Physician burnout may affect patient care
Tuesday, October 16, 2018
Physicians are at high risk for burnout, which is marked by emotional exhaustion, depersonalization and a lack of sense of personal accomplishment. The Minimizing Error, Maximizing Outcome (MEMO) study found that more than half of primary care physicians felt stressed because of time pressures and other work conditions.
Researchers surveyed 422 family physicians and general internists who worked in 119 ambulatory care clinics and surveyed 1,795 patients from these clinics, reviewing their medical records for information on care quality and medical errors.
More than half of the physicians reported experiencing time pressures when conducting physical examinations. Importantly, about a third felt they needed at least 50 percent more time for this patient care function. Nearly a quarter said they also needed at least 50 percent more time for follow-up appointments.
For physicians, the emotional exhaustion of burnout can have professional and personal consequences — depression, alcohol abuse, thoughts of suicide or even quitting medicine completely.
For patients, being examined and treated by a physician dealing with burnout, manifesting in lack empathy or agitation, may result in dissatisfaction or unwillingness to comply with treatment recommendations.
A recent meta-analysis was conducted to determine whether physician burnout is related to an increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism and poor patient satisfaction.
The core outcomes were the quantitative associations between burnout and patient safety, professionalism and patient satisfaction reported as odds ratios (ORs) with their 95 percent confidence intervals (CIs).
The researchers used combinations of key terms, such as physicians, burnout and patient care. They performed detailed standardized searches through MEDLINE, EMBASE, PsycInfo, and CINAHL databases until Oct. 22, 2017, and reference lists of eligible studies and other relevant systematic reviews were included.
Quantitative observational studies were selected, and two independent reviewers were involved. Of the 5,234 records identified, 47 studies on 42,473 physicians (59 percent men; median age, 38 years) were included in the meta-analysis.
Physician burnout was associated with an increased risk of patient safety incidents (OR, 1.96; 95 percent CI, 1.59-2.40), poorer quality of care due to low professionalism (OR, 2.31; 95 percent CI, 1.87-2.85) and reduced patient satisfaction (OR, 2.28; 95 percent CI, 1.42-3.68).
The links between burnout and low professionalism were larger in residents and early-career (≤5 years post residency) physicians compared with middle- and late-career physicians (Cohen Q = 7.27; P = .003).
This meta-analysis shows that physician burnout may adversely affect patient care. The findings indicate that physician burnout may result in jeopardized patient care. Healthcare organizations need to improve physician wellness, particularly for physicians who are just starting their careers as well as record patient care quality and safety outcomes in a way that reflects physician burnout on performance.
Preventative measures for physician burnout might include engaging in self-awareness and mindfulness training, establishing work/life balance and healthy boundaries between work and non-work life areas, lowering stress by learning effective leadership skills, exerting control where possible over work hours and creating focus where possible on work activities that provide the most meaning.
Improving mental health by eliminating burnout not only benefits physicians, but less stress also benefits physicians’ families, patients, staff and even payors.
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