This is Part II of our three-part research series with LeverageRx, an online financial marketplace exclusively for doctors.
Changes in healthcare often have a domino effect on employees and patients. The medical profession has to evolve and change to share the latest in medical findings. But what if those changes cause the people that patients depend on to burnout? Recent changes in the industry are taking a serious toll on physicians.
Medscape’s annual Physician Lifestyle Report surveyed more than 15,000 physicians from 29 specialties. Of survey respondents, 42% of physicians reported burnout.
Could change in the healthcare industry be boosting the number of physicians who experience burnout? What factors could be contributing to physician burnout?Let's take a closer look at the four most common causes of physician burnout in 2018.
Relationships
Mergers and acquisitions are on the rise in healthcare. In fact, they were up 57% in the first half of 2018 compared to the same period of 2017 per
The Wall Street Journal.
Nowadays, it can be rare to find a physician who isn’t practicing within a large healthcare group.
Due to the rising costs of owning your own practice, joining a healthcare system may seem like a no-brainer. For physicians, it means less to worry about when it comes to things like:
- New technology.
- Medical equipment.
- Insurance.
But does joining a healthcare system alleviate physician burnout? Or could it actually be adding to it?
On one hand, these large healthcare systems can be a great fit for physicians:
- With no time to run their own practice.
- Looking to take on less risk.
On the other hand, large healthcare systems can be a source of stress for patients. And that patient stress often ends up taking a toll on their physician.
Healthcare systems tend to increase efficiency by utilizing multiple locations and specialties. For patients, this may have removed the basic comforts of seeing a local physician. Instead of calling the office’s front desk, patients pass through large, automated phone systems. Other factors that may cause stress for ill patients seeking treatment include changes in:
- Location.
- Hours of operation.
- In-network insurance.
As physicians advance in their careers, their workload grows. This often times means they can no longer communicate with patients like they once could. The endless chase for answers can cause damage to the relationship a physician may have spent years building.
33% of physicians surveyed said that they're easily exasperated with patients. 32% said they are less engaged with patients due to physician burnout.
Could this loss of loyalty be adding to physician burnout?
Loyalty
When patients lack loyalty to physicians, this causes a lack of enthusiasm for physicians. Patient loyalty may decrease due to the healthcare system and the absence of a personal touch.
An underlying reason for the lack of patient loyalty to physicians is insurance. For patients and healthcare systems, coverage is subject to constant change. As of 2018, many health systems see this as a concern for their business. As a result, many have transitioned from volume-based care to value-based care. Utilizing a value-based strategy should help health systems rebuild lost patient relationships. Value-based care restores relationships by offering patients easier communication and more convenience. This shift to a value-based strategy will affect physicians in several ways, including:
- An increasing focus on technology.
- A more holistic approach to health in the community.
Due in part to this lagging patient loyalty, physicians do not receive the praise they once did. For most physicians, the reward they seek goes beyond their paycheck. Patient approval justifies their hard work as time well spent. This attitude shift toward the medical profession raises concerns when considering the results of a recent
Prophet/GE study. It found a staggering 81 percent of consumers are unsatisfied with their healthcare experience.
Emphasis on Profits
For many healthcare systems, a value-based strategy may cause additional physician burnout. This strategy requires physicians to perform more administrative tasks, which takes away from patient care.
For example, if testing is required under this type of strategy, it would be imperative to explain as to why the additional testing is needed. Not only is there more paperwork that falls on the responsibility of physicians, but there could be less
staffed physicians. In addition, health systems routinely only contract with a percentage of physicians of one type of specialty. This lack of staff depth leads to:
- Longer regular working hours.
- More overtime hours.
- More on-call duties.
The medical profession already faces a great deal of pressure and stress. Add to this a lack of work-life balance, and naturally, they are at a greater risk for depression and burnout.
Health systems are often for-profit based organizations. Like any industry, the desire to drive bottom lines is huge.
According to the
2018 Medscape compensation report, physician salaries have been on a steady incline. Supply and demand for physicians is as strong as ever. But for physicians who feel overworked and undervalued, the minor salary bump may not be enough. According to the
Medscape National Burnout & Depression Report of 2018, here are the top three contributing factors:
- Too many bureaucratic tasks (paperwork) – 56%
- Spending too many hours at work – 39%
- Insufficient compensation – 24%
Student Loan Debt
Physicians illustrate a concern for financial wellness.
To pursue a career in medicine, most need student loans to finance their education. In turn, seventy-five percent of medical school graduates begin practice with debt. What's worse is that the
average medical school grad carries $192,000 in debt. It’s no surprise that the burden to pay off these loans can cause extreme financial strain for young physicians. And although many overcome to lead successful careers, some never fully recover.
According to the
Medscape Physician Wealth and Debt Report of 2018, most school loans are paid off by age 50. Thirty-two percent of physicians surveyed were still paying down their own student loan debt from medical school.
With so many physicians paying down
student loan debt, it's no wonder their financial outlook is unique. More money for student loan payments means less money for lifestyle spending and retirement planning. This financial stress extends beyond large monthly payments, too. It also impacts their experience as
first-time homebuyers.
In addition to the long hours physicians typically work, they now have little money to add to their budgets. In fact, 24% of physicians in the Medscape survey said that insufficient compensation contributed to their burnout. And when asked what could be done to reduce burnout, 35% said: “increase compensation to avoid financial stress."
In a large healthcare system, it can be tough to stand out. Most CFOs are not closely involved with physicians. This lack of engagement means physicians are less likely to get the financial resources they need. Most raises and bonuses in large healthcare systems come at a preset rate or a generic structure. As a physician,
refinancing student loans can offer significant cost savings.
Depending on the repayment plan, this is possible both:
- Over the life of the loan.
- On a monthly basis.
Large health systems should consider offering
student loan debt assistance to physicians and other employees.
Key takeaways
Like student loan debt, physician burnout is a crisis affecting the healthcare industry today. Based on our research, the former is actually fueling the latter. But that's not the only culprit. Other leading causes include:
- Less meaningful relationships.
- A decline in patient loyalty.
- Profits over work-life balance.
The healthcare industry is subject to constant change. Although advancements in medicine are needed, they should not overshadow those who provide care. Prioritizing the personal and financial well-being of physicians is the first step to overcoming the burnout crisis.
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