A recent study by the University of Texas Medical Branch (UTMB) revealed that physician burnout on a national scale is increasing the frequency of premature retirement and attrition rates.
“Data from the Well-Being Index in 2021 demonstrates the incidence of physician burnout to be ~55%, with 52% of respondents narrating emotional lability, and one-third of physicians reporting not having adequate time for personal or family life, thereby exacerbating the anticipated shortfall in the physician workforce,” read the report.
Identified in 1974 by psychologist Herbert Freudenberger, “burnout” in the health care context refers to the stress and pressure state health care professionals experience as a result of employment-associated emotional and physical debilitation.
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The study said the trend has adverse effects downstream on patients, physicians, trainees, and health care organizations.
Burnout has negative impacts on patient satisfaction, medical oversight and errors, physician productivity, access to patient care, and administrative costs. The total annual cost from burnout among health care managers— professionals who oversee the health services provided by a particular department or medical facility— alone is estimated to be $300 billion, according to the report.
Nowhere has this impact been felt more deeply in Texas than in rural communities. Currently, 40% of rural hospitals in Texas are vulnerable to closure, according to the National Rural Health Association (NRHA), a rate that is among the highest in the nation.
Kelly Cheek, Head of the West Texas Division of the Texas Rural Health Association (THRA) said the medical staffing shortage continues to be the top priority for rural community health.
“What we’re seeing is just a lack of workforce. We’re losing individuals. They’re coming, they’re leaving the workforce, in health care and going into other fields, either through burnout or just different factors,” Cheek said.
“The pandemic strain on people leaving their professions altogether, that’s one of the biggest challenges right now that rural hospitals face. … [Pandemic burnout] is a real struggle for these hospitals and clinics.”
Hospital administrators across the state have been looking into a wide range of programs and workforce solutions to address burnout by examining the complex range of factors causing burnout on an individual, case-by-case level.
In North Texas, hospitals have been working with staff to give them the support they need to continue to be productive, like time off, schedule rotations, financial support, and more.
The Dallas-Fort Worth Hospital Council (DFWHC) partners with more than 90 hospitals across North Texas and has been engaged in creating programs to support physician and staffing burnout. It recently endorsed a bi-partisan bill in the US Congress seeking protections against workplace violence for health care professionals. The bill was introduced earlier this month and remains under review in the House committee.
DFWHC was also focused on finding creative ways to attract younger people to fill the void of older workers who left the profession because of the pandemic, including easing visa restrictions on foreign workers, incorporating more technology such as artificial intelligence into the delivery system, and improving overall efficiencies at the administrative levels.
Stephen Love, CEO of DFWHC, said without mitigation, the workforce shortage is estimated to reach 3.2 million health care professionals by 2026.
“There is a [federal] bipartisan Healthcare Workforce Resilience Act that deals with expediting [prior] authorizations,” Love said. “We need to support that. It’s not an easy fix. It just isn’t. But I think when you look at workforce, you have to look at, ‘What are we dealing with now?’ We’re trying to [create] a culture of healing. We’re trying to make people feel a sense of well-being. We’re trying to deal with the burnout. And then we’re trying to learn creative ways to staff and also to listen to the voice of the workforce.”
According to a survey of physicians conducted by the American Medical Association, one-third of respondents reported prior authorizations led to delays that caused patients to experience serious health problems.
Prior authorizations exact a toll on doctors, who say the paperwork has gotten out of hand. The average physician must now seek approval for dozens of prescriptions and medical services from insurers to treat their patients, an administrative burden that contributes to burnout and costs physician practices an estimated $26.7 billion in time each year.
The US Surgeon General laid out proposals to aid the 35% to 54% of physicians and nurses, and 45% to 60% of medical students and residents, reporting symptoms of burnout. He called for individuals, health care organizations, academic institutions, government, and more to help address the problem.
The Texas Medical Association introduced Physician Benevolent (PBF) and PBF Wellness Funds, support programs for doctors needing financial and mental health care assistance. Through these, doctors practicing in Texas can receive financial support for treating conditions that impair their ability to practice medicine safely. Qualifying physicians can also receive financial support to cover their family’s living expenses while undergoing treatment.
Area Health Education Centers (AHEC), a national organization of learning centers focused on improving the supply and distribution of health care professionals via strategic partnerships, places local trainees and graduates in rural health care settings.
One of its workplace development programs encourages young people interested in health care to remain in and serve their communities. West Texas area education centers have placed hundreds of trainees and graduates in rural health care settings across the region and have seen positive workforce retention rates.
“The West Texas area Education Center serves 105 counties in the state of Texas. The federal funding is matched by state dollars through the university’s appropriations,” said Cheek, who also heads the West Texas AHECs. “AHECs are a really good resource and serve a really good purpose in terms of workforce development through certification programs. One of the things we’re really working on is trying to get students familiar with telemedicine and learning equipment.
Telemedicine is something people are going to start utilizing more and more. It’s important [that] those kids can get experience using [telemedicine] equipment and they can take that with them when they leave high school and pursue a career in health care.”