PHYSICIAN BURNOUT: Causes and Conclusions

By Dr. David Edward Marcinko; MBA MEd

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Healthcare comes with its share of mental challenges, especially considering that clinicians often care for patients when they’re in difficult and sometimes tragic situations. New research shows that even the path to getting into the workforce can be a challenge, with some physicians burning out before they make it to graduation.

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American medicine is undergoing vast changes, placing the status of physicians in the medical industrial complex at great risk. Most physicians feel overwhelmed by increasing bureaucratic mandates from insurers, hospitals, and government. At the same time, physicians are the front line employees of healthcare and assume the majority of the risk for patient care. This has left many in the profession with increasing disillusionment. 

Samantha Meltzer-Brody a psychiatrist and director of, Taking Care of Our Own, University of North Carolina, Chapel Hill, NC states it best:

“Daily, I am contacted by good doctors who are struggling with symptoms of burnout syndrome and who have become overwhelmed by the challenges of attempting to practice medicine in today’s health care environment. As a psychiatrist who runs a program to address and treat these distressed doctors, I am troubled by the ever-growing number of calls I receive.”

What causes physician burnout?

The “Big 4” factors known to contribute to stress and burnout include:

  1. Time pressure, especially in patient visits or documentation
  2. Lack of control over work environment
  3. Chaotic, fast-paced workplaces
  4. Culture of the organization, specifically a culture that does not emphasize communication, cohesion, trust, and alignment of values between clinicians and their leaders

In addition to burnout rates, these factors can be assessed to help direct interventions toward those drivers that are most likely to be contributing to burnout at your organization.

OK BURNOUT: https://medicalexecutivepost.com/2022/08/30/u-s-hospitals-feeling-the-pain-of-physician-burnout/

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The burned-out physician is exhausted — mentally and physically — and often no longer able to find empathy or connection with patients. The question of how to escape from what has become a highly unpleasant situation becomes a frequent one. Given the high demands of the profession and serious consequences of mistakes, the burned-out doctor is a potentially impaired one. And the impaired physician is not able to maintain the unflappable, perpetually cool under fire, always objective, professional and yet compassionate demeanor that is expected by society. Worst of all, the impaired physician is at great risk for developing depression, suicidal ideation, or a serious addiction.

The doctors who contact me report feeling beaten down by an increasingly hostile work environment. They say that they don’t have time to take care of patients the way they envisioned when they decided to apply to medical school. Many describe feeling betrayed by a system that they say seems focused on achieving the bottom line with little regard for the impact on both doctors and patients.

Most of these doctors report spending a significant amount of their time dealing with the electronic medical record and documentation. The ratio of time spent on doctor-patient

interactions compared to physician-computer ones appears so horribly skewed that it has reached the point of complete dysmorphia. These good physicians call me when they feel like they can’t continue any longer in the profession. They want to quit medicine. They report a loss of joy and meaning in their work. They describe the toll that the profession has had on their mental health, physical health, and personal lives. And most wrenchingly, they don’t see an end.

What can we do? There are no easy answers to the complex issues that threaten our profession.  “The Taking Care of Our Own Program…has had an over 200% rate of growth in the first year, reflecting the enormous need…”  

PHYSICIAN COACHING: https://medicalexecutivepost.com/coach/

Assessment

Burned out physicians will eventually be labeled as disruptive, impaired, an outlier or arrogant.  There’s a reason it’s difficult and extremely expensive for physicians to find disability insurance; psychiatric claims.  Burnout leads to depression, anxiety, PTSD, suicide, divorce, drug abuse, surly behaviors and interactions, etc.  It’s nothing new; it’s been occurring for a long time.  Go without routine sleep, eat erratically, work long hours, operate under constantly stressful situations and have no time for your family or self and most individuals will de-compensate physically and psychologically within weeks. 

Conclusion

Physicians operate within these parameters year after year. 

How are they to remain healthy, functional humans? They can’t.  Even a superhero couldn’t, yet physicians are expected to endure and thrive under such conditions. 

If a physician makes a single mistake, or snaps just one day, their entire career is on the line.

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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PHYSICIAN PERSONAL COACHING: Financial Planning and Retirement Consulting

SPONSORED BY: http://www.MarcinkoAssociates.com

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Most doctors report feeling overworked and are considering a change in career, according to a new poll.

Doximity, a virtual network for physicians, found that 81% doctors surveyed last fall said they felt overworked—a slight decline from 86% who reported burnout in 2022 but still up from 73% in 2021. Meanwhile, about three in five doctors said they were considering early retirement (30%), looking for another employer (15%), or leaving the profession altogether (14%), the poll found.

The findings, released last year, come amid reports of rising rates of physician burnout and dissatisfaction since after the Covid-19 pandemic.

