Healthcare is changing. Many improvements have been made to streamline work, create better quality care, and lower costs in medicine. Initiatives around EHRs, public reporting and transparency, and patient portals all aim to achieve these goals. And while improvements like these are important to success in healthcare, they also change how medicine is delivered — and that, in turn, can have some collateral damage: professional burnout.
Burnout in practicing radiologists increased from 36 percent in 2013 to 49 percent in 2017, according to a task force report published by the Association of University Radiologists.1 And those increases can cost the field of medicine. Burnout can contribute to an increase in medical errors, a decrease in productivity, and an overall decrease in morale, says Lori Deitte MD, FACR, chair of the ACR Commission on Publications and Lifelong Learning and professor of radiology at Vanderbilt University Medical Center.
Finding the Cause
Professional burnout can have many causes, but it is primarily caused by workload issues, says Lotte N. Dyrbye, MD, MHPE, an internist at the Mayo Clinic whose research focuses on the well-being of medical students, residents, and physicians. “Burnout is driven by factors such as high work load, lack of social suppport
at work, and problems with work-life integration, but it is also due to things such as practice inefficiencies: how much time a physician has to spend entering information into an EHR or managing their inbox — as opposed to activities they find meaningful — has a huge impact on a physician’s wellness,” Dyrbye says. “It’s difficult for physicians to find meaning in their work when they’re spending two hours on clerical tasks for every one hour they spend on patient care.”
Adds Deitte, “Increased administrative burdens related to credentialing, licensing, certification, and other training requirements, coupled with increased workload, all add to burnout. These factors can result in little or no time for lunch or other breaks during the work day.” Burnout is often seen in physicians who feel they have little sense of autonomy. “As organizations merge, physicians who were leaders in private practice, who find themselves now employees, struggle with a sense of powerlessness and loss of flexibility, which significantly impacts their well-being,” says Dyrbye.
Addressing Burnout at All Levels
Many aspects of medicine affect burnout, but there are also aspects that can help combat the condition. Radiologists can fight burnout at three levels: individual, leader, and organization, says Dyrbye. Work at the individual level often includes things radiologists have heard before and should try to incorporate into their busy
schedules. “Exercise, designating time for hobbies and other interests, and spending time with family and friends are important in combatting the work-life struggle that many physicians feel,” notes Deitte.
However, because burnout is often caused by workplace issues, focusing only on individual interventions may not truly address the problem. “When the emphasis is placed solely on individual strategies, there is an implication that burnout is caused by a weakness or lack of coping skills in the physician,” says Dyrbye. “That implies that the physician is in fact the problem, and the true issues never get addressed.”
Attacking From the Top
Physicians can also combat burnout at the leadership and organization levels. Empowering physicians to create meaning in their work is critical, says Deitte. “Studies have found that if an individual spends at least 20 percent of their time on a meaningful activity he or she is passionate about, that individual’s work satisfaction increases.”² For Deitte, part of this means spending time with patients, an interaction she is able to have when performing ultrasounds.
But what about radiologists who don’t manage their schedules? That’s an opportunity for leaders to get to know individual physicians, says Deitte. “Practice and department leaders need to learn what really motivates the people on their team and try to arrange the schedule so that people can spend time each week on that meaningful activity,” she says. “Often it works out because not everyone enjoys performing the same activities.”
As organizations merge, physicians who were leaders in private practice, who find themselves now employees, struggle with a sense of powerlessness and loss of flexibility, which significantly impacts their well-being.
Effective leaders who are liked by their colleagues also contribute to work satisfaction, says Dyrbye. “Physicians who rank their immediate supervisor highly in
factors such as respectfulness, seeking others’ opinions, and encouraging their team to develop skills often report a higher job satisfaction,” she notes.
According to Dyrbye, practice leaders also have a responsibility in managing workload inefficiencies, such as advocating for adequate resources and working to optimize flexibility and autonomy through changes in policy — all of which can help decrease some of the frustrations that occur in the workplace.
Improving the Specialty
Finally, there’s work to be done at the organizational level. For some, this means getting involved in professional societies such as the AMA and working with these organizations to change policy, says Dyrbye.
The ACR also has a role to play in fighting burnout. In its strategic plan, the ACR lists enhancing wellness among radiology professionals as a priority — and the organization is making headway on that goal. After being inspired at the 2018 Intersociety Meeting, the Commission on Human Resources and the Commission on Publications and Lifelong Learning formed a workgroup that created the Radiologist Well-Being Program — a resource comprised of a validated well-being self-assessment, a toolkit of resources for recovery, and an educational curriculum for strategies to promote improved well-being.
“The first step in combatting burnout is to recognize the early at-risk signs and have access to resources and strategies to improve well-being,” says Deitte. “The Radiologist Well-Being Program can help you do that.”