Editor’s Note: Dr. Kapil Parakh, MD, MPH, PhD is a practicing cardiologist, medical lead at Fitbit and the author of “Searching for Health.” The opinions expressed in this commentary are his own.
Almost two decades ago, I was a resident physician working in the Cardiac Intensive Care Unit at Johns Hopkins Bayview when I got word that my mother had been diagnosed with metastatic breast cancer. Despite feeling supported by those in my residency program, my first instinct was not to fly to India to be with her as soon as possible. Instead, I thought about what would happen to my patients and how much of a burden I would be putting on my fellow residents who would be pulled from other rotations to cover my shifts. I finished up my shifts and by the time I got to India, she had already undergone surgery.
It quickly became clear to me that I had made the wrong call. I should have been with my mom, helping her navigate the system and make more informed choices about her treatment. Thankfully, my mom did well and is still alive today. As painful as it was, the lessons from that period stuck with me, and I have tried hard not to let work overwhelm the rest of my life.
Unfortunately, I routinely come across friends and colleagues in medicine who struggle to strike the right balance between work and personal life. It often takes a toll on their health or relationships — or both. These anecdotes are indicative of larger trends, with 47% of physicians in the US saying in a 2021 survey that they felt burned out. The impact of health care worker burnout is felt across the health system with unprecedented staff turnover and resignations.
One of the most tragic examples of burnout is Dr. Lorna Breen, an emergency room doctor in New York who died by suicide in 2020, overwhelmed by the toll of the pandemic. But as recognition of the problem becomes more widespread, there is hope for relief. Recently, Congress approved a bill in Dr. Breen’s honor, and President Biden signed it into law. It will provide support for health care workers, including up to $135 million over three years for training providers on suicide prevention and behavioral health, and awareness efforts to improve mental health among medical workers.
This is an important start, and one of the first national efforts at supporting health care workers, but it is only the beginning. Research into mental health is as critical as raising awareness of the issues. There is so much we don’t know: What roles and specialties are experiencing effects of burnout at the highest rates, and therefore which workers are most at risk? Can we identify vulnerable workers before they experience burnout? How can we prevent it? How do we do any of that at a cost that is not prohibitive to health systems, many of which are already strapped for budget?
While the additional funding from the Dr. Lorna Breen Health Care Provider Protection Act will provide much-needed support in finding answers to these questions, health care organizations will also need to ensure they’re putting their employees’ mental and physical health front and center.
Here’s where they can start:
Provide more support
Similarly to how airlines recommend passengers put on their own oxygen masks first before helping others, health care workers need to prioritize their own well-being. Providing resources to those with poor mental health could help them cope and build up resilience. We’re seeing more health systems providing a variety of benefits to their employees, including mental health tools like on-site counseling for staff, flexibility in scheduling and support groups. For instance, Boston Medical Center offers a program for staff dedicated to teaching mindfulness, which includes weekly group discussions, guided meditations, yoga and more.
Spot burnout early on
A second priority is to better identify those at high risk. Burnout happens when a vulnerable individual is placed in a high-stress environment. Instead of waiting for burnout to happen, it’s possible to detect and intervene before things get too severe. Research shows that factors like practice size and tenure may influence burnout.
Health system leaders should facilitate regular meetings between management and their direct reports to see how they’re doing, prioritizing clinicians who are early in their careers, along with those who are practicing in understaffed areas, and those who are dealing with high-acuity patients, witnessing severe disease and death. It’s important to make it easy for workers to come forward and ask for help — and normalize doing so — through different channels or forums.
Implement operational improvements
Perhaps most importantly, efforts to support health care workers should be coupled with organizational changes. Many health care workers spend hours on administrative tasks and documentation, dealing with inefficient technology systems. Better technology and processes can help them to be more efficient and save time on administrative work. Health systems can seek out solutions to help solve for electronic health record and documentation-related burdens, in particular, like tools that make it easier to find buried information, or artificial intelligence that assists with note-taking.
Further, companies should hire more workers. When units are short-staffed, the existing workers often have to take on more responsibilities. Careful attention to workload can offset some of these burdens. For instance, clinicians would benefit from dedicated help making templates or order sets for common situations to help save time, or administrative staff can manage some tasks that don’t necessarily require a doctor.
Lasting change will require dedicated and continued efforts from health system leadership, policymakers, technology companies, researchers and each one of us. I think we can all agree that tackling health care worker burnout is a worthwhile investment. Let’s make sure we’re using every tool in our toolbox to support the physical and mental health of the dedicated professionals who heal us every day. That is how we can truly honor Dr. Breen’s legacy.