Physician Well-being and Mental Health: What Health Systems Must Do to Heal the Healers

Doctor teamwork and wellness

The good news: Physician burnout rate has dropped from a COVID-era high of 62.8% in 2020 to 45% in the first 2 quarters of 2024, according to exclusive survey data from the American Medical Association (AMA).

The bad news: 45% of physicians surveyed – close to half – remain burned out. While individual resilience strategies have their place, the reality is that physician burnout and related mental health issues are primarily a systems-level problem that demands systems-level solutions. Here’s what health system leadership can – and must – do to address the physician burnout crisis.

1. Make Well-being Structural, Not Just Programmatic

A 2024 American Hospital Association report Building a Systemic Well-Being Program: A 5 Step Blueprint stresses the importance of executive leadership support and a dedicated team as crucial to making the necessary structural changes to address physician well-being. Some key changes include:
Incorporate physician wellness into overall strategic planning

  • Establish chief wellness officer positions
  • Ensure appropriate staffing levels
  • Create schedules that allow for true work-life integration

2. Measure What Matters

According to the National Association of Medicine, measuring physician well-being, addressing key issues, and re-measuring is crucial to improvement. Currently, most metrics focus solely on productivity and patient satisfaction. These must be expanded to include:

  • Physician well-being scores
  • Team satisfaction and turnover rates
  • Time spent on EHR after hours
  • Quality of care metrics that physicians help define

3. Prioritize Team-Based Care

Physicians shouldn’t have to do it all. And when they are forced to, burnout becomes worse, physician attrition increases, and remaining clinicians bear more and more administrative, clinical, and call responsibilities. Team-based care can reduce and even prevent physician burnout, as shown by efforts like Stanford Health Care’s Primary Care 2.0 team-based model. Here are some effective strategies for developing team-based care:

  • Ensuring adequate support and clinician staff levels
  • Creating care teams that remain consistent over time to build trust and efficiency
  • Implementing regular team huddles to improve communication and workflows
  • Create coverage systems that don’t burden colleagues when someone takes time off
  • Monitoring physician workloads including daily appointment volumes, post-work EHR times, and call schedules

4. Restore Autonomy, Control, and Competence

The New England Journal of Medicine cites the loss of autonomy and control in medical decision-making as a major factor driving physician burnout and mental health issues. An equally important and related area is the diminished value of physician competence in patient care, where insurance and production requirements regulate even the amount of time allowed per patient visit. To address this, health systems should:

  • Allow for flexible patient scheduling, recognizing that some health issues require more time and attention
  • Review and streamline protocols to eliminate unnecessary bureaucratic tasks, minimizing non-clinical responsibilities
  • Create physician advisory boards with real decision-making power
  • Give physicians ample time to complete notes and minimize financial penalties when notes are not completed within required timelines

5. Optimize the EHR Experience

Electronic Health Records (EHRs) consistently rank among the top contributors to physician burnout. To reduce the significant time physicians spend outside of work hours on updating records, health systems must reconfigure EHR systems to accommodate physician needs vs. those of “The Business.” The National Academy of Medicine highlights a number of priorities for healthcare systems and hospitals:

  • Invest in EHR optimization teams that regularly gather physician feedback and streamline workflows to address pain points
  • Change inbox workflow to engage physicians when it truly makes sense
  • Deploy additional physicians, trainees, nurses, medical assistants and medical scribes to assist with documentation
  • Provide adequate training at all levels to ensure optimal EHR system usage

6. Invest in Leadership Development

In her article Leadership development may be linked to reduced burnout rates, AMA News Editor Sara Berg explores how leadership development programs in the general medicine program at the University of Alabama has led to an astonishingly low 13% burnout rate. To reduce burnout, hospitals and departments can:

  • Provide formal leadership training for physician leaders
  • Involving physicians in setting their own professional goals
  • Allow physicians to align their roles with their personal passions and interests
  • Create mentorship programs

The Bottom Line

Effectively addressing physician burnout requires changes to the culture of medicine. Creating an environment where physicians can thrive and practice medicine in the way they envision is fundamental. Improving physician well-being requires a genuine commitment from leadership, significant resource allocation, and a willingness to reimagine how healthcare is delivered. The cost of inaction is far greater than the investment required to create meaningful change. When physicians are supported by systems designed to help them succeed, everyone benefits – most importantly, our patients.

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