AAFP Calls on CDC to Address Physician Stress, Burnout

The agency should “continuously conduct research and develop evidence-based guidance to inform health systems, employers and other stakeholders on how they can use institutional policy changes to prevent and mitigate stress and burnout in the health care workforce,” the AAFP said in its Jan. 21 letter.

CDC-directed research and resulting guidance, “should consider the disparate impact of workplace stress and burnout on health professionals who are women, Black, Indigenous or other people of color, as well as those who identify as part of the LGBTQ+ community,” the Academy added. “The CDC should proactively share this research and guidance with other agencies, Congress and the broader health care community to help inform policymaking.”

In line with such an approach, the Academy further called on the CDC to “streamline requirements for participating in federal vaccination programs” that fall within the agency’s purview.

“Requirements for participating in the Vaccines for Children program and for administering COVID-19 vaccines in physician practices are overly burdensome,” the AAFP wrote. “Primary care physicians are already overburdened with administrative tasks, and we are concerned that these requirements could inhibit participation in vaccination programs and worsen burnout.

“Additionally, we urge the CDC to partner with CMS to develop policies that reduce administrative burden and allow physicians to focus on patient care.”

The Academy’s letter was sent in response to a request for information titled “Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health,” published Sept. 27, 2021, in the Federal Register. It was sent to CDC Director Rochelle Walensky, M.D., M.P.H., and signed by Board Chair Ada Stewart, M.D., of Columbia, S.C.

In expressing concern with “the high level of physician burnout prior to and exacerbated by the COVID-19 pandemic,” the letter cited a 2021 report indicating that 47% of family physicians said they felt burned out, while 20% of all physicians were clinically depressed. “Data show that physicians in the United States face higher incidents of suicide than almost any other profession,” the AAFP added.

Primary care physicians are more likely to experience burnout than other specialists, the letter warned, citing a recent survey. “Even prior to the pandemic, burnout among clinicians was a pervasive public health concern, with some studies showing more than half reporting burnout.” As the public health emergency enters a third year, the Academy added, physician burnout has worsened, negatively affecting both physicians and patients.

Given these impacts, the Academy repeated to the CDC a message that it and other medical societies recently sent the White House: “Prioritize the mental health and wellbeing of frontline health care workers in the federal COVID-19 response.”

Specifically, the CDC should “increase efforts to combat misinformation,” the Academy said, noting that widespread COVID falsehoods had contributed to clinician frustration and burnout while creating new financial burdens on the health care system. The letter pointed to an Oct. 2021 Johns Hopkins Center for Health Security study estimating that false or misleading information had caused “between $50 million and $300 million in total harm to our nation since May 2021, when COVID vaccines became widely available.”

Primary care physicians last year reported that their relationships with patients were helping to combat misinformation and vaccine hesitancy, the Academy said. But such encounters are “time intensive and typically undertaken in addition to a full clinical schedule,” the letter added — factors that ultimately contribute to physician burnout.