Senate spotlights physician burnout

Senators heard Feb. 11 that physician burnout is being driven less by bedside medicine than by the paperwork, approvals and compliance chores that increasingly define the workday. Witnesses warned that those pressures can translate into longer waits and reduced access to care. The Senate Special Committee on Aging convened “The Doctor Is Out: How Washington’s Rules Drove Physicians Out of Medicine” to examine how federal rules and administrative burden are accelerating workforce strain.

In testimony submitted to the committee, Jeffrey Smith, CEO of Piedmont HealthCare and incoming chair of the Medical Group Management Association, argued that documentation demands and regulatory complexity are pushing some physicians to cut hours, retire early or leave practice. MGMA cited survey findings that more than half of practices reported losing a physician to burnout in the past three years, and among those practices, more than 75% said regulatory burden played a substantial role.

Prior authorization and “nonclinical” work took center stage

A major theme was prior authorization, which witnesses and health care groups described as time-consuming for clinicians and staff and a source of delayed care.

MGMA’s testimony cited survey results showing 95% of practices called prior authorization a “significant burden,” and 85% said the burden increased over the past 12 months. The testimony also said more than 35% of surveyed practices employ at least three staff members per physician to help with tasks such as prior authorization.

The American Hospital Association, in its “Feb. 11 statement,” urged Congress to advance prior authorization reforms and argued payer processes remain fragmented and outdated. “Many insurers continue to rely on fax machines and call centers to process prior authorization requests,” the group said, tying the burden to care delays and clinician burnout.

Alignment, trust and autonomy became the retention test

The burnout debate is also colliding with a broader workforce reality. Practices often cannot solve retention problems with perks alone if clinicians do not trust leadership or feel they have control over how they practice.

In a January interview, Scott Polenz, a principal consultant in advisory services at CHG Healthcare, said his teams learned that engagement scores alone did not explain why physicians were unhappy because many clinicians “were engaged and wanted to be there,” but “just weren’t aligned with the mission, the vision, the values and our executive leadership.” See the Physicians Practice Q&A on “why physician alignment beats engagement perks when trust and autonomy are on the line.”

Polenz described alignment as a trust problem first, saying that improving retention “boils down to trust,” including “trust that we’re living our mission” and “trust in executive leadership.”

He added that physicians “truly care about quality of care and the patient experience” and want “to be able to practice medicine the way they want to practice medicine,” a point he framed as central to autonomy in clinical care, scheduling and long-term practice strategy.