Physician burnout has become an increasing concern over the past couple of decades. The Agency for Healthcare Research and Quality defines physician burnout as “a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment.” Burnout is known to contribute to medical errors, poor patient outcomes, job loss, substance abuse, and unfortunately, suicide.1,2 Unfortunately, the COVID-19 pandemic appears to have only worsened an already critical issue.
To address this issue, Pediatrics is early releasing a new Clinical Report this month on physician health and wellness (10.1542/peds.2022-059665). This report is a primer on the definition of burnout, current statistics on pediatric burnout, and suggestions to mitigate and prevent that burnout. It should be required reading for all pediatric providers and pediatric hospital leadership.
Some key takeaways about burnout from this Clinical Report include:
- Burnout is not a mental illness. Although it can be exacerbated by mental illness such as depression, it can be better defined as a work-related condition.
- Burnout is bad for patients and families. It contributes to poor patient outcomes and increases in medical errors.
- Pediatricians report less burnout than other specialties, but a burnout rate of 35-46% is still unacceptable.
Attributes that bring many of us into medicine, such as altruism, compassion, and perfectionism can also contribute to burnout. For example, the recent pandemic and the increase in vaccine refusal can cause moral distress when providers feel they have no control or that patients are being placed at risk. Self-awareness and self-care can help providers on an individual basis to manage the stress that comes from caring for patients and families.
While resilience-building is important for individual providers, it must be recognized that the actual landscape of medicine contributes to and causes burnout. Just telling physicians to meditate and exercise is not going to solve the problem. Therefore, medical institutions, practices, and academic medical centers need to respond to improve the work environment and promote wellness throughout the organization.
This Clinical Report covers pediatric provider wellness and burnout. We also must recognize that the same drivers that cause burnout in our peers also cause burnout in our partners. Nurses, ancillary staff, therapists, and other organizational employees are also at high risk for burnout. We, as pediatricians, can set the example by not only taking care of ourselves, but by continuing to advocate with organizations to change the culture and promote wellness for all employees and staff.
References:
- Tawfik DS, Scheid A, Profit J, et al. Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Ann Intern Med. Oct 15 2019;171(8):555-567. doi:10.7326/M19-1152
- West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. Jun 2018;283(6):516-529. doi:10.1111/joim.12752
