Like many people, I’m beginning to venture out to medical practices for long overdue visits. I always ask my providers how they’re doing. They tell me the truth—maybe because I’m also a doctor and somebody who is focused on helping medical practices thrive.
One provider told me she’s selling her medical practice and retiring early, in her late 50s, after losing her mother and a close friend to COVID-19. Another was in the room with me physically, but barely there mentally. And another who used to love talking about her practice with me only wanted to talk about her weekends in the mountains.
Provider burnout was a critical issue before COVID-19. Now, the amplitude is potentially catastrophic, cutting across our front-line ranks. The systems they rely upon failed them. When the pandemic we had been “planning” for finally came, we couldn’t fulfill providers’ most basic need—safety. Financial stress climbed as patient volumes plummeted and medical practices shut down. The mental exhaustion of caring for sick or anxiety-ridden patients overwhelmed the intrinsic rewards of practicing medicine. According to Medscape’s National Physician Burnout & Suicide Report 2021, worklife happiness has dropped from 69% pre-pandemic to 49%.
The repercussions of this traumatic year aren’t going to play out over the next six to 12 months, but over the next generation. We recognized years ago that relying on burned out providers makes it impossible to achieve cost-effective, high-quality, satisfying care. To avoid blows to accessibility, patient trust and engagement, and the financial stability of the healthcare system, we need to take comprehensive, collaborative action.
The immediate danger is that providers are leaving their profession. In a recent MGMA survey, 28% of practices reported a doctor retiring unexpectedly in the past year, and many reported pandemic-related burnout as the reason. The long-term financial impact of this trend could be massive. When we account for marketing, signing bonuses, relocation reimbursement and interviewing, the cost of recruiting a physician is roughly $250,000. Onboarding, training and transitioning patients add to the burden. And if we face a provider shortage, salaries will rise as competition increases for those who remain. Replicate these numbers across medical groups around the country, and the impact on cost of care becomes clear.
Our greatest healthcare disaster isn’t providers leaving, though; it’s providers staying and not getting the support they need. At a time when greater than 10,000 baby boomers are popping into the 65-plus category daily, with more complex needs and chronic conditions, we need providers who are engaged enough to avoid mistakes. We need providers who can rebuild patient trust in healthcare, through strong communication and empathetic relationship building.
I hear healthcare leaders—from policymakers to payers to tech CEOs to practice group leaders—talk about burnout in the same way they talk about the latest healthcare legislation, as something over which they have little influence. I understand why it can feel that way, which is why we need to take action, together.
First, we need to address the impending physician shortage. Congress must pass the Resident Physician Shortage Reduction Act of 2019 and finally increase sponsored residency positions for medical school graduates.
Second, we need organizations to brutally attack operational dysfunction and administrative burden, the No. 1 cause of burnout in almost every survey. Healthcare is like a fishing line pulling through seaweed: we’ve picked up a lot of detritus. The accelerated change of the past year may add to it. Payers have to partner with medical groups and systems to revamp requirements of proof and reduce prior authorizations and claim rejections. Healthcare organizations should demand that electronic health record companies improve their technology so physicians spend less time on the systems. And practices must invest in better training for staff and streamlined patient systems to lessen the burden on providers.
Finally, we need to recognize that our providers are in crisis and financially invest in their well-being. Psychological wounds, if not treated, can deepen and fester. No free meditation lunch-and-learn in the world will resolve the aftermath of the past year. We need robust mental health programs and work-life support benefits that are accessible throughout the entire healthcare culture.
As a nation, we need to solve this problem or we face losing the critical talent that makes healthcare function for all of us. We can do it, but we have to be proactive and collaborative.