As more burned-out physicians cut back on hours, retire early, or give up practicing entirely, those who remain are more overworked and at greater risk of burnout, creating a vicious cycle. While it can be difficult to establish direct links between the physician shortage and burnout, it is worth noting the considerable overlap between specialties where the shortage is most severe and specialties where burnout is increasing most rapidly, experts say. Family practice ranks high on both lists, for example.
"A lot of family practice doctors are seeing up to 40 patients a day," says John Cullen, President Elect of the American Academy of Family Physicians, who practices family medicine in Valdez, Alaska. "At that rate, you don't have much time with each patient. That can take a lot of joy out of it."
According to a 2017 report commissioned by American Association of Medical Colleges, the medical field is facing a serious supply and demand problem. Several factors contribute to the shortage of physicians: a growing and aging population, as well as increasing numbers of people covered by insurance or Medicaid. Without changes in physician training, the physician shortage is expected to reach near crisis proportions by 2030.
If overwork is already contributing to burnout, this data suggests that things are only going to get worse. However, there is hope on the horizon. Janis Orlowski, chief Health Care Officer for the AAMC points out that efforts to increase the numbers of medical students have been effective. "Next year we will see a 35-percent increase in the number of medical students graduating," she says. Enrollment in medical school is up as well. Overworked doctors can take heart — help is on the way. But physicians who are already working need relief now.
It Takes a Team
In today's healthcare environment, it takes a team to treat a patient. A well-functioning team of nurse practitioners, physician assistants, and other advanced practice providers can make a huge difference in how much time you spend with your patients (and how much time you get to spend with your family). Of course it's not enough to hire these clinicians and give them the same tasks as people with less training. You have to organize your practice in such a way that these professionals really do take the pressure off you. "We have to ask ourselves how do we work with other professional colleagues? If we want to grow strong inter-professional teams, we have to define the roles and plan how we will work together," says Orlowski.
Not all team members need be clinicians. Much of the excess physician workload is due to administrative burdens created by EHRs. In this instance, scribes can be the solution to this problem. Scribes can document visits in the EHR, gather pre-visit patient info, track down lost labs, and generally cover all the clerical duties that otherwise you would have to do. Some studies have found that the use of scribes can increase physician satisfaction. "Pass the 'make-work' on to somebody else," says Cullen. Then you can get back to practicing medicine.