As physician burnout continues to be a severe and worsening epidemic in the United States, among anesthesiologists in particular it can pose an even bigger danger in healthcare.
Anesthesiology as a specialty suffers higher degrees of burnout, according to an American Society of Anesthesiologists (ASA) abstract from a survey of resident and attending physicians in orthopaedic surgery and anesthesiology at urban medial centers who responded anonymously in 2017 to determine signs of burnout and possible contributing factors.
More than one-half of all physicians report at least one major symptom of burnout, the rate is even higher among anesthesiologists than the mean rate for all physicians. “Anesthesiologists are primed for burnout,” states Amy E. Vinson, M.D., FAAP, of Boston Children’s Hospital and Harvard Medical School at the Annual Meeting of Anesthesiologist in San Francisco.
This is a topic that was covered by Vinson in a session during the conference, titled “Burnout in Anesthesiology Practices: Realities and Remedies”.
In an article authored by Shena J. Scott, MBA, FACMPE for ASA, burnout is defined as “a state of emotional, mental and physical exhaustion caused by excessive and prolonged stress, often from multiple sources. It is characterized by exhaustion, cynicism, depersonalization, reduced feelings of meaning or accomplishment and minimized effectiveness.”
“Burnout causes a variety of physical and psychosocial symptoms that contribute to high rates of early retirement, substance abuse and suicide. Physician burnout also affects patient safety, with physicians self-reporting compromised patient care and medical errors,” according to an ASA-published article.
Vinson said the profession is suffering from an epidemic of burnout. “It is affecting our health, our professionalism, the care of our patients and our career longevity.”
The five most common stressors of physician-anesthesiologists are listed below.
Excessive workload, time pressures, chaotic work environments, declining pay, and inefficient work processes.
Bureaucracy and paperwork and the vast quantity of time spent at work are the most common reasons for burning out physicians, according to a New York Times article.
Changes in the healthcare system
Increasing government regulation, administrative burdens, expanding coverage demands, and the transition to value based payments are sources of strain for doctors.
“Healthcare reimbursement is moving to a value-based reimbursement model and that is a move away from a traditional volume based fee-for-service model. So whether that's bundled payments or some other type of value based reimbursement methodology, it makes it incredibly important to be able to deliver care in as efficient a manner as possible.” adds Jones.
The constant threat of litigation
This is a worry that never goes away. As Harvard Medical School states, “parasitic malpractice lawyers are always circling, which causes us to waste an enormous amount of time with defensive documentation.”
The time away from family is resented when they work more and earn less. A study showed higher exhaustion levels amongst women, in whom burnout was notably linked with work–home conflicts.
Vinson said that burnout starts with a compulsion to prove oneself, “...so you work harder and you neglect yourself and your needs.” And this results to the seeming loss of control over clinical practice.
Failure is not an option to all, but it is lived by doctors in their practice with much more pressure because the cost to them is higher – the lives of the people they serve.
But Shena J. Scott, MBA, FACMPE, believes that, while there are some common traits that push physicians towards burnout, physicians also stereotypically possess other traits that equip them to overcome it once the problem is acknowledged.
“They are highly intelligent, quick learners who are trained to analyze and attack problems. They don’t give up easily. They have a deep connection to their purpose and to their profession and they also tend to have really strong family support systems,” says Scott.
Advances in technology
From mounting complexity of modern medicine to health data automation, these advances in technology are challenges and opportunities physicians need to face on top of an already burgeoning requirements of their practice.
According to the Harvard Medical School, “the transition from paper charts to electronic medical records, which seemingly were designed to maximize revenues instead of clinical care, has created a technological barrier between doctor and patient, and between doctors.”
Anesthesiologist Perrin Jones, M.D. believes that a lot of the systems that are in place right now are very cumbersome, and aren’t user-friendly either to the provider or the patient.
“There’s a lot of talk in the industry about physician burnout specifically as awaits their interaction with their EMRs (electronic medical records), that are more focused on generating data for billing purposes potentially or just collection as opposed to being able to interpret what has been collected for health and medical decision-making,” said Jones.
ASA believes that there is “need to focus more on how to change critical sources of burnout within the job context, rather than simply helping people cope with the negative effects.”
Bon Ku, M.D. (@BonKu), Jefferson University Assistant Dean for Health and Design tweeted a Health Design Lab project brief for med students with a challenge to “design products and services to reduce physician burnout.”
There are innovative health technologies that can ease the workload by automation, coordinate work processes and communication seamlessly, and analyzes patient data instead of just collecting it.
LifeWIRE, a patented interactive communication platform, has a product for anesthesiologists that will address requirements for a perioperative care.
“One of the great things about LifeWIRE, is that their software platform is like a blank canvas for you to add your clinical content very easily to that system. It really becomes a way for you to be able to use your own voice through their platform. That's something that is very rare, I think.” ~ Perrin Jones.
LifeWIRE enables maximum personalization to an individual site on its platform, unlike the one-size-fits all model of a lot of EMRs and different care trackers. “The tech should compliment the provider. The provider should not have to change their practice to support the tech,” Jones added.
In using LifeWIRE, Jones noted a dramatic decrease in day-of-surgery (DOS) cancellations and improved clinical outcomes, leading to happier doctors and patients.