful have lower rates of burnout. According to the charter, “authentic, humanistic interactions with patients and colleagues enhance physician well-being, and physicians who are well may, in turn, provide better patient care.”
It calls on health systems and organizations to foster a supportive culture in medicine and advocate for policies that reduce physician workload and administrative burden. For example, automated prescription lines, having medical assistants enter patient data into electronic health records, and more efficient patient flow through clinics have been linked to reduced physician burnout and increased satisfaction.
Organizations also have a responsibility to develop physician health leaders and ensure all members of health care teams are doing the work for which they are uniquely trained.
The charter calls on individual physicians to practise and promote mental health and self-care, and to anticipate the emotional challenges of their work. This includes a collective responsibility to provide training, resources and protected time for debriefing and other coping strategies. Organizations should also support adequate rest, sick leave and vacation.
More than a dozen organizations have endorsed the charter. “Achieving national health goals depends on an energized, engaged and resilient physician workforce,” said AMA President Dr. David Barbe. “The AMA strongly supports the charter and its declaration that the nation is best served by a healthy system that promotes professional fulfillment by allowing physicians to meet their patients’ needs for high-quality care.”
Photo credit: Dean Mitchell/iStock
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