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HE A LTH • Fall 2019 11 most burnout, putting the field at the forefront of both how to help itself and how to help others address the issue. Roughly half of physicians in some fields said in an American Medical Association survey they felt burnout, including those in urology, neurology, internal medicine, emergency medicine and family medicine. Research has shown electronic health records now almost ubiquitous in health care are a major factor. Physicians feel they have too little time for time-consuming documentation requirements, and they end up managing records at home on platforms not intuitive to those using them, Dr. Rebekah Gardner, an associate professor of medicine at Brown University's Warren Alpert Medical School in Rhode Island, said in a study she published last fall in the Journal of the American Medical Informatics Association. Patients of such physicians can be harmed, too, Gardner said, with research showing more errors and unnecessary tests. The medical community has begun paying more attention. In March, physician burnout was called a public health crisis in a report authored by the Massachusetts Medical Society, the Massachusetts Health and Hospital Association, the Harvard T.H. Chan School of Public Health, and the Harvard Global Health Initiative. The severity of the issue became clear in the last few years as research has brought more to light, said Dr. Maryanne Bombaugh, the president of the Massachusetts Medical Society. "We recognized, gosh, there's something really significant going on here," she said. Bombaugh cited another factor tugging at physicians: different reimbursement systems, a fee-for- service model prioritizing seeing more patients, and value-based systems encouraging holistic care. "It's a conf licting healthcare model that physicians and everyone is working in right now," Bombaugh said. "Physicians are leaving medicine because of the impact burnout is having on their personal lives and professional lives." How to address burnout The World Health Organization emphasized it doesn't consider burnout a medical condition, but a factor that inf luences someone's health status. Burnout, the WHO said, includes feelings of exhaustion, negative or cynical feelings about one's job, and a reduced effectiveness. Not everyone can simply take extended time off or choose to ignore pressure to work harder and longer in order to effectively address burnout. But there are steps that can be taken, said Dr. David Ballard, the director of applied psychology at the American Psychological Association. Ballard recommends exercise, limiting the use of electronic devices making breaking away from work especially hard, getting enough sleep, and making time for relaxing activities. "Hobbies and interests are easy to get cut out when you're busy, but they're important to your stress recovery as well," he said. The medical field has so far taken the broadest steps to cut down on burnout, with some large hospitals in Massachusetts devoting new positions to addressing physician burnout, including UMass Memorial Health Care in Worcester. UMass Memorial, with the affiliated 1,100-physician medical group and the UMass Medical School, jointly funded a new position, a clinician experience officer, who will work primarily in physician engagement and addressing burnout. UMass Memorial has created a peer- to-peer network to allow physicians to better help out one another, and other steps including creating private rooms for physicians to decompress or get work done by themselves, said Tosi, the UMass Memorial Medical Group president. "No one has the perfect recipe for addressing the problem of burnout," he said. Source: American Medical Association (2019) H Dr. Maryanne Bombaugh, president, Massachusetts Medical Society Burned out physicians An American Medical Association survey this year of more than 15,000 physicians found 44% reported feeling burned out at work. Some specialties had especially high rates. Urology Neurology Physical medicine and rehabilitation Internal medicine Emergency medicine Family medicine Specialty | Burnout rate 54% 53% 52% 49% 48% 48% Many think job conditions have become more challenging than a generation ago and that more stressful change is coming % saying each aspect of work is compared with 20 to 30 years ago and will be 20 to 30 years form now Note: Questions about the past and the future were asked of different samples. "Don't know/Refused" responses not shown. Source: Survey of U.S. adults conducted May 25 - June 29, 2016. "The State of American Jobs" Pew Research Center College-educated Americans are more likely to think job stresses have grown since a generation ago and to anticipate more strains in the future % saying they see negative changes in jobs form a generation ago and believe they are coming in the generation ahead Note: Questions about the past and the future were asked of different samples. "Some college" includes those with a two-year associate degree. Source: Survey of U.S. adults conducted May 25 - June 29, 2016. "The State of American Jobs" Pew Research Center Bachelor's degree+ Some college Bachelor's degree+ Some college High school or less High school or less

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