Physician Burnout Poses Risks to Patient Safety

Burnout can have profound physical and emotional consequences on physicians. A large meta-analysis published today in JAMA Internal Medicine now clarifies the adverse effects of physician burnout on patient care. The meta-analysis found that physicians with burnout are twice as likely to be involved in patient safety incidents, more than twice as likely to deliver suboptimal care due to low professionalism, and more than twice as likely to receive low satisfaction ratings from patients.

“We found that physician burnout is associated with a reduced efficiency of health care systems to deliver high quality, safe care to patients,” wrote Maria Panagioti, Ph.D., of the University of Manchester, United Kingdom, and colleagues. “Preventable adverse events cost several billions of dollars to health care systems every year. Physician burnout therefore is costly for health care organizations and undermines a fundamental societal need for the receipt of safe care.”

Panagioti and colleagues combined data from 47 separate studies that encompassed 42,473 physicians. The combined analysis showed that physician burnout was associated with a 1.96-fold increased risk of patient safety incidents (such as adverse events due to giving improper medications), 2.31-fold increased risk of poor quality of care due to low professionalism (such as failing to make proper referrals), and 2.28-fold increased risk of reduced patient satisfaction reports. Emotional exhaustion, depersonalization, and a lower sense of personal accomplishment all contributed to these adverse patient outcomes, though depersonalization showed the most adverse association with the quality and safety of patient care and with patient satisfaction.

The authors also found that the association between burnout and low professionalism was particularly strong in residents and early-career (≤5 years post residency) physicians compared with middle- and late-career physicians.

“It is likely that burnout signs among residents and early-career physicians have detrimental associations with their work satisfaction, professional values, and integrity,” Panagioti and colleagues wrote. “Health care organizations have a duty to support physicians in the demanding transition from training to professional life. Residents will be responsible for the health care delivery for over two decades in the future. Investments in their wellness and professional values, which are largely shaped during early-career years, are perhaps the most efficient strategy for building organizational immunity against workforce shortages and patient harm/mistrust.”

To learn more about individual and organizational interventions for burnout, check out APA’s Wellness Toolkit.

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APA Urges Budget-Cutting Committee To Spare GME Funding

APA has joined with organizations representing almost every medical specialty in calling on the congressional budget-cutting "supercommitee" to protect graduate medical education (GME) funding that comes through the Medicare program. Coalition members sent a letter to committee members October 3 saying that they "are gravely concerned that reductions in Medicare's support for GME potentially worsen an already problematic national physician workforce shortage." That shortage is expected to soar to 91,500 in 2020 because of an imminent wave of physician retirements and rapid aging of the U.S. population. The current cap on GME funding is already preventing teaching hospitals from expanding training positions and prevents new hospitals from establishing teaching programs, the coalition emphasized. "Ensuring access for Medicare beneficiaries requires long-term and rational physician payment reforms, as well as an adequate supply of physicians to care for an aging nation," the letter states.

Read more about how the budget crisis may affect Medicare's funding of graduate medical education and payment for physician services in Psychiatric News at http://pn.psychiatryonline.org/content/46/16/1.2.full.

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Psychiatrists Urged to Fight Threat to Graduate Medical Education

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 APA is urging its members to contact their U.S. senators and representatives to register their oppostion to a plan that would save money in the Medicare program by slashing the funds Medicare pays to support graduate medical education throughout the country. Raised as one strategy in Congress's contentious debt-reduction negotiations, the cuts to teaching hospitals that train residents in primary care and specialties such as psychiatry could total between $14 billion and $60 billion over 10 years. APA emphasizes that such cuts would seriously jeopardize "the country's ability to care for an aging population and close a projected physician shortfall." 

APA members can call their senators and representatives using APA's toll-free hotline at (866) 727-4894 and leave a message urging them to oppose deficit reduction that guts funds for graduate medical education. 

Read more about Medicare issues affecting graduate medical education and patient care in Psychiatric News at      http://pn.psychiatryonline.org/content/46/5/15.1.full and http://pn.psychiatryonline.org/content/45/10/15.full.