A career in healthcare is stressful. It is an inherent part of the job. Physicians must use high level problem solving and human interaction at the same time to provide care for patients in every form of health. Each situation is different and provides a new challenge in diagnosis and treatment. Breaks on the job are few and far between. Shifts are long and days off are sparse. This is understood to be part of the job of being a physician. But why does stress escalate into burnout? Why now more than ever?

Physicians have a passion for what they do. The 12+ years of education and training are intense and consume most of their time. They have dedicated their life to patient care. But the job description of a physician has changed over the years. In past decades, the hours at work were primarily spent on patient care. Physicians enjoyed more autonomy at their institutions, or in their own practice. They didn't have to justify every decision made with a mountain of paperwork. Even in these glory days of lighter regulation and self-governance, there was still the stress of curing sick patients. But the stress didn't lead to burnout as much as it does now.

Today physicians still have patient care as their primary objective, but the job has become more complex. Regulatory and administrative burdens have come cascading in from all sides. Insurance companies and the CMS have made documentation and billing requirements a time-sucking burden on the physician. More than ever, physicians answer to administrators untrained in medicine and highly focused on the bottom line. We now have a healthcare system that takes up %18 of the U.S. GDP and the business objectives seem to be overtaking the care objectives.

Organizations have the opportunity to enhance or hinder physicians. When any individual’s vision isn’t aligned with their employer, the disconnect can lead to feeling purposeless or like a cog in a machine. Physicians give a lot to the organization they work for. They are the primary source of income. On average, they make their employers about 9 times their salary, an incredible return on investment. Physicians are generating all of this income with sub-optimal conditions in EHR usability and excessive documentation responsibilities. They are working after hours to get it all done day after day. This is adding to the daily stress and the disconnect that leads to burnout. But is anyone listening?

A large part of the solution lies with the administration. It is time to actively seek input from providers on how institutions can be improved. The value of a healthcare organization is in helping people become and stay healthy. Making patients healthy benefits from having a healthy doctor. Reinvestment into systems that reduce administrative burden and allow physicians to focus on patient care will pay off in the long run. The humanitarian and financial benefits of eliminating burnout are clear: Fewer mistakes leading to better outcomes. Less turnover, a large financial burden on organizations. Improved efficiency from healthy doctors that feel aligned with their purpose. Improved morale throughout the organization, because people want to work for someone that appreciates them and provides the tools for success. Understanding and empathy are needed to solve the problems for providers that exist beyond patient care.

People are resilient, but when an organization fails them, people can be broken. How can organizations combat burnout on an institutional level?