Viewpoint: Medical schools need to care about physician burnout — should patients?

Although the medical profession is speaking out about physicians feeling overworked, it is difficult to determine how patients should feel about physician burnout, a health policy professor argues in a STAT op-ed.

Here are six insights from the op-ed, written by Timothy Hoff, PhD, professor of management, healthcare systems and health policy at Boston-based Northeastern University:

1. There is currently a lack of systematic research linking physician burnout to patient health, Dr. Hoff writes. "I'm not saying that physician burnout doesn't matter for patients. It likely does. If my auto mechanic is burned out, it probably affects the quality of repairs I get, just as an emotionally exhausted clinician may not be at the top of his or her game."

If this is true for physicians, Dr. Hoff wonders, why isn't the healthcare industry talking more about what physician burnout means for patients?

"Plenty of workers, from fast-food cooks to bus drivers and accountants go to work feeling burned out every day, yet we aren't devoting pages of analysis to them, even though they, too, deserve to have work that is joyful and rewarding," Dr. Hoff writes. "Nurses have experienced burnout for decades, yet there hasn't been the same intense hue and cry for them as there is for physicians."

2. Dr. Hoff, who researches and works with physicians and writes books about them, says he is bothered by the lack of blame given to medical training institutions when discussing burnout. "They have largely ignored this growing problem for years in the students and trainees they work to turn into competent physicians," he writes.

3. But an earlier problem, Dr. Hoff argues, is many physicians-in-training "get put in a deep hole before they even get into their work careers as full-fledged physicians." A recent analysis found nearly half of medical students said they suffered from burnout before they reached residency, increasing their risk of depression and medical school dropout.

"That undermines their desire to pursue the more altruistic, patient-centered form of professionalism that satisfies many physicians and gives intrinsic meaning to their work," Dr. Hoff writes.

4. Additionally, medical school and residency and fellowship cultures place too much emphasis on academic credentials and tend to ignore ways to give future physicians the street smarts, business training and emotional intelligence necessary to succeed in difficult work environments, Dr. Hoff argues.

"Because many role models in medical training are burned out themselves, they often lack the compassion and motivation to teach young doctors about the full rewards and realities of being a doctor, thus spreading their own psychological distress like a contagion," Dr. Hoff adds.

5. "I want to care that many doctors are burning out in their jobs. I think that everyone should be aware of this reality, given that healthcare is a service industry and physicians provide many of its most important services," Dr. Hoff writes. "But I would care more if the profession and its training institutions took their culpability more seriously by shining a light directly on what they must do — and do quickly — to create doctors who are psychologically and emotionally prepared for what they will encounter in their jobs."

6. To address this issue, Dr. Hoff calls for an "educational revolution" for medical training programs. "We need … radical shifts in the content of what medical schools and residency and fellowship programs teach their students, how they evaluate and interact with them, and greater awareness that they have the first and most important responsibility for preventing burnout in doctors," he writes.

"Without these, we can expect the problem of physician burnout to get worse, and I as a patient will keep wondering why I should care," he said.

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