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13 Articles in Volume 18, Issue #3
Anger Expression & Chronic Pain
Ask the Expert: Should reliance on gabapentin/pregabalin be limited?
Chronic Pain in Children
Considering Comorbidities When Selecting Medications for Chronic Pain Management (Part 1)
Dousing the Physician Burnout Epidemic: An AMA Perspective
Harnessing the Power of Words
Inside ASRA with David Provenzano, MD
Management of Intrathecal Therapies by Interprofessional Teams
Nurse Burnout in Pediatric Pain Management: A Model and Pilot Intervention
Physician Burnout: An Oldtimer’s View
Reporting Metrics, Media Coverage...Letters from the Minds of Peers and Patients
The Case for Slow-Release Anesthetics
The Impact of Pain Practice

Dousing the Physician Burnout Epidemic: An AMA Perspective

David O. Barbe, MD, president of AMA, discusses how the organization is leading a necessary change in medicine—one that embraces physician well-being.

Editor's Note: In spring 2019, the WHO added "burnout" as an official medical diagnosis to the International Classification of Diseases (ICD-11), defining the condition as: feelings of energy depletion/exhaustion; increased mental distance from one's job or feelings of negativism/cynicism related to one's job; and reduced professional efficacy. PPM has covered this subject from the healthcare provider perspective starting with the AMA's view below. See also: The Impact of Pain Practice and Nurse Burnout.



An energized, engaged, and resilient physician workforce is essential to achieving national health goals. Yet, burnout is more common among physicians than other US workers, and that gap is increasing as the bureaucracy of modern medicine inflicts a mounting toll on physicians.

Physicians & Their Patients

Physicians who report high professional satisfaction have patients who are more satisfied with their care. Unfortunately, the work-induced syndrome of burnout and caregiver fatigue among physicians is a real and growing problem with potential to impact patients.

Approximately half of US physicians experience burnout.1 Each one-point increase in this statistic equates to a 43 percent greater likelihood of clinical reduction within 24 months.2 Studies have demonstrated that burned-out physicians retire early, reduce the time they devote to clinical work, or leave medicine entirely. As a result, patients have longer wait periods to see their doctor or, worse yet, lose their trusted physician forever.

Face Time versus Desk Time

An AMA time-motion study4 quantified how much time physicians spend conducting different tasks during the clinical day. The study determined that physician time was being taken away from patients due to the data entry demands of electronic health records (EHR) and other administrative tasks. Physicians reported spending 27 percent of their office day in direct clinical face time with patients and just over 49 percent of their day managing EHR and deskwork activities. In other words, for every hour of direct clinical face time with patients, physicians spent nearly two hours on EHR and deskwork.

To those of us who practice medicine, it is clear that physicians spend too much time on administrative tasks that do not require the expertise of a licensed doctor of medicine or doctor of osteopathy. AMA’s subsequent push for meaningful change in the US healthcare system is based on the consensus that: patients deserve the full and undivided attention of their physicians; populations deserve access to care; and society deserves more from its investment in medical education.

Making Improvements from the Ground Up

Based on the clear correlation between physician well-being and successful health system transformation, AMA has built upon the principles noted above and made the assessment and prevention of burnout a core priority. The organization is working to help physicians and institutions alike to help them succeed in their work of caring for patients. At the 2016 annual meeting, for example, AMA’s House of Delegates adopted policy on “the goal of improving the work-life balance of physicians and other healthcare providers.” The new goal was added to the organization’s existing triple aim of improving population health and patients’ care experiences while cutting per-capita healthcare costs.

Since then, AMA has been striving to help physicians cope with the real challenges of providing quality patient care in today’s environment by arming them with relevant, cutting-edge tools, information and resources, and, in so doing, hopefully rekindling a joy in medicine. AMA’s STEPS Forward collection, for example, provides physicians with practice improvement strategies to help make transformative changes to their daily office lives. The collection offers modules specific to physician well-being, including those on preventing physician burnout in practice, improving physician resiliency, and achieving practice sustainability.

At the institution level, AMA is helping individual organizations assess internal burnout levels to provide a baseline metric. Solutions and interventions are being identified to help reduce systems-level burnout rates and improve physician well-being. Many teams can benefit from AMA’s publically available practice improvement strategies, including interventions on enhanced communications, team huddles, and optimizing clinical workflows.

In addition, the AMA is supporting a framework published in late March 2018 by the Collaborative for Healing and Renewal in Medicine—a group of medical educators, academic leaders, and wellness research experts from across the country. The group’s “Charter for Physician Well-Being,” aims to guide healthcare organizations in the development of policies and interventions that align with best practices for promoting physician well-being. The AMA strongly supports the charter and its declaration that the nation is best served by a health system that promotes professional fulfillment by allowing physicians to meet their patients’ needs for high-quality care.

Through its ongoing work, AMA is committed to help physicians and their practices thrive so they can continue to put patients first. By advancing initiatives that enhance efficiency, professional satisfaction, and the delivery of care, AMA is striving to help physicians navigate and succeed in a continually evolving healthcare environment. The organization welcomes all feedback on this effort. Medical practices and health systems may contact the AMA at www.ama-assn.org or 800.621.8335 to learn more about its Burnout Assessment Program.

The Stats

According to Medscape’s 2018 National Physician Burnout & Depression Report:

  • 42% of physicians reported feeling burned out, and 15% reported either a clinical or colloquial form of depression
  • Intensivists and neurologists reported the highest rate of burnout at 48%, followed by family physicians (47%) ob/gyns and internists (46%), and emergency medicine physicians and radiologists (45%)*
  • More female physicians reported feeling burnout as opposed to their male counterparts (48% to 38%)
  • Burnout rates rose dramatically by age, peaking in the 45- to 54-year-old range at almost 50%
  • When asked to scale the frequency of their burnout from 1 (rarely) to 7 (always), 48% of physicians chose a 5 or higher
  • 40% of physicians with depression from burnout reported that their condition has no effect on patient care, while one-third (33%) reported that they are more easily exasperated by patients, or less engaged with them (32%)
  • Contributing factors leading to a physician’s burnout included an excess in bureaucratic tasks (56%) and too many hours at work (39%), according to respondents
  • Half (50%) of respondents coped with burnout by exercising, followed by talking with family members or close friends (46%), and sleeping (42%).

*The annual physician lifestyle survey, released in January 2018, included responses from 15,000 physicians across 29 specialties. Pain practitioners were not specifically called out in the report. Available at: www.medscape.com

Last updated on: May 29, 2019
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