2024 Burnout Trends for Physicians & Nurses

Erik Sunset [00:00:00] Hey folks. And welcome back. I’m Erik Sunset, your host, the DocBuddy journal here at DocBuddy. We deliver healthcare solutions and take the pain and costs at a broken workflows like Op Note, which gives ASC the power of instantly generated operative reports approved from the point of care. You can learn more about Op Note and our other solutions at doc, buddy.com. Thanks for joining us today. We have the unusual solo show after. Oh, gosh, a month and a half of ASCA focused podcasts and the run up to their annual conference.

Fantastic event. By the way, as it always was, this one was at the Gaylord palms in Orlando. Then we had Andrew level on the show, a widely recognized name and face in the ASC space. And all those episodes are available on dock buddy.com/blog, YouTube, apple, podcasts, and Spotify. So you can take a look back at our category. And today we’ve got something just a little [00:01:00] bit different for you. And in some ways it’s a callback to one of our very early episodes where we took a look. At an arch collaborative reports and arch collaborative of course is a part of the class research family. And they did some really good work and continue to do really good work, looking at factors that drive physician burnout.

Like I said, we looked at this really early on in this show episode. One, if I’m not mistaken. And today we are going to look at a newer version of the same type of reporting. It’s a class urge, collaborative reports, article titled understanding and addressing trends in physician and nurse burnout in 2024. Of course want to thank the authors of the report is written by Connor, BICE and miles Hepworth. Keep up the good work folks. And then. As we look to the new set of data.

The original report that we looked at was actually titled provider burnout has leveled [00:02:00] off. And if you’re a longtime listener of the show, you may remember that one. That was a, a fairly long monologue. Th digging deep into that report. I don’t think we’re going to go quite that deep into the report on today’s episode, but we do want to call out what’s changed. What’s the Delta between the data in that initial report we looked at, which was from 20 21, 20 22 versus 2018 to 2020 data. You all haven’t forgotten about the COVID-19 pandemic, have you so pretty timely a set of reports or datasets rather in that report looking pre and post pandemic. And we look back in time.

So again, this is the initial class. Arch collaborative report that we looked at the top contributors to burnout against the self-reported by physicians. Too much time spent on bureaucratic tasks. After hours workload. EHR or other it tools hurt my efficiency, no personal control over [00:03:00] my workload payout, a work environment. And so forth. Essentially each one of those majors. Increased post pandemic. And there’s a lot of reasons for that.

Obviously the pandemic drove a lot of heartburn and a lot of heartache in healthcare. so I’m not sure. That these things can be totally attributable, you know, in a vacuum to the self reported. Cause although some of them can. And then the one really interesting piece is when you look all the way down this list of contributors to burnout and that initial 2021 2022. 20 18 20 20 dataset. Staffing shortages.

We’re just about at the bottom of the list of only 13% of respondents giving that as a reason for their burnout. And we look at this new report. And the report has been published for a while. We’ll obviously share a link to that article in the show notes. When we share that we spread the love here to class because they do really good work. [00:04:00] But this new report shares that burnout rates remain higher than pre pandemic levels. And that they’re beginning to stabilize for some and slightly decline overall. Some of the other key takeaways from the headline with its staffing shortages have been increasingly mentioned as a contributor to burnout. For those in the ASC space in particular, those in the physician practice space and those, and any space healthcare they’ll know that that is a reality that they are having to face.

Practices. Physician organizations need to do more with less than they’ve really ever had to do primarily due to the inability to hire and retain staff as a whole. Now, obviously we talked to Andrew level of last week. wE’ve talked to Todd courier up in up in bend Oregon with the right culture and the right processes. You can still make your. You can still make your healthcare organization a really attractive place to work.

So that’s not to say that it can’t be done. The [00:05:00] times have certainly changed. Another key takeaway here is that those who have started to feel burnout, site efficiency, related issues, as reasons for it, all, those who are completely burned out. It’s like concerns related to the organization more broadly, like a lack of alignment from leadership.

And I think that’s a really interesting distinction because you have those who are starting to feel burned out versus those who were saying. I am burned out. I’m completely burned out. And then as a, sort of a no brainer here, the severity of clinician burnout and their likelihood of leaving their organization are strongly correlated. And for those who need a refresher on their high school statistics. Correlation shows that there’s some relationship between these two things.

There’s more of one. There might be more of the other. There’s less of one, there might be less of the other, or some combination of less and more. Causation would give you the reason why something is happening [00:06:00] and it’s fairly obvious. And the class report, can’t say this I’m not, I don’t want to put words in their mouth, but sitting in my seat here. The severity of clinician burnout and the likelihood of leaving an organization are not just correlated.