LEARN MORE: https://tinyurl.com/y3j2t3ab

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FINANCIAL PLANNING: Physician and Fiduciary Focused

(“Informed Voice of a New Generation of Fiduciary Advisors for Healthcare”)

By Dr. David Edward Marcinko MBA CMP

http://www.MarcinkoAssociates.com

As fellow doctors, we understand better than most the more complex financial challenges physicians can face when it comes to their financial planning. Of course, most physicians ultimately make a good income, but it is the saving, asset and risk management tolerance and investing part that many of our colleagues’ struggle with. Far too often physicians receive terrible guidance, have no time to properly manage their own investments and set goals for that day when they no longer wish to practice medicine.

For the average doctor or healthcare professional, the feelings of pride and achievement at finally graduating are typically paired with the heavy burden of hundreds of thousands of dollars in student loan debt.

You dedicated countless hours to learning, studying, and training in your field. You missed birthdays and holidays, time with your families, and sacrificed vacations to provide compassionate and excellent care for your patients. Amidst all of that, there was no time to give your finances even a second thought.

Between undergraduate, medical school, and then internship and residency, most young physicians do not begin saving for retirement until late into their 20s, if not their 30s. You’ve missed an entire decade or more of allowing your money and investments to compound and work for you. When it comes to addressing your financial health and security, there’s no time to waste.

And you may be misled by unscrupulous “advisors”.

For example:

Question: Do you know the difference between a “Fee-Only” and a “Fee-Based financial advisor? Not knowing may cost you tens of thousands of dollars, or more, in excessive advisory fees.

MORE: https://marcinkoassociates.com/financial-planning/

Of course, all of this compound’s physician stress and burnout related issues, as well.

MORE: https://marcinkoassociates.com/process-what-we-do/

COMMENTS APPRECIATED

Thank You

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FINANCIAL PLANNING: Physician Niche Focused Fiduciaries

(“Informed Voice of a New Generation of Fiduciary Advisors for Healthcare”)

By Dr. David Edward Marcinko MBA CMP

http://www.MarcinkoAssociates.com

As fellow doctors, we understand better than most the more complex financial challenges physicians can face when it comes to their financial planning. Of course, most physicians ultimately make a good income, but it is the saving, asset and risk management tolerance and investing part that many of our colleagues’ struggle with. Far too often physicians receive terrible guidance, have no time to properly manage their own investments and set goals for that day when they no longer wish to practice medicine.

For the average doctor or healthcare professional, the feelings of pride and achievement at finally graduating are typically paired with the heavy burden of hundreds of thousands of dollars in student loan debt.

You dedicated countless hours to learning, studying, and training in your field. You missed birthdays and holidays, time with your families, and sacrificed vacations to provide compassionate and excellent care for your patients. Amidst all of that, there was no time to give your finances even a second thought.

Between undergraduate, medical school, and then internship and residency, most young physicians do not begin saving for retirement until late into their 20s, if not their 30s. You’ve missed an entire decade or more of allowing your money and investments to compound and work for you. When it comes to addressing your financial health and security, there’s no time to waste.

And you may be misled by unscrupulous “advisors”.

For example:

Question: Do you know the difference between a “Fee-Only” and a “Fee-Based financial advisor? Not knowing may cost you tens of thousands of dollars, or more, in excessive advisory fees.

MORE: https://marcinkoassociates.com/financial-planning/

Of course, all of this compound’s physician stress and burnout related issues, as well.

MORE: https://marcinkoassociates.com/process-what-we-do/

COMMENTS APPRECIATED

Thank You

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PODCAST: Physician’s Mental Health

Doctor Burnout According to Specialty

By Eric Bricker MD

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SDOH Challenges = Physician Stress?

SOCIAL DETERMINANTS OF HEALTH

By Staff Reporters

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SDOH Challenges Cause Physicians Stress

A recent Physicians Foundation survey that asked questions relating to whether Social Determinants of Health [SDOH] challenges cause them to experience stress or frustration.

CITE: https://www.r2library.com/Resource/Title/082610254

The survey found:

 •  71% Identified limited time during patient visit to discuss SDOH
 •  64% Identified insufficient workforce to navigate patients to community resources to address SDOH
 •  63% Identified existing payer reporting requirements taking time away from being able to address patients’ SDOH
 •  57% Identified lack of reimbursement for screening for or addressing SDOH
 •  57% Identified community resources unavailable, inadequate or difficult to access.

Source: The Physicians Foundation 2022 Physician Survey: Part 1, March 22, 2022

Physician Suicide: https://medicalexecutivepost.com/2016/04/23/more-on-physician-suicide-video/

COACHING: https://medicalexecutivepost.com/coach/

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ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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