What do stressed-out, overworked and exhausted healthcare workers have that we as lawyers don’t? Our profession may require a tremendous amount of self-sacrifice, long hours, and stressful work but physicians experience burnout to such an extent that it is affecting patient safety. In fact, there is a direct correlation—you are more likely to be a victim of a preventable medical error if your healthcare provider is exhausted and burned out. So, though exhausted we may be, our community of healthcare workers are, unsurprisingly, more tired than we are. We must commend our frontline healthcare workers for their incredible work and for the sacrifices they’ve made.
It may not surprise you that the pandemic accelerated burnout among physicians to extreme levels. But would it surprise you to hear that physician wellbeing has been suffering for years before the pandemic, with the pandemic only exacerbating the disorder? Whether your answer is yes or no, you are probably wondering why we even care since it is generally understood that a career in medicine is, and likely to be, stressful. My past writings have highlighted the disparities and need for change in areas of our healthcare system for a better environment for patients and their safety. Today I acknowledge the long-existing public health crisis of physician burnout; partially because it harms the physical and mental wellbeing of our institutional caretakers, but more so because of the severe implications it has on the safety of and risk taken on by patients who are seen by these very burned-out physicians.
Burnout is considered a long-term stress reaction, and can sometimes become a fatal disorder, that is commonly marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. Anywhere from debilitating mental health to negative relief outlets, physicians are suffering the repercussions of burnout and are finding very little help to prevent it. In turn, patients are more dissatisfied, lacking access to quality care, and becoming victims of higher medical error rates and instances of malpractice. The cascading domino effect of harm is very much real here and it is doing nothing but hurting healthcare consumers.
In The Physicians Foundation’s “2018 Survey of America’s Physicians,” the foundation found that a staggering 78% of physicians felt widespread burnout. The Maslach Burnout Inventory, the leading measure of burnout, measures burnout among physicians by analyzing their feelings of being emotionally overextended or exhausted by their work; lack of feeling or impersonal attitudes toward patients; and feelings of accomplishment, achievement, and competence in their own work. These factors work together in ways that have ultimately increased overall burnout amongst physicians. With this increase, studies have found that physicians dealing with burnout are twice as likely to be involved with patient safety incidents, low professionalism, and patient dissatisfaction.
On the most basic level this all makes sense. When physicians are working on an empty tank, disassociated with their practice and patients, how are they to adequately adhere to treatment guidelines or communicate empathetically? They really can’t, and the studies prove it.
These feelings of burnout were only heightened and stretched during the pandemic. Physicians were, and still are, on the frontlines of this pandemic yet such high numbers of them have cited feelings of hopelessness or anger, with many of them turning to increased usage of medication, alcohol, or illegal drugs. Patients have been dying at horrendous rates this past year and a half, and it frightens me to think that maybe not all of those deaths should be completely attributable to COVID-19. We have already felt some of the pushback and it doesn’t help that varying levels of legal immunity are still in place for physicians when it comes to COVID-19 care. So, the scary question is, what are the real numbers of medical malpractice committed during this pandemic, and how many of those patients will achieve actual justice? I’m not sure I want to know the answer.
Burnout has been so prevalent within the nation’s community of physicians that some scholars call it an epidemic. A burnout epidemic within a community of physicians that are supposed to be fighting our pandemic. That doesn’t sound right now does it? It is a dangerous reality that warrants more attention than it has ever gotten. Physician burnout goes hand in hand with patient safety. If the stigma of asking for help or taking a break is not broken, patients will continue to suffer at the hands of burned-out physicians, unknowing future defendants in malpractice suits.