Government should step in to curb physician burnout, Case Western Reserve University researcher says

Physician burnout is a growing concern within the profession, but it’s also a public-health issue because of the potential to harm patients.

Now, in new published research, a Case Western Reserve University law professor insists that government—not just the medical profession—needs to step up to address the problem.

“We need to take burnout seriously,” said Sharona Hoffman, the Edgar A. Hahn Professor of Law, co-director of the Law-Medicine Center and a professor in the Department of Bioethics at the university’s School of Medicine.

“The government traditionally oversees and protects the health and well-being of the American workforce,” she said. “This is especially true for safety-critical jobs, such as those in the transportation industry. Likewise, physicians should be understood to be doing safety-critical work because patients put their lives in clinicians’