Alcoholism, broken relationships, depression, despair, suicide.
These all are are symptoms of physician burnout, a growing problem that affects more than half of U.S. physicians, according to a 2015 study in Mayo Clinic Proceedings. That represents a sharp increase over the previous five years.
In central Indiana, some health systems are taking steps to deal with a problem that, left unchecked, could lead to decreased quality of care, increased medical errors, high turnover and decreased patient satisfaction.
Community Health Network has set a Center for Physician Well Being and Professional Development. The center, launched this month, brings in speakers for physicians and offers a website with tips on how to recognize and deal with burnout.
Community has also entered a contract with Vital WorkLife, a national behavioral health consulting company based in Minneapolis that offers a raft of offerings, from “virtual concierge services” that help stressed-out docs deal with personal daily living tasks to professional counseling and confidential referral services for chemical dependency.
The service costs Community about $96,000 a year. But leaders there say it’s worth it to raise awareness and to keep good doctors from engaging in self-destructive behavior that could hurt them, their families and their patients.
On top of that, it’s a lot cheaper than the cost of recruiting a new physician, which can run up to $250,000, said Dr. Kevin Coss, medical director of Community’s Physician Well Being program.
Too many physicians are afraid to seek help for fear of stigma and possible repercussions from state medical authorities, he said. Offering them confidential resources from an outside provider is one way to encourage them to seek help, he said.
“The money you invest in programs like this is money well spent,” Coss said.
Indiana University Health, the state’s largest health system, found a strong voice for the issue earlier this year when Dr. Adam Hill at Riley Hospital for Children wrote a first-person article in the New England Journal of Medicine discussing his depression, alcoholism and suicide attempt.
“In the past year, two of my colleagues have died from suicide after struggling with mental health conditions,” Dr. Hill wrote in the New England Journal. “On my own recovery journey, I have often felt branded, tarnished, and broken in a system that still embroiders a scarlet letter on the chest of anyone with a mental health condition. A system of hoops and barriers detours suffering people away from the help they desperately need—costing some of them their lives.”
Hill also delivered a grand-rounds lecture to 200 people at Riley, telling his own story of addiction, depression, and recovery.
“Afterward, hundreds of emails poured in from people sharing their own stories, struggles, and triumphs,” Hill wrote. “A floodgate of human connection opened up. I had been living in fear, ashamed of my own mental health history. When I embraced my own vulnerability, I found that many others also want to be heard—enough of us to start a cultural revolution.”
He now speaks widely about the issue and helps other physicians suffering from burnout seek help.
At Eskenazi Health, administrators say their goal is to allow physicians to spend 20 percent of the time doing work that is meaningful to them, such as teaching, mentoring and community service.
Yet the overall issue might be bigger than any health system can solve on its own, said Dr. Lisa Harris, Eskenazi’s CEO, said at an IBJ Health Care & Benefits Power Breakfast last month.
“I think we can't discount the impact of the fatigue and the discouragement that comes with constantly pushing a bat against a growing burden of chronic disease, a lot of which is not within the control of physicians,” Harris said. “These are social and environmental factors beyond our control. We spend a lot of time working with our patients helping them to move more, eat better, quit smoking, but our patients can't do it alone. We need investment in public health and policy change.”
At Franciscan Health, treatment for physician burnout runs the gamut from therapeutic massages to mentoring programs with retired doctors, said Dr. Christopher Doehring, Franciscan’s vice president of medical affairs.
“We want to increase awareness of this issue and acknowledge it,” Dr. Doehring said. “It’s the first step.”
At St. Vincent Health, administrators say the current health-care environment is full of stress from the demands of electronic health records to policy debates in Washington, which often leads to physician dissatisfaction.
“The provider purpose—caring for the sick—is sometimes compromised by the challenge of managing paperwork and insurance demands while simultaneously facing the uncertainty of health care reform,” said Dr. Joseph Cacchione, medical group president of St. Louis-based parent Ascension.
He said that Ascension’s move to a “team care approach” takes much of the administrative burden off of our physicians.
“We have seen elevated provider satisfaction and engagement,” he said.