Physician Burnout and Healthcare Quality - a Chicken and Egg Conundrum

Posted by Dike Drummond MD

physician-burnout-quality-of-care-chicken-and-egg-OPT150WThere is plenty of evidence that Physician Burnout has a negative effect on a doctor's quality of care

Make's sense, right?

If you are a physician who is

  • exhausted
  • cynical and sarcastic
  • and doubting that your work is making a difference

- BTW, these are the three cardinal symptoms of burnout
If that is the way you are feeling today at work, you care clearly not on your "A" Game as a clinician and healer ... right? Oh yes, and in the average healthcare workplace, 50% of the doctors are suffering from at least one symptom of burnout on each practice day.The question for physician leaders is a simple WHY?

Why are so many of your doctors burned out?

Quad Aim Physician Leader Retreat

Please don't doubt their Resilience.

Physicians are some of the most resilient people on the planet. We survived residency for heaven's sake. That should be all the evidence you need of our ability to take a lickin' and keep on tickin'.

  • We are some pretty tough CANARIES.
  • What is it about your COAL MINE that is taking us down?

Yes, burned out doctors provide lower quality care.
And I invite you to dig a little deeper. Notice that the doctor's level of stress and burnout and the quality of their care are in a reciprocal relationship.

The burnout - quality of care link is actually a CHICKEN AND THE EGG CONUNDRUM.

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Which of these comes first?

If you are Burned Out ... it has an effect on the quality of care you deliver

This loop is well understood, well documented in the existing quality literature and being actively studied.

If you are locked in a system that destroys your ability to offer the highest quality care
... that causes physician frustration and burnout

THIS LOOP is NOT being studied or looked into in any detail. It is one of the elephants in the room whenever I talk about burnout with senior physician leaders.

Now that the majority of US physicians are employees, healthcare leaders everywhere need to understand this return loop -- where poor quality drives physician burnout -- as a key cause of physician stress.

If the doctor does not control their practice
- and the employer's systems of care prevent an adequate level of quality - physician burnout and turnover is the result.

Every healthcare delivery system has some combination of the following - these are some of the major causes of Physician Burnout:

  • Inefficient patient flow and scheduling systems inside your organization
  • Understaffing in the back office - not enough hands on deck
  • The well documented overwhelm of EMR and other digital tasks
  • The blizzard of quality indicators and payor rules and denial of treatment authorizations


Which begs these questions ... 

  • What is it about your workplace that interferes with providing the highest quality care to your patients?
  • How stressful is this quality of care blockage to you?
  • When you raise your quality concerns, what reaction do you get from your leadership team?
  • Have you ever quit a job because of an avoidable quality issue - something your employer simply would not address?
  • If yes, what was the issue and what reasoning did your employer give for not addressing it.

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Tags: Physician Burnout