Patient Trust Erodes with Physician Burnout

March 27, 2019

Burnout affects 42 percent of doctors, a survey shows. Loss of patient trust has been identified as a casualty of burnout.

Burnout-the emotional and physical exhaustion and disconnect, physicians feel-affects 42 percent of doctors, based on a 2018 Medscape survey of 15,000 providers across 29 specialties.

Not only has the burnout epidemic contributed to the physician shortage and increased the turnover rate, but it’s also expensive. Replacing a physician costs approximately $1 million.

A recent commentary published in the March issue of The American Journal of Medicine discussed what it’s like to experience burnout and the problems it causes.

“Risk of burnout increases when physicians lose connection to natural rhythms of life and when work is not tempered with self-care, self-compassion, and activities that bring a sense of playfulness, joy, youth, and lightheartedness,” said author Noshene Ranjbar, M.D., from the Univeristy of Arizona College of Medicine.

CONSEQUENCES FOR PHYSICIANS

According to Dr. Ranjbar, burnout impacts doctors in several ways:

1. Emotional exhaustion: The reduced ability to be emotionally present for patients, friends, and family enhances irritability, misplaced anger, and frustration.
2. Reduced sense of personal accomplishment: Forgoing personal time for professional obligations can make providers feel ineffective. Losing enthusiasm leads to unhealthy coping mechanisms, such as substance abuse, as well as depression and anxiety.
3. Depersonalization: Burnout impedes connecting with the workplace or feeling empathy for patients and colleagues. It can cause feelings of isolation and loneliness and can contribute to suicide.

MEDICAL INDUSTRY IMPACT

Burnout can also significantly impact healthcare, Dr. Ranjbar wrote.

1. Quality of care: Studies show a cyclical relationship between burnout and medical errors. Committing medical errors causes a provider stress which can lead to more medical errors.
2. Loss of patient trust: Little empathy for a patient’s health problems can lead to a patient’s distrust. According to a New England Journal of Medicine study, public trust in the healthcare system fell from 73 percent in 1966 to 34 percent in 2012.
3. Low staffing: Burnout has contributed to the physician shortage and low staffing ratios. Having fewer physicians available to handle the workload puts more pressure on remaining providers, adversely impacting work quality.

Overall, Dr. Ranjbar said, physicians battle forces contributing to burnout daily.

“Burnout should be considered a result of external pressures, not an individual syndrome,” Ranjbar said.

REFERENCE

Ranjbar N, Burn Bright I: Reflections on the Burnout Epidemic (Part One of a Two-Part Series). The American Journal of Medicine (2019), https://doi.org/10.1016/j.amjmed.2018.09.036