There’s causation there. And there’s a bigger macro picture to this, right? That there is an ongoing cataclysm that you’ve heard. And you mentioned before. We’re already seeing a shortage of physicians. The retiring early. Medical students aren’t going through medical school at the rate that we need them to, to replace these physicians retiring early or leaving medicine outright. So. There’s not really an answer for. Exactly why that’s happening on the medical school front. But clearly the severity of clinician burnout and the likelihood to leave an organization or leave medicine altogether. Pretty confident in the causation there.

What caught my eye and why we’re going back to this.

Well, then I think the reporting is really worthwhile and I’ll encourage you to [00:07:00] click through in the show notes, take a look at the data for yourself. If you’re a class subscriber, you get even more data. And as a matter of full disclosure doc, but he has no relationship with class. We are not a partner vendor. But they are a voice in the marketplace that should be listened to. And so coming back to the point here, the part that really surprised me was that the rates of self reported burnout have actually decreased. And there’s really great graph on the site that the trend in burnout among physicians and nurses from 2018 to 2023, you can see it’s a fairly positive trend line.

And by that, I mean, the. Rates of burnout. Go up over time from 2018 till 2021. You hit 20, 22 and it’s essentially flats. The data shows a one point difference or 1% difference in both the physician and nurse responses here. And then really unusually really surprisingly is that through 2023. And obviously we’re in [00:08:00] 2024 now.

So there isn’t any 24 Davids to look at yet, but the most recent data that is shared. Is that those. Rates of providers reporting burnout have decreased by two points, respectively for physicians and nurses down from 36 to 34 and then 34 to 32 for physicians and nurses. That is shocking to me with the amount of guests on the show who have shared just how tough times are both for their physicians, their staffs and their facilities. But I think that’s, that’s a good thing. I think. Because when you look at how data is captured, And how these surveys work, you know, are people acclimating like the frog and the boiling pot of water, or if you put a frog in a pot of just room temperature, water, and you put it on the heat. You know, it won’t jump out once that water starts to boil because it’s acclimated it is used to the hot water.

Whereas if you put a frog in a pot of boiling water, That jumps out, at least that’s what the The science says and the [00:09:00] old. The old trope would have us believe. So. Is there really a reason that burnout is decreasing or are we just acclimated to this new normal? I think that’s a fair question. That’s probably a little bit both as with most things, the answer will lie in the middle.

So we leaned really heavily on the contributors to burnout in this initial look at the arch collaborative data.

And again, going back in time. Too much time spent on bureaucratic tasks after hours workload and then EHR or other it tools hurt. My efficiency are the top three in that initial report. And I think those three things are interrelated. When you look at EHR after hours workload and too much time spent on bureaucratic tasks, we’d have to really kick the tires and get under the hood to know how this data was collected and how the questioning was phrased. You can point a finger at EHR for being the root cause of all three of these concerns, which would [00:10:00] make EHR far and away.

The number one contributor to burnout. We’ve talked about it at length on the show legacy tech. Doesn’t always have the physician first. At least in terms of their direct and explicit workflow and the way that they use these softwares. For a variety of reasons, which we won’t go over again. Looking at the new data, the newer data, because as we said, this report was published a couple of months back.

The new top contributors to burnout are. Staffing shortages. Too many bureaucratic tasks. A chaotic work environment, no control over the workload after hours workload and then EHR inhibits and efficiency. And that’s only about half the list or a third of the list of the contributors to burn out listed. And there’s a split between physician and nurse response. So just quickly here, unless it’s tough without a visual on screen and click through the link, you’ll be able to [00:11:00] check out the data for yourself, but a couple of call-outs that catch my eye. Staffing shortages worse for nurses and for physicians. Bureaucratic tasks. No control over workload after hours, workload, EHR inhibits and fish efficiency. And again, I think those things are pretty tightly related when the EHR system of record for our physician. All of those things are reported as worse by the physician. Then by the nurse. Now K out of work environment, does you pretty, pretty heavily towards a nursery response?

10% more or 10 points more on the nurse side than the physician side. So not a whole lot has changed with the exception of the staffing shortage. And we’ve had guests on the show before experts in medical office and medical facility staffing. There’s really an answer. Nobody can point to one thing over why it’s so difficult. For medical organizations to hire and retain staff. There’s paid [00:12:00] dynamics between the practice, the ASC and the hospital.

