Even as COVID-19 pandemic eases, a physician burnout epidemic continues

Despite making significant progress in combatting the COVID-19 pandemic, the healthcare industry’s epidemic of physician burnout and turnover remains a significant challenge heading into 2022.

An Oct. 26 MGMA Stat poll found that 33% of medical practices had a physician retire early or leave due to burnout in 2021, compared to 63% who did not and 4% who responded “unsure.” The poll had 930 applicable responses.

These findings come after a March 2 MGMA Stat poll found that 28% of medical practices had a physician unexpectedly retire from the organization in the past year — of which nearly half were related to the COVID-19 pandemic.

Of the one-third of practices reporting burnout-related physician departures/retirements, some of the top causes of that burnout included:

• Onerous administrative/paperwork burdens
• EHR fatigue
• Fighting with insurance companies over prior authorization and other payer requirements
• Loss of work-life balance, either from higher volumes amid the COVID-19 pandemic or staffing shortages throughout the care team
• Worries about loss of revenue during the pandemic or reimbursement rates not keeping pace with costs of care delivery
• Loss of alignment with the organization’s mission or vision following an acquisition by a competitor hospital or other entity.

“Burnout” is just one method of defining the issue at hand. As one practice leader told MGMA:

A more appropriate term is “moral injury.” Stress physiology is a real problem, and physicians can benefit from stress reduction techniques, but the real problem is bureaucratic burdens that interfere with patient care: productivity demands, EHRs, excessive paperwork, declining incomes, insurance-related burdens, and practice integrations resulting in loss of control. The business of medicine has become impersonal and placed too much pressure on physicians and impacted the physician-patient relationship. Most physicians got into this career to help patients but feel they are now just pushing paper and checking boxes.

Among the nearly two-thirds of practice leaders polled who did not have a physician retire early or leave this year due to burnout, a large majority of them — in a follow-up question — said they do not expect a doctor to leave due to burnout in the next year; however, some noted that many physicians could not afford to leave or have considered selling their practice, shifting to part-time work or leaving for hospital employment. Several of these respondents, despite not expecting physicians to leave due to burnout, noted significant issues with staff and clinical providers leaving due to burnout, as well as concerns with the ability to recruit anticipated physician openings in coming years.

Getting ahead of physician turnover

During this week’s Medical Practice Excellence: Leaders Conference, MGMA and Jackson Physician Search released a whitepaper, How to Get Ahead of Physician Turnover in Your Medical Practice, that details key findings from qualitative and quantitative research on how physicians and administrators view physician engagement, burnout, succession planning and recruitment.
Those findings include:

• Over the past year, nearly half (46%) of physicians considered leaving their current role to work for a new healthcare employer, and 43% considered early retirement.
• Administrators acknowledge high levels of burnout in physicians, but physicians often don’t perceive enough being done to mitigate that burnout or engage them.
• Most physicians (62%) cite their burnout is being caused by their current employer, and only 25% attributed their burnout to COVID-19 pandemic stress.
• Physicians highly value two-way communication with management/administration, more so than small gifts and other minor efforts to engage them.

Solutions for practice administrators

Polling data and interviews with physicians and administrators yielded several suggestions for mitigating burnout, boosting physician engagement and minimizing physician turnover:

• Ensure two-way communication with (and formal recognition from) management and administrators.
• Minimize administrative burdens for physicians, especially in the EHR.
• Optimize physician schedules to fit their style of work.
• Make better use of clinical support team members, such as scribes, and advanced practice providers (APPs).
• Offer more mental health resources, such as peer-to-peer counseling and life coaching.

Insights from #MPE21

The issues with staffing medical practices and healthcare leaders’ role in building resilient organizations that effectively recruit, onboard and retain top talent were key themes throughout the Medical Practice Excellence: Leaders Conference, which wrapped up Wednesday, Oct. 27, in San Diego.

In her session on how to lead despite the exhausting pace of change in healthcare, Katie Lawrence, MHA, CMPE, founder of Willow Strategy Group, emphasized that practice leaders need to be storytellers to their physicians and employees to connect them to the organization’s purpose and help build workers’ sense of passion for their roles.

To be effective in those efforts, Lawrence reminded attendees that they need to carve out the energy to perform amid the strain on themselves, doctors and workers. “Humans have an infinite ability to adapt, yet finite emotional capacity for change at any time,” Lawrence said.

In another session on physician onboarding, alignment and engagement, speakers Chris Hyers, MBA, FACHE, vice president of strategy and business development at UConn Health, and Mitzi G. Kent, RN, BSN, partner, Barlow/McCartney, said that intentional, formal efforts are necessary in the face of looming physician shortages — and that those efforts need to involve the entire team, not just the practice manager, recruiter and/or marketing team.

That coordinated approach is needed when bringing physicians in successfully. “Think about the entirety of the person,” Hyers recommended, and how different areas of your organization can make sure that the “exquisite detail” involved in recruiting a physician is addressed (e.g., the community offerings for a physician’s family, their relocation issues).

More resources

• For more insights from #MPE21 speaker Ronald Menaker, CPA, MBA, EdD, FACMPE, radiology administrator at the Mayo Clinic, read his article on succession management in MGMA Connection magazine.
• Check your preferred social media for “#MPE21” to catch up on the top posts from San Diego.

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