Addressing Physician Mental Health and Rising Burnout
While many physicians, nurses, and other health care professionals have full workloads at the best of times, the current COVID-19 pandemic has created an especially heavy burden. An American College of Cardiology survey of just over 1,200 ACC members conducted in late 2020 found burnout rates among responding cardiologists had increased markedly from what they were in 2019. US-based cardiovascular team members were particularly affected—with 55 percent saying they were experiencing at least some burnout symptoms at the pandemic’s peak. Mid-career cardiologists and women cardiologists, who are underrepresented in the field and often have added stressors contributing to burnout, were also at a higher risk. Around 20 percent of respondents said they were considering leaving their careers or retiring early. Around 30 percent said they were considering reducing their hours. Two of the biggest reasons respondents cited were the pressure to put quantity over quality in care and increased administrative burdens. COVID-19 in particular, saw higher mortality rates, rising workloads, and made it harder for health care professionals to balance their work and home lives.
The rising rate of stress and burnout among health professionals rings an alarm bell. As well as serious consequences for the individual, they will impact patient care.
The worsening situation prompted the American College of Cardiology, along with the European Society of Cardiology, American Heart Association, and World Heart Federation to issue a joint opinion paper with six specific recommendations.
“The rising rate of stress and burnout among health professionals rings an alarm bell,” said ESC President Professor Stephan Achenbach. “As well as serious consequences for the individual, they will impact patient care.”
The joint opinion’s authors stressed that the problem wasn’t new, and that COVID-19 was making an existing problem worse. Over the years, technological changes, increased administrative work, and regulatory burdens had already been compounding the stressors physicians are facing. Indeed, a 2018 US-based study of 15,000 physicians across 29 specialties found around 42 percent experiencing burnout symptoms, from depression to lower patient engagement. Researchers further reported that cardiologists tended to suffer from the highest rates of burnout, but were also the least likely to seek professional help—with only 17 percent saying they were likely to do so.
Among the joint opinion recommendations were for health care organizations to do what they could to end the stigma of physicians asking for mental health resources, to expand diversity and inclusion initiatives that promote a sense of belonging, and to develop tools that could improve clinical efficiency.
There is also another side to digital health evolution. There’s a lot of information and data that comes through remote monitoring that physicians need to review. How to optimize that process to make the review as easy as possible is one of the most pressing questions in digital health.
Improving Clinician Well-being
Addressing physician burnout is a multifaceted undertaking, requiring solutions from individual clinics and medical societies. Digital health offers promising possibilities as technology advances, there are more and more ways in which industry can help physicians and clinics manage their high workloads.
“There is also another side to digital health evolution. There’s a lot of information and data that comes through remote monitoring that physicians need to review. How to optimize that process to make the review as easy as possible is one of the most pressing questions in digital health,” said Dr. Naveed Khan, BIOTRONIK’s Director for Business and Commercial Development in Digital Health in a previous interview. “The next frontier in digital health is pioneering services, fully or partially automated by Artificial Intelligence, that can help physicians manage workflows.”
Overall though, joint opinion authors highlight how many of the fixes required go far beyond what any individual physician can do by themselves. “Health care organizations have predominately focused on the concept of ‘fixing the employee’ with individual-focused programs (self-resiliency and stress management training) as the solution to improving well-being,” they write. “However, much more effort needs to be tailored to systemic issues that affect the work environment.”
Specifically, the societies recommend that health organizations invest more in psychosocial support and models for employees—using the Stanford WellMD Professional Fulfillment Model as a best practice example. In particular, they urge health care organizations to have—or put in place—means for physicians and health care professionals to confidentially report any mistreatment, and to take away the stigma of asking for psychosocial help. This may mean hospital credential systems have to adapt certain mental health inquiries to ensure that employees can report issues without fear of losing hospital privileges.