Who’s paying me the most. That’s certainly a factor. But even keeping that equal there, isn’t really a great reason why in 2024 and in 2023 as well, which is the data that we’re looking at. Why that is such a difficulty for these provider organizations. And I’ll share a quote here from the authors of the report. That quote in general physicians and nurses feel they’re overworked and those experiencing symptoms of burnout report, multiple contributors. End quote. So it’s important to note that this is not a single selection for your contributors to burn out.

It’s sort of a mix and match. You tell us which ones are hurting you. And those are all accounted into the same. Dataset. So it’s not just one thing. That’s driving a burnout sentiment in this reporting.

A couple more highlights. From the table on just physician [00:13:00] burnout. So you can take a look at the highlights for just nurse burnout in the report, but that the contributors to burnout for physicians who are burning or completely burned out is slightly different. And those that are completely burned out, obviously are saying things that are worse than those are just starting to burn out or beginning to feel that way. That the new control over the workload, the chaotic work environment, the lack of shared dies of leadership, lack of autonomy, EHR inhibits quality. Each of these things are worse for those that are completely burned out than those who are just beginning to feel that sensation.

And I think there’s something to that, that frog in the pot of water versus the frog and the boiling pot of water here. That if you are already fried, Anything else that could be the straw that breaks the camel’s back. And you just throw in the hat and say, I’m all done. Time to retire, tend to move into a different area where I can leverage my my medical degree. [00:14:00] But the bottom line from the report is that to alleviate burnout, both physicians and nurses want to improve staffing. And better alignment from leadership. Physicians also want improve DHR efficiency while nurses want better pay.

Now I don’t want to stick my nose into the nurse compensation discussion that is ongoing. We’ve seen a lot about this since COVID. You know, traveling nurses are able to sign huge bonus checks. Get a lot more money from their employer versus those nurses that aren’t traveling around and moving employer at whatever period of time. Certainly a factor there, those nurses that have stuck it out at their facilities or at their organizations. Feeling pretty hard done by those that show up for six months, nine months, whatever the case may be, make a ton more money and then leave. There’s even commentary out there that these Maine state nurses that aren’t moving around are having to pick up the workload for those that do move around.

[00:15:00]

When you look at sort of the, the end goal of getting reporting like this or statistics like this. At which is how do you. Fix it. What do you do to make things better class? Once again, did a great job splitting out nurse responses from physician responses, but there’s a few things that, that really stand out to me. Everybody wants improved staffing.

So more staff. Nurses are asking for that at a much, much higher rate than physicians are.

And that seems to make sense to me. When you look at the the work product of each type of clinician, obviously physician it’s very patient centric. Nurses knew one at all. So shout out to all of our nurses out there. This call is to me though, too. That the health care fix of just hiring somebody to solve a problem.

I think gone are the days of doing that regardless of the ability to hire and retain staff. Especially when there’s so much new and [00:16:00] so much good technology out there that can automate a lot of these paper moving processes or data moving around processes. You’re a lot of talk about AI in healthcare.

Some of the administrivia can be removed from the equation. If the provider organizations are willing to look at and adopt new technology. so Don’t want to say that that’s self-inflicted because there’s certainly a staffing shortage where being able to improve headcount, being able to improve the number of FTEs in your facility does and would make a difference.

However, Maybe you don’t need to hire quite to the pre pandemic levels that you think you do. If you’re using technology. As in like using doc, buddy. That you would think you’d have to.

Aligning leadership with physicians and nurses, it’s fairly evenly splits, providing better pace. Use really heavily towards nurses. Improving EHR efficiencies use really heavily toward [00:17:00] physicians. And let’s look at that for just one second, too. There’s certainly instances where EHR is. Just are not as efficient of the tool as they could, or that they should be, but let’s put a little bit of onus back on the provider here, too.

That there’s a. Basement threshold for buy-in and training and being able to learn the software that needs to take place. Still seeing that out there in the market. So that is not me being an apologist for the legacy technology that’s in use at so many healthcare organizations. But it’s a two way street to an extent that you’ve got to have that provider.

Buy-in.

And then looking through the rest of the list, you know, enhance EA our EHR education. That’s a very small subset. Of the responses on ways to alleviate burnout. Limited and toxic culture, improving quality of care, adjust patient message volume. These all really pale in comparison to improving [00:18:00] staffing, aligning leadership, better pay and EHR efficiency along with workload. Each of those sort of subsets and there’s even categories with less responses, these are five and 10% of those top four. Ways to alleviate burnout.

And just want to share a quote with drive this point, home around EHR problems quoted from the article, obviously.

