A Cost-Consequence Analysis of Physician Burnout
Han and colleagues developed a mathematical model to estimate physician burnout costs. The researchers used this model to estimate fiscal impact on the U.S. healthcare system using a cost-consequence analysis. Specifically, the authors focused on the costs of turnover and reduced clinical hours.
The researchers gathered input from a literature review of recent, pertinent, peer-reviewed journals. Costs were inflation-adjusted via the Consumer Price Index medical care component. The researchers described their model’s primary output as burnout-attributable cost.
The researchers estimated national burnout-attributable costs at between $2.2 billion and $6.7 billion annually. The model did not include other potentially negative costs associated with burnout such as decreased patient satisfaction and malpractice lawsuits. Therefore, Han and colleagues characterized their cost estimates as conservative.
The study authors wrote, “Traditionally, the case for ameliorating physician burnout has been made primarily on ethical grounds. Our study provides the tools to evaluate the economic dimension of this problem…our results suggest that a strong financial basis exists for organizations to invest in remediating physician burnout.”
Characteristics of Physician Burnout
Social and health psychologist Christina Maslach, Ph.D., professor emerita of psychology at the University of California at Berkeley has characterized workplace burnout symptoms to include three primary features:
- feelings of emotional exhaustion
- a lowered sense of personal accomplishment
- a sense of detachment or cynicism related to work
Authors of the Annals study report that research indicates over 50% of physicians identify at least one burnout symptom, roughly twice the instance reported by the general population. Possible contributing factors include high patient volumes, difficult work hours and the increasing demands of electronic record keeping.
Physician burnout symptoms can also lead to a decreased quality of care for patients. Extensive electronic documentation protocols often pressure providers to decrease patient care time in order to satisfy clerical requirements.
Dr. Ellison stated in his editorial that “An unwell and unhappy workforce may result in high turnover and replacement, low-quality care, a high risk for medical errors and malpractice claims, and suboptimal outcomes.”
Psychological Costs of Burnout
Physician burnout also has high psychological costs.
Dr. Ellison wrote that “beyond the anxiety, depression, insomnia, emotional and physical exhaustion, and loss of cognitive focus associated with physical burnout, an estimated 300-400 U.S. physicians take their lives every year.” Dr. Ellison reported that the suicide rate among doctors is 40% higher for men and 130% higher for women than general population suicide rates.
Ellison cited suicide rates among physicians as higher than those among combat veterans and wrote “Although the fiscal impact of physician burnout is important, we cannot underestimate the urgency, severity, and tragedy of the human cost.”
