Doctors are still burned out five years after COVID exposed systemic failures
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Five years after COVID shook the world, doctors and other health providers continue to suffer from burnout that the pandemic highlighted and exacerbated.
Why it matters: Provider burnout — an ongoing state of significant stress — takes a toll on patients, too.
- A pre-COVID study found burnout costs the health system about $4.6 billion a year due to physicians leaving the field or cutting back on hours. Another study linked doctor burnout with a doubled risk for patient safety issues.
The big picture: There's been significant progress to reduce the stigma around doctors seeking mental health treatment since the pandemic, but physicians say systemic change to payment and administrative workloads are needed to really improve their wellbeing.
- "We need to address the root causes of the problem, all the failures in our health care system right now that are causing challenges for physicians," American Medical Association President Bruce Scott told Axios.
Where it stands: Nearly half of physicians (48%) say they feel burned out, according to the AMA's most recent poll, published in July. Women physicians face higher levels of burnout and risk of suicide than their male counterparts.
- The overall burnout rate is down from 2021's high of 63%, when the Delta coronavirus variant raged.
- Still, "the fact that one in two physicians in America are showing signs of burnout is an unacceptable number," Scott told Axios.
- Burnout among nurses and other health providers also worsened during the pandemic.
Flashback: Providers' poor mental health and burnout has been a problem for years. The pandemic supercharged it, as doctors, nurses and other medical providers worked long hours with less equipment and often in isolation to save the first COVID-19 patients.
- Health providers were lauded as heroes at the start of the pandemic, and some even reported improved wellbeing at work, citing more time spent with patients and less spent on paperwork.
- But that didn't last. "Five minutes later, it felt like those same workers were being questioned about the science, getting spit on, threatened," said Corey Feist, CEO of the Dr. Lorna Breen Heroes' Foundation.
- Feist started the advocacy group in memory of his sister-in-law, an emergency room physician who took her own life in 2020.
State of play: There's growing awareness of the stresses on health providers.
- More than half of states and hundreds of individual hospitals have now changed their licensure requirements to remove questions that ask whether a doctor has received mental health treatment or diagnoses. Those questions have historically deterred doctors from seeking needed help.
- The Dr. Lorna Breen Heroes' Foundation coordinates learning collaboratives for hospitals and medical groups to work together on implementing operational changes that support provider wellbeing.
- Congress also passed a law in 2022 that opened federal grants for training health providers on strategies to reduce and prevent burnout and other issues. The funding authorizations expired last year, but lawmakers have introduced a bipartisan bill to extend them.
Yes, but: Real improvement requires tackling structural issues, like decreasing Medicare payment rates that make it harder to operate a practice and rising administrative burden associated with insurance claims, doctors and experts say.
Zoom in: The primary driver of health care provider burnout is too much work for too few people, said Srijan Sen, a psychiatrist who researches physician well-being at the University of Michigan.
- "Increasing the number of people working, and, even more long term, helping people stay healthier, so less people need health care — those sorts of things will be a big part of the solution," he said.
What to watch: Scores of health tech companies now advertise tools, often driven by artificial intelligence, aimed at cutting down provider workload by automating administrative tasks.
- It's not yet clear if they'll deliver, Sen said. The electronic health record once promised to make a physician's job easier, and research now shows it has directly contributed to increased burnout.
- Despite the stressors and predicted workforce shortages, health care still is projected to add the most jobs in the U.S. of any sector over the next decade, and medical schools are seeing more interest than ever.
- Today's students are more attuned to their mental health than in the past, and they're asking what can be done to make the field one they want to continue working in, said Kelly Holder, chief well-being officer at Brown University's medical school.
