Reducing burnout: using doctors for their expertise

An increase in both administrative burden and caseload has left a growing number of clinicians fatigued and questioning whether they should remain in practice. America’s aging population will only exacerbate a shortage that already exists. Healthcare leaders must seek out innovative solutions to stem the tide of burnout and ensure clinicians are in the right mindset to provide high-quality care.

Suja Mathew, MD, FACP, chair of medicine at Cook County Health, notes that burnout doesn’t just present a problem for the bottom line—it can pose a serious risk to quality and safety. “We know when physicians are burnt out, they make more mistakes,” Mathew said, noting that an unhappy clinician also can lead to decreased patient adherence.

“Burnout, in most cases, is among highly motivated workers,” Mathew said. “The only way they achieve success is constant vigilance, which is why they’re burnt out when they’re overworked.”

The effort to stem burnout at Cook County started with residents. House staff were too often doing ancillary work like blood draws or patient transport—tasks that were below their license and typically performed by technicians. Mathew charged her residency program directors with creating a culture where it is unacceptable for residents to do work that does not belong to them, and rather “force the system to work the way it’s supposed to work.”

This virtue was eventually passed down to attending clinicians, who began to chip away at administrative work and bureaucracy in clinics. A pooled inbox strategy allowed non-physician team members to triage emails, and physicians have increased their use of templates and auto-text for EMR notes and email responses so that they can spend more time on care.

There is an unusual burden placed on doctors, Mathew noted: “Would you ask a chef to make high-quality food, bus tables, enter food into the electronic record, call the credit card company, wash dishes and seat guests?” she said, paraphrasing a 2018 article in The Atlantic by Rena Xu, MD.