Discussions about physician burnout often accept the phenomenon as a given throughout the U.S. healthcare ecosystem, with a focus on its intensity and the efforts made to combat it. Sometimes these conversations come with the acceptance that it’s just one of the inherent traits of clinician work today.
While awareness of burnout is important, it’s also crucial to understand the extent of its effects on medical group practices:
- The Physician Foundation’s 2023 Survey of America’s Current and Future Physicians finds that six in 10 doctors report feeling some form of burnout.
- More than half of physicians know of a physician who has ever considered, attempted or died by suicide.
- A separate survey of final-year medical residents by AMN Healthcare (PDF) suggests three in 10 medical residents would not choose medicine if they could have a do-over on their careers.
An Oct. 3, 2023, MGMA Stat poll asked medical group leaders if they experienced a physician leaving the organization or retiring early due to burnout in 2023. Almost three in 10 (29%) answered “yes,” compared to 67% who responded “no” and 4% who were unsure. The poll had 493 applicable responses.
These findings suggest a slight decrease in the share of healthcare provider organizations that lost physicians to burnout in the past year versus 2022, as an Aug. 23, 2022, MGMA Stat poll found four in 10 medical groups experienced such loss related to burnout. Similar MGMA polls conducted in 2021 put the share of medical groups facing burnout-related physician retirements and departures at 28% to 33%, respectively.
What’s being done in response to burnout
Among the respondents to the latest poll who indicated they had at least one physician leave due to burnout, more than half (55%) signaled the organization has created or updated a strategy to confront clinician burnout in the past two years. Those medical group leaders told MGMA that these efforts included:
- A shift to a four-day work week and the introduction of flexible work schedules
- Renewed surveys of clinicians to measure satisfaction, as well as the creation of physician wellness committees to plan and deploy burnout mitigation and prevention strategies
- Increased inclusion of physicians in wellness activities and resiliency counseling
- New emphasis on physician mentoring and coaching
- Offloading of administrative tasks to other team members, as well as improved training on enterprise EHR systems and implementation of enhanced tools to reduce technical burdens
- Use of hospitalist and part-time roles as a path to retirement for physicians who would otherwise leave.
Still, not all respondents voiced optimism about ongoing efforts. In the case of geriatricians, one respondent told MGMA that the stagnation of Medicare payment rates is a unique driver of dissatisfaction and moral injury within the specialty. In other cases, the significant demands for patient care are difficult to balance with these efforts. Even as some organizations shift more of the workload to advanced practice providers (APPs), “there is no mechanism” available to properly combat burnout “with rising overhead and dropping reimbursement” adding pressure on physicians to work harder.
What about the practices who haven’t lost physicians to burnout?
When asked if they were concerned about future physician departures due to burnout, most of the respondents who told MGMA they had not lost a physician to burnout in 2023 said “no.” Unfortunately, their efforts in combatting burnout did not differ significantly from practice leaders who did experience the departure of burnt-out physicians: This group also reported efforts to shorten the work week, update scheduling, encourage time off, create focus groups to tackle work-life balance, and automate administrative tasks that interfered with physicians’ face-to-face patient care time.
And even in this group, there are still plenty of administrative leaders who recognize that their wellness and scheduling efforts may not be sufficient to prevent their physicians from suffering burnout. “We try to support providers’ work-life balance,” one respondent told MGMA, “but there are so many fundamental issues in healthcare that it is no longer just an issue of long hours.”
Preparing for a wave of physician retirements
Earlier this summer, the MGMA Business Solutions podcast heard from Tony Stajduhar, president of Jackson Physician Search, about the complex challenges of demographic shifts in the physician market and how practices should prepare.
“Physicians are used to working five days a week, seeing 30 patients a day, doing call every other night – they’ve been doing it their entire lives,” Stajduhar noted. “They didn’t worry about the work-life balance that you hear about today. But over the years, that’s got to wear on you.
“Now, all of a sudden, you’ve got this huge percentage of physicians who are above the age of 55, nearing what the world thinks of as retirement age,” he added. “You’re always going to have diehard physicians who say they’ll probably work until they pass, but most physicians are getting to the point where they want to have some type of plan and future outside of medicine as they go forward. There are a lot more physicians that are willing to transition than we ever thought before.”
Stajduhar noted that among medical groups and hospitals his organization works with, “the one thing you never hear addressed is the attrition — but the average age of physicians is going to be a potential cliff that will just exacerbate the shortage even more if we don’t have some strategy in place.”
Having a strategy is especially important, as a recent study commissioned by Jackson Physician Search found that about four in 10 (41%) physicians think they only need to give three months’ notice, while another 32% say four to six months. “Basically 75% of physicians think as long as they give less than six months’ notice, they’re golden, and that’s all that their practice needs,” Stajduhar said. “On the flip side, you’ve got administration, where maybe 30% feel like seven to 13 months is a minimum. But even that’s not optimal, because it’s going take you 12 to 18 months to recruit a physician. It doesn’t take rocket science to figure out where that lands.”
Stajduhar said practice administrators need to start having open conversations with their physicians about their plans and why they want to retire. Understanding physicians better will help organizations better understand the options available to retain the doctors who might still want to deliver care on a part-time basis versus leaving the field. “Let them know that you not only want to help the facility, but that you also care about what they’re looking for and what they need to make their lives better,” Stajduhar said. “They’re in a stage where life should be better and they should be able to transition and do what they want — they earned it.”
Learn more at #MGMALeaders
We’re just a few short weeks from the start of the 2023 Leaders Conference, Oct. 22-25 in Nashville. Join us to learn more about this topic at these sessions:
- “Shifting from Burnout to Engagement” — Join Steve Brewer, DHSc, MBA, FACMPE, FACHE, vice president of operations, SSM Health Monroe Clinic, Wisconsin, as he details best practices for employee engagement and learnings from neuroscience to rebuild a sense of joy in work.
- “Beating Burnout for Leaders: Making Mindfulness Meaningful” — This two-part session on Wednesday, Oct. 25, features Jeff Comer, PhD, MHA, FACHE, of Parkview Regional Hospital and Ennis Regional Hospital, exploring the impacts of burnout on medical practice leaders, the underlying stress-induced causal factors of that burnout, and practical ways to improve well-being, health, productivity and overall life happiness.
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