The depletion of doctors costs the American health care system billions of dollars every year: shots

Physician burnout is costly for the US health care system – about $ 4.6 billion a year, according to a study released this week in the US Annals of Internal Medicine.

"Anyone who embarks on medicine knows that his career is stressful and that it requires a lot of work," said Lotte Dyrbye, a physician and professor of medicine at the Mayo Clinic in Rochester, Minnesota, who said co-authored the study.

She says the medical profession is now bearing increasing burdens of paperwork and bureaucracy, adding stress to the doctor's life. "We want to be able to provide quality care to our patients and our systems interfere," said Dyrbye.

The study defines burnout as an important symptom of "emotional exhaustion, cynicism and detachment from work, and a low sense of personal accomplishment". This description closely follows the definition recently updated by the World Health Organization for burnout.

To quantify burnout, the study's authors collected data from recent research findings and reports, including direct or inferred results for physicians reducing hours of work or shutting down their activities. as a result of burnout. They used a mathematical model to estimate costs associated with burnout, focusing on physician replacement costs and the loss of income from unfilled positions.

A previous study, which shares some of the same authors, found that 54% of physicians said they had experienced at least one burnout symptom, according to Maslach Burnout's inventory, a validated tool for measuring of burnout.

According to Dyrbye, research shows that physicians find meaning in helping patients, but are subject to a systemic burden that they consider tangent to patient care. "Cumbersome, ineffective" electronic health record systems, increased reporting requirements, and busy and irregular schedules give physicians the feeling of being socially isolated and lacking in autonomy.

"There is a general feeling of loss of meaning [to the work]," she says.

The authors of the study calculate that for health care organizations, the cost of burnout is $ 7,600 per physician per year. The study notes that their cost estimate is conservative, taking into account only the hours of work lost and the turnover of physicians. But other research shows that exhausted physicians are also more likely to make medical mistakes, have less satisfied patients and be sued for malpractice, resulting in indirect costs.

Constance Guille, a physician and professor at the South Carolina School of Medicine, who did not participate in the study, says it's important to highlight the economic costs associated with the study. ;burnout. However, she says that one of the weaknesses of the study is that it relies on inconsistent data, a problem identified in the literature: "We are not able to properly measure burnout ", she says.

Guille co-authored an article published last year in JAMA, who found at least 47 different definitions of "burnout" across 182 studies. From Guille's point of view, mental health diagnoses offer clearer indicators.

"Exhaustion is strongly associated with major depression," she says. "It's measurable, and we have very good interventions for that." She adds that focusing on depression "could improve the health of doctors and reduce the financial impact of burnout".

This study is accompanied by an editorial also published in the Annals of Internal Medicine by Edward Ellison, medical director of Southern California Permanente Medical Group, a health care provider on the Kaiser Permanente network that employs over 8,500 physicians.

He writes that burnout is associated with "anxiety, depression, insomnia, emotional and physical exhaustion and loss of cognitive concentration". But the most worrying, Ellison notes, is that the suicide rate among physicians is much higher than the general public and even exceeds that of veterans. "[W]We can not underestimate the urgency, the gravity and the tragedy of the human cost, "he writes.

According to the authors of the study, the exhaustion of doctors is a problem known for years. By imposing a cost on the problem and using the language used by policy makers and CEOs, they aim to compel organizations to act.

"We hope people will think about these numbers and say," If I invested half of that money in systems that improve work efficiency or build better teams to lighten some of the money. " This is a good thing to do, but it will also improve my quality and safety, and save me a few dollars at the end, "said Dyrbye.

Bottom line, she says, fighting burnout is not just a moral responsibility: it could also save money.

Pien Huang is NPR's Reflect America Fellow, helping to broadcast more diverse voices online and on the air.