By Kelsey Laird, PhD and Jonathan Adler, MD

Healthcare providers face numerous chronic stressors, including high and increasing productivity expectations, the pressure of high-stakes decision-making in the face of ambiguity, and witnessing the pain, loss, and suffering of patients and their families. Caregivers often experience distress when they perceive that the treatments they are administering are futile (1) or when they are unable to deliver the quality of care that they believe it is their duty to give. (2) In the context of insufficient support and resources, each of these factors can lead to the emotional exhaustion and depersonalization that is characteristic of burnout. (3)

Roughly 50 percent of physicians report symptoms of burnout, a rate that is twice that of the general working population. (4) The costs of burnout to provider wellbeing are high, including increased rates of depression and suicidality. (5,6) Studies of physicians have found burnout to be associated with a 200-percent increase in suicidal ideation. (7) Sadly, estimates suggest that among physicians experiencing suicidal ideation, only one in four seek help,7 largely due to a fear of professional consequences, perceived stigma, and limited time to seek care. (7,8)

Caregivers experiencing burnout also suffer from poor overall physical health, resulting in increased healthcare costs for employers. Burnout is associated with memory impairment, decreased productivity, decreased patient satisfaction, and increased medical errors. (9) As such, the financial impact of provider burnout is substantial. Direct costs attributed to physician burnout in the U.S. are estimated to be $4.6 billion per year in the form of physician turnover and reduced clinical hours alone ($7,600 per year per MD). (10) Ultimately, burnout poses multiple threats to your organization’s long-term viability including decreased quality of care, patient satisfaction, and patient safety. (11)

The COVID-19 pandemic amplifies the risk of burnout, testing the resiliency of both healthcare workers and the institutions that support them. Fortunately, research has identified a variety of approaches with demonstrated success for increasing engagement among healthcare providers and reducing the personal, financial, and organizational costs of burnout. (3) The National Academy of Medicine categorizes successful interventions into “external factors,” such as the steps an organization can take to support clinicians, and “individual factors” that can decrease stress and build resiliency. There are simple, inexpensive steps you can take immediately to decrease clinician burnout and the associated adverse impacts on care.

CredibleMind supports your caregivers by helping them learn and practice skills that increase resilience amid workplace stressors. CredibleMind is a population mental health platform designed to help employees mentally and spiritually flourish by connecting them to credible, expert-curated resources. Evidence-based approaches for reducing burnout include psychotherapy and support groups, practicing mindfulness, increasing meaning and purpose, engaging in healthy lifestyle habits, and practicing other resilience-enhancing strategies such as self-compassion.

We are both practicing clinicians and enjoy the opportunity to contribute to CredibleMind. We both feel we have learned new approaches from its content ourselves and have shared links with colleagues and patients so that they can benefit from evidence-based approaches. Clinically, Jon is a busy emergency physician, and even now, he takes some time out for breathing/mindfulness during a shift. Kelsey is a clinical psychologist who makes time for mindful movement and stretching in between sessions, which helps her stay grounded and more present with her patients. Your caregivers experience all the stresses of “regular” life too, such as addiction, divorce, caring for a loved one with a new illness, coping with a new diagnosis, and other life transitions. CredibleMind content includes resources to address these and many other life challenges.

CredibleMind customizes the system for each organization we work with. This helps you engage your employees and users, reduce stigma around help-seeking, and integrate the EAP benefits and preferred resources you’ve already invested in to help your employees find resources so they can flourish.

Ultimately, CredibleMind serves as part of a multifaceted approach to improve caregiver retention, satisfaction, and productivity by improving outcomes upstream—before burnout takes its toll. We are here to care for the emotional and physical wellness of your caregivers so that they can in turn care for your patients.

References

(1) Meltzer, L. S.; Huckabay, L. M. Critical care nurses’ perceptions of futile care and its effect on burnout. American journal of critical care 2004, 13, 202-208.
(2) Glasberg, A.-L.; Eriksson, S.; Norberg, A. Burnout and stress of conscience among healthcare personnel. Journal of advanced nursing 2007, 57, 392-403.
(3) Peterson, U.; Demerouti, E.; Bergström, G.; Samuelsson, M.; Åsberg, M.; Nygren, Å. Burnout and physical and mental health among Swedish healthcare workers. Journal of advanced nursing 2008, 62, 84-95.
(4) Yates, S. W. Physician stress and burnout. The American journal of medicine 2019.
(5) Letvak, S.; Ruhm, C. J.; McCoy, T. Depression in hospital-employed nurses. Clinical Nurse Specialist 2012, 26, 177-182.
(6) Ohler, M. C.; Forbes, D. A.; Kerr, M. S. Depression in nurses. 2010.
(7) Shanafelt, T. D.; Balch, C. M.; Dyrbye, L.; Bechamps, G.; Russell, T.; Satele, D.; Rummans, T.; Swartz, K.; Novotny, P. J.; Sloan, J. Special report: suicidal ideation among American surgeons. Archives of surgery 2011, 146, 54-62.
(8) Clough, B. A.; March, S.; Leane, S.; Ireland, M. J. What prevents doctors from seeking help for stress and burnout? A mixed‐methods investigation among metropolitan and regional‐based Australian doctors. Journal of clinical psychology 2019, 75, 418-432.
(9) Hall, L. H.; Johnson, J.; Watt, I.; Tsipa, A.; O’Connor, D. B. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PloS one 2016, 11.
(10) Han, S.; Shanafelt, T. D.; Sinsky, C. A.; Awad, K. M.; Dyrbye, L. N.; Fiscus, L. C.; Trockel, M.; Goh, J. Estimating the attributable cost of physician burnout in the United States. Annals of internal medicine 2019, 170, 784-790.
(11) Shanafelt, T.; Goh, J.; Sinsky, C. The business case for investing in physician well-being. JAMA internal medicine 2017, 177, 1826-1832.