So quote. My main pain points are one, the amount of work I take home and the amount of administrative work I do during nonclinical days with the added bonus that all administrative work is uncompensated. To the out of control. In-basket so inbox that I cannot keep up with. Three poor access to my patients because my schedule is filled up with other people’s patients. And for the fact that the panel size is too large and still growing resulting in us seeing an average of six to eight new patients per day.

Let’s break that down a little bit. [00:19:00] So pain point number one. The amount of work I take home and the amount of administrative work I do during non-clinical days. That’s uncompensated. That’s an EHR problem. That’s a lack of the right technology and not to lay down too thick, but obviously doc, buddy providers, whether they’re in the. Clinic. The ASC or whether they’re on call, you know, that’s one of our value adds to the market is that providers are able to have dinner with their families.

They’re not doing pajama time charting. They’re not having to work on the weekends. When they need to recharge and everybody needs to recharge, regardless of how big of a workaholic you think that you are, you can not be doing the same thing, 24 hours a day, seven days a week at forever. Eventually you break. So this pain point number one. Truly a legacy technology problem. Second pain point.

The out-of-control in-basket that I cannot keep up with. So I read in basket is in box it’s in basket and the article. That’s [00:20:00] tough. We’ve talked about this on prior episodes of the show. Some healthcare systems and some practices and organizations are charging now for patients to send messages to their provider via the patient portal. That puts the incentive chain in a little bit more alignment. You, if you really want to talk to our doctors, you you’re going to have to pay. There’s also been topics discussed on this very podcast that look at the ability for AI to respond to these sort of run of the mill messages. That brings along another set of hurdles and challenges for that provider organization, to be sure that AI is the right tool for the job.

And then it’s sending appropriate and relevant information back and keeping that message out of the provider’s inbox. And then three and four. Man. I’ve said it once I’ve said it a million times, this relates exactly and directly to this shortfall of physicians that we have, whether you’re in a major Metro, like I am down here in Miami or whether you’re in [00:21:00] a more rural area. Poor access to my patients because my schedule is filled up with other people’s patients. And the fact that panel size is too large and still growing resulting in us seeing an average of six to eight new patients per day. And if, if there were more providers, you wouldn’t have those issues.

So that’s a big problem to solve in this market. How do you get more people interested in becoming doctors? Or providers of any type or clinicians of any type. To be clear.

So that’s some of it’s catch 22, some of it’s a little bit chicken and egg, right? Like we look at all these We’ve got all this data around burnout providers are on data. Lake burned out. Nurses are undoubtedly burned out.

If you were going into a college. Would you really want to sign up for that career where you’re burned out all the time and all of your predecessors in that career path or retiring early or leaving medicine for. Just grinding it out. Becoming burned [00:22:00] out. And the answers now. So you need to be able to fix that. Better technology and you know, more recently being able to hire and retain employees. Aligning your leadership with physicians and nurses providing better pay. And better pay, man.

The reimbursement issue just cannot It just seems like there’s no end provider organizations are getting squeezed at every level.

All that to say, coming back to the central point, getting off my, stepping down off my soap box for just a second here. That you can fix this. Physician’s TA two of his top four. Two of their top four pain points with more providers being able to render service to more patients.

Oh man. So that, that got a little heavy and a little dark there.

There is a glimmer of hope. I think it’s more than a glimmer of hope too. I think it’s less a frog boiling in the pot without knowing it and more that things are starting [00:23:00] to turn a little bit. Of a corner. Better technology. Being able to keep physicians and physician clinicians focused on their work. The phrase is working at the top of their degree.

So you don’t have mid-level providers handling patient paperwork things of that nature. The, the. The medical organization, communities, seeing that those things don’t work, they’re seeing that you can’t just hire an FTE to solve a manual problem. That there’s a better way of technology with automation. With being able to move data around without needing to fax it. So. The fact that in this report, The trend and burnout is down from 2022 to 2023.

After it had increased for. Five straight years based on this data. That’s good. That’s a really good thing. And that makes me even more excited about we’re doing and what we’re building here at DocBuddy, to be able to give [00:24:00] providers more time for life. Fridays and their staffs for that matter. Being able to access, create and move data from the point of care.

That’s the key. More legacy tech does not fix the. Overarching concern with all of these burnout considerations. Which is the bad technology that’s so many have been forced to use for so long.

And as we look to put a bow on this Longer than intended monologue. There’s hope at the end of the tunnel, there’s a light at the end of the tunnel that isn’t a train rather. And on behalf of the entire doc, buddy team on the thank you for listening, be sure you’re subscribed on apple podcast, Spotify and YouTube.

So you can always hear and watch the newest episodes of the DocBuddy journal. And until next time I’ve been your host, Erik sunset. It’s been great. Talk to you again, Sam.