National Academy of Medicine calls to improve professional well-being of clinicians

In a consensus report released Wednesday, Oct. 23, the National Academy of Medicine makes recommendations for system-level change needed to improve the professional well-being of clinicians, students and trainees across health care.

Clinician burnout has been identified as a major problem in the U.S., affecting 35%–54% of nurses and physicians, and 45%–60% of medical students and residents. Some research suggests that these numbers are reflected in all areas of health care (oral, pharmacy, etc.). Along with burnout comes a corresponding threat to organizations' abilities to provide high-quality patient care.

Lotte Dyrbye, M.D., co-director of Mayo Clinic's Program on Physician Well-Being, was on the committee that developed the report and presented its findings to Congress and the nation. Dr. Dyrbye also is a general internal medicine physician and professor of medical education and medicine, Mayo Clinic College of Medicine and Science, at Mayo Clinic in Rochester, Minnesota.

Burnout in health care professionals threatens quality and safety of patient care, as well as access to care. To reach our common goal of improved patient outcomes at a reduced cost, we need a health care professional workforce that is thriving. Getting there will require system solutions that address workload, work complexity, administrative tasks, practice efficiency and other factors. Health care professionals expect and want to work hard, but need to do so in environments that are sustainable.

Lotte Dyrbye, M.D., co-director of Mayo Clinic's Program on Physician Well-Being

Mayo Clinic has invested in the Program on Physician Well-Being since 2007. Clinic leaders realized that for patients to receive excellent care from compassionate, collaborative and competent physicians, strategies were needed to reduce burnout and mitigate it when it occurs, notes Dr. Dyrbye.

The Mayo Clinic program, which she co-directs with Colin West, M.D., Ph.D., also a general internal medicine physician at Mayo Clinic in Rochester, conducts and promotes innovative research focused on physician well-being. Research led by their team has established that physician burnout threatens the quality of patient care, patient satisfaction, access to care and physicians' lives. Dr. West is professor of biostatistics and medical education, and medicine, Mayo Clinic College of Medicine and Science.

"I was pleased to be able to represent Mayo Clinic and our work as a member of the National Academy of Medicine committee that wrote the consensus study," she says. "Physician burnout, and indeed that of all health care providers, is of growing concern in our country and around the world."

The new report, "Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being," advances these goals, stating, "Taking action to mitigate burnout requires a bold vision for redesigning clinical systems -; one which focuses on the activities that patients find important to their care, and which enables and empowers clinicians to provide high-quality care."

This consensus study contains current information on the prevalence and consequence of clinician burnout -; a problem across all clinical disciplines. Burnout has personal and professional consequences for the individual, and negative effects for health care organizations and society as a whole.

The report calls attention to the factors that contribute to clinical burnout, and offers evidence and principles for well-being systems and interventions. It discusses the effects of laws, regulations, standards and societal norms, as well as implications of emerging technology.

Finally, it offers recommendations for future research and mitigating currently understood burnout contributors.

"My fellow panel members and I hope that this report leads to meaningful system-level change that effectively addresses the underlying factors driving the high prevalence of burnout in today's health care professionals," says Dr. Dyrbye. "Burnout is the result of chronic workplace stress. Solutions lie within the work environment."

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