Physician burnout is real! It is not unusual to see routine articles in the news nowadays about the dissatisfaction with the current state of practice for clinicians. Aside from the COVID-19 pandemic shutdown which affected the majority of physician practices one way or another, continuing struggles post COVID-19 re-opening have only exacerbated the issue. In an era of high inflation, Medicare reimbursement cuts aren’t making things easier. There have been several observations and reasons that have contributed to the burnout. The list is quite large, but there are a few main points to cover:

1. Physician Shortage – Several providers near retirement during the start of the COVID-19 pandemic decided to retire as there was concern about getting infected, or they were waiting for a reason to get out of medicine. When the volumes dropped several older providers quit medicine. Meanwhile, other providers decided to take on less patients or shifts to limit their risk. Now we are facing a system that is trying to take on more patients with less providers or provider availability.
2. Work/Life Balance – Providers that would previously go above and beyond a normal patient load would stress themselves seeing as many patients as possible. This wasn’t sustainable. For example, during the COVID-19 re-opening patients with common cold symptoms and mild self limiting conditions would swarm the Emergency Department and Outpatient Clinics. This would contribute to burnout overtime. Many providers then chose their work/life balance ambitions during this time instead of extra work.
3. Crowded Emergency Departments – In addition to the reasons listed above, the Emergency Room has gone from a place of treating mainly urgent cases and emergencies to serving as the “catch-all” convenience clinic. Unfortunately, the provider staffing of the Emergency Departments hasn’t caught up to patient demand as a whole. Recently, volumes have doubled in some cases with the same number of working providers. This has contributed to increases in patient wait times. For some providers, this increase in patient load contributes to unneeded stress overtime. This contributes to burnout and providers taking on less shifts. This further increases the shortages of providers which leads to ED staffing issues for hospitals and contract management groups.
4. Decreased Medicare Reimbursement and Wages – Several outpatient providers that are involved with owning/running their own practice are having trouble making decent profit or end up breaking even after all expenses. This includes but is not limited to employee payroll, equipment, etc. In addition, having to argue with insurers about reimbursement and other coverage for patient needs has lead to burnout and practice shutdowns. This has further decreased outpatient provider options for certain communities.
5. Employed Provider Salary Cuts – Many providers employed by large groups or hospitals are seeing salaries decrease over-time or are having to see more patients in order to make the same take home salary despite higher inflation. Providers find themselves working more in order to make the same “Ends Meat.”

As you can see, there are many reasons for physician burnout and the above reasons are only a few main contributors. In order for an improvement in the burnout amongst providers several things need to happen.

1. There needs to be a better physician to patient ratio across specialties (easier said than done). Outpatient providers need to be adequately staffed to better occupy non-urgent cases. This will help with Emergency Department crowding and an improvement in provider burnout rate.
2. Community education about when to seek medical attention. Many conditions people go and seek medical care for really don’t need to be evaluated by a provider as the condition is self limiting on its own. For instance, the common cold in the young adult.
3. Utilize available tools and tests before seeking care. For example, when the Fed announced free COVID-19 tests along with cheap OTC tests there was a decrease in ED and Outpatient Clinic visits for COVID-19 testing. This was short lived. Although these tests are still available and free or cheap, we are back to a high rate of visits to the Emergency Department and Outpatient Clinics for basic COVID-19 testing.
4. Increase provider compensation. Instead of reimbursement cuts and decreased pay, pay a bit more to the provider. They will be more inclined to work extra if they are adequately compensated while efforts are made to try to increase the provider workforce. Unfortunately, many places are cutting provider compensation and expecting them to work more hours and this needs to be fixed.

In Summary, an increase in the number of providers improving the provider to patient ratio or decrease in work days while maintaining competitive compensation would be a good solution to the burnout providers face.

Administrator