Physician Burnout

Independent practitioners can make positive changes in their lives and practices 
By Susan Sirota, MD

EXPERTS SAY that about one in three physicians will experience burnout at some point in their career. Most cases are not caused by bad experiences with patients or patient communications. Rather, burnout is due largely to overwhelming administrative and clerical responsibilities as well as inefficient work processes that are interfering with our focus on our patients.

Given this growing epidemic, it’s critical to assess what it means for us. Consider how much we physicians have invested in becoming good doctors. We spent significant amounts of time, money and effort because we are committed to this path. And now, after years of practice and so heavily investing in our work and our patients, we must not only recognize burnout, but more important, make changes so we can return to enjoying the practice of medicine.

Understanding the Need for Change
There are three components to physician burnout: lack of energy both emotionally and physically, feelings of cynicism, and a low sense of personal achievement. Anyone suffering from extreme exhaustion simply can’t perform at their best. Physicians who suffer from these feelings aren’t going to be able to form a strong relationship with their patients, and eventually the overall care will decline.

Years ago, we trained to be physicians, not business owners. Fortunately, for more recently trained doctors, universities are recognizing changes in healthcare and its landscape, and are responding by offering alternative educational tracks such as business and healthcare policy. This shift in education presents a notable advantage for our younger colleagues.

But for independent physicians with plenty of years left to practice medicine, how do we maintain a workplace where physician wellness prevails?

Finding the Right Balance
Like everyone else, we need to set goals. Perhaps we can’t change the direction of healthcare, but we do have the power to change how we approach our work as a whole.

Independent physicians can start by taking a mental inventory of their work and consider what responsibilities they enjoy most. These responsibilities are often addressed by one of three approaches: 1) focusing more on the business side of your practice; 2) dedicating more time to practicing medicine than running your business; or 3) deciding you want to do both equally. The key to success is finding the right balance, one that enables you and your practice to thrive.

Once you’ve reflected on your responsibilities and set your goals, you can assess how you are going to achieve them and who is going to help manage each of the responsibilities. To do this, you need to evaluate which aspects are weighing you and your practice down and look at some of the demands outside of caring for patients.

For me, in addition to caring for patients, my partners and I were juggling everything else that comes along with owning a business. This included HR, operations, business development and revenue cycle management, to name a few. We realized we needed to develop a plan and delegate responsibilities to alleviate some of these burdens.

It is extremely difficult to find one person with a broad enough skill set to manage all the business functions successfully. Hiring outside experts to assist with practice management can be highly effective in preventing the kind of exhaustion to which we are all susceptible, and in promoting the success of your practice.

For us, it made sense to outsource our revenue cycle management. Our internal billing team was excellent, in fact, it was so good that not only did we outsource, but we also formed a billing company, separating it from the practice completely. And we did this with an important goal in mind: to help other independent physicians successfully navigate the tedious, time-consuming, complicated, and exhausting realm of revenue cycle management that can contribute to physician burnout.

Prioritizing Wellness
As physicians, we focus on the care of our patients and their health. We must do the same for ourselves. Though difficult, recognizing the signs of burnout is an important first step. Setting goals to strike a healthy balance comes next. This balance is very individualized. For some, it might be outsourcing internal processes that are inefficient or ineffective, and put your practice at financial risk. For others, it might mean internal changes.

Whatever your solution, it must start with thorough self-reflection. Prioritizing physician wellness will be better for you, your practice and your patients.

Dr. Susan Sirota has been a practicing pediatric physician for over 20 years. In 1993, she founded Pediatric Partners practices in Highland Park and Vernon Hills, which later merged with eight other practices to form PediaTrust, LLC. She also serves as the chair of the PediaTrust Board of Managers. Dr. Sirota is an assistant professor in clinical pediatrics at Northwestern University Feinberg School of Medicine.
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