January 17, 2018 / 3:53 PM / a year ago

Physician burnout takes a toll on U.S. patients

(Reuters Health) - Nearly two-thirds of U.S. doctors feel burned out, depressed, or both – and those feelings affect how they relate to patients, according to a survey conducted by Medscape.

“One in three depressed doctors said they were more easily exasperated by patients; 32 percent said they were less engaged with their patients; and 29 percent acknowledged being less friendly,” Leslie Kane, Senior Director, Medscape Business of Medicine, said in an email to Reuters Health.

What’s more, nearly 15 percent of depressed doctors said their depression might cause them to make errors they wouldn’t ordinarily make, while 5 percent said depression led them to make errors that might have harmed patients.

More than 15,000 doctors across 29 specialties responded to survey questions about depression and burnout, which was defined as feelings of physical, emotional or mental exhaustion; frustration or cynicism about work; and doubts about the value of their work.

Critical care doctors and neurologists had the highest rates of burnout (48 percent), followed by family doctors (47 percent) and ob/gyns and internists (46 percent).

The lowest rates were among plastic surgeons (23 percent), ophthalmologists (33 percent) and dermatologists and pathologists (32 percent), all specialists who are less likely to work under emergency conditions, according to the report.

Fourteen percent of all doctors surveyed said they feel both burned out and depressed.

“Some specialties, by their nature, have shorter visits with patients and may have more pressure to see patients faster,” Kane said. “They don’t feel they can have the satisfaction of getting to know their patients, which was once the norm.”

“For doctors such as primary care physicians who see many patients in relatively short time frames, it becomes increasingly difficult to stay on schedule and feel that there is any ‘decompression’ time during the day,” Kane noted.

Physician burnout and depression are driven largely by bureaucratic and practice demands, but “patients can make a difference,” she said.

“For example, if you have a problem with or complaint about something that happens in the office or an interaction with the office staff, try to find a way to let the physician know,” Kane suggested.

“Giving the doctor a chance to solve or address the problem averts having a disgruntled patient write a nasty online review for something the doctor wasn’t aware of,” she said.

On the other hand, she said, “if you are really happy with something a doctor has done for you, or you’ve had a particularly good visit, you might consider sending a nice note to let the doctor know. Any show of appreciation or thanks is always very welcome.”

Dr. Carol Bernstein, a past president of the American Psychiatric Association and professor of psychiatry and neurology at NYU Langone Health in New York City told Reuters Health by email, “Physician wellbeing is important because physicians who care for themselves will do a better job caring for others, and are less likely to make medical errors or leave the profession.”

However, she added, “Concern about the stigma related to seeking mental health services is overwhelming, in part due to anxiety about licensure, credentialing and hospital privileging.”

While resources to prevent burnout and reduce stress can help, the survey found that only 45 percent of hospital-based doctors and 31 percent of office-based multispeciality practices or outpatient clinics have burnout prevention programs.

Medscape has a free online Physician Business Academy (wb.md/2DI8iGi) to help doctors manage the business and regulatory aspects of their practice, which contribute to burnout, Kane said.

Bernstein added that the Action Collaborative on Clinician Wellbeing and Resilience (bit.ly/2DHXUOV) has “important initiatives in progress to address this crisis.”

SOURCE: wb.md/2DHC51S Medscape, online January 17, 2018.

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