Responding to physicians who are feeling the pressure of today's complex practice environment, the AAFP has joined a coalition of medical associations in launching a campaign to promote improved clinician wellness.
Clif Knight, M.D., left, AAFP senior vice president for education, and Neil Busis, M.D., a member of the board of directors of the American Academy of Neurology, speak about the aims of the Action Collaborative on Clinician Well-Being and Resilience at its first public meeting.
The National Academy of Medicine hosted the first public meeting(nam.edu) of the Action Collaborative on Clinician Well-Being and Resilience(nam.edu) on July 14.
The collaborative, which the AAFP helped launch as one of 36 inaugural sponsors, plans to publish reports, host public meetings and develop support tools for clinicians during 2017 and 2018. The goals are to improve systemic issues that lead to increased clinician burnout and provide resources for clinicians who seek support.
Among the collaborative's first efforts is a discussion paper(nam.edu) published July 5 titled "Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care."
"The high prevalence of burnout among health care professionals is cause for concern because it appears to be affecting quality, safety and health care system performance," the paper stated. "Efforts are needed to address this growing problem."
- The National Academy of Medicine hosted the first public meeting of the Action Collaborative on Clinician Well-Being and Resilience created to address the causes of burnout on July 14.
- The AAFP is one of 36 organizations that support the collaborative as inaugural sponsors.
- Clif Knight, M.D., AAFP senior vice president for education, said reducing burnout will require addressing sources of frustration throughout the health care system.
Examining Contributors to Burnout
More than half of U.S. physicians are experiencing symptoms of burnout, and those working on the front lines of care, including family physicians, carry the greatest risk. There are clear demographic differences between clinicians who are most likely to experience burnout and those who are not, with physicians under age 55 reporting a much greater risk for burnout than their older colleagues, and a 30 percent to 60 percent higher risk of burnout among female physicians than their male counterparts.
Speakers at the meeting identified some of the factors that contribute to burnout among physicians who face a long list of demands that their forebears could not have imagined.
"The days of Marcus Welby seem like a very long time, ago," said Marc Moss, M.D., vice chair of clinical research at the University of Colorado, Denver, School of Medicine. "Physicians have less autonomy, increased documentation requirements and are seeing patients with more chronic illness and disease."
Clif Knight, M.D., AAFP senior vice president for education, spoke at the meeting about the aims of the initiative. He said reducing burnout will require addressing sources of frustration throughout the health care system. The AAFP is preparing to roll out member tools and CME opportunities specifically for family physicians in the coming months, but also is working with others on broader efforts such as those of the collaborative.
"When clinicians are at their best, everyone wins," Knight said. "This is about every member of the care team and about everyone receiving better health outcomes. We are looking for solutions at a macro-system level."
Doug Fridsma, M.D., Ph.D., president and CEO of the American Medical Informatics Association, noted how the information age requires physicians to "show receipts" documenting the treatment they provided before they can receive payment. These ever-increasing demands for data collection consume physicians' time while increasing costs.
"If I have to ask about a duck egg allergy, that becomes incredibly costly," Fridsma said. "If we try to collect everything, it will be burdensome."
That's largely because electronic health records (EHRs), for all their initial promise, continue to be a source of frustration.
"EHRs were sold as being good for patient care, but they are actually used for billing," said Lois Nora, M.D., J.D., M.B.A., president and CEO of the American Board of Medical Specialties. "How do we reframe it?"
Lack of autonomy is cited as another cause of burnout, especially for many older physicians. But speakers noted that many younger physicians express a preference for working in larger medical institutions that pay higher salaries even if it means less independence.
Meeting participants were invited to experience one anti-burnout tactic: a physician-led, 30-minute mindfulness break to slow down and focus on the moment through relaxation and breathing exercises. Knight and others have recommended the practice as one way for physicians to reduce daily stress.
But burnout can begin long before physicians enter practice.
"We have to admit that in a way we are teaching burnout to students," said Michael Rabow, M.D., a professor of clinical medicine and urology at the University of California, San Francisco, School of Medicine.
More than 100 medical schools are helping their students by offering an elective course called healing arts that includes five sessions where participants attend lectures and then break into groups to discuss their values and their reasons for entering medicine.
For those who are well into their careers, the Brigham and Women's Hospital Center for Professionalism and Peer Support(www.brighamandwomens.org) offers guidance on interactions with medical teams that promote mutual respect, trust and teamwork, as well as the counsel of peers.
"We need to be there at the toughest moments," said Jo Shapiro, M.D., director of the center. "We cannot sit and wait for clinicians to come to us."
Related AAFP News Coverage
Focus on Physician Well-being
More From AAFP
Physician Burnout (Position Paper)