Some call it a national crisis; others say it’s the elephant in the room no one wants to talk about.
Clinician burnout is a very real phenomenon, and not a day seems to go by without something being published alluding to the rising rates.
What is Clinician Burnout?
The term burnout originated in 1974 and most descriptions relating to healthcare workers include emotional exhaustion, depersonalization (i.e., cynicism, or seeing patients as a diagnosis and not as individuals), and feelings of low personal accomplishment.
These descriptions may be accurate, however they are only what we see at the surface level. If you dig down to find the root cause, you’ll discover the real culprit is a disconnection from a sense of purpose. Burnout occurs in clinicians who have become estranged from their original sense of purpose – which, in most cases, was to make a difference in the lives of others, and to be a part of a community of great healers.
The extent of burnout among healthcare professionals today is alarming, with the numbers being nearly twice as much among clinicians as US workers in other industries. The recent report Burnout Among Health Care Professionals states that more than half
of US physicians experience substantial symptoms of burnout. Meanwhile, the figures for nurses, are between 35-45% (1).
Why is this Happening?
Healthcare was once filled with passionate clinicians. However, this changed when the relational practice of healing became an industrialized business – disease a commodity and patients a revenue stream.
This industrialization gave rise to processes such as efficiency management that eliminated time for relationship and trust building, as well as a bureaucracy that created endless hoops to jump through. Moreover, technology has been installed without careful consideration to the unintended consequences, one of which is more face time with computers than with patients.
How do we Address the Root Cause?
Many healthcare organizations are responding with programs that help clinicians cope with stress and become more resilient. While there is a place for these types of interventions, the problem with this as a primary strategy is it only addresses the symptoms of burnout, and not the root cause which is a production-oriented healthcare delivery system that is toxic for workers.
What needs to be done instead is to create conditions for clinicians to reconnect with the passion and sense of purpose that brought them to their professions in the first place.
As Viktor E. Frankl famously said,
Life is never made unbearable by circumstances, but only by lack of meaning and purpose.
Workplace environments that foster individual and collective states of thriving at work do just that. These environments provide clinicians with:
- decision-making discretion over critical aspects of their work
- collegial relationships characterized by trust and respect
- transparent information sharing, and
- support for continual learning
This type of environment works because it aligns with 6 basic human needs:
- learning and development
- support and respect from and to others
- meaning beyond the self
- and the ability to shape one’s own destiny
Clinician Burnout: Moving Forward…
The last wave of changes in the US healthcare system have been employed with the intent to deliver better care, improve health, and lower costs (1). An unintended consequence has been a high prevalence of burnout among healthcare providers, which ironically diminishes both patient safety and clinician well-being (2).
This growing problem is no doubt a cause of concern, yet it also provides an opportunity to create the next wave of changes that will address the dysfunctions and spur the development of new strategies to create work environments that enable clinicians to thrive.
1. Dyrbye, L.N., T.D. Shanafelt, C.A. Sinsky, P.F. Cipriano, J. Bhatt, A. Ommaya, C.P. West, and D. Meyers. 2017. Burnout among health care professionals: A call to explore and address this underrecognized threat to safe, high-quality care. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC.
2. Shanafelt TD ; Dyrbye LN ; West CP.Addressing physician burnout: the way forward. JAMA. 2017; 317: 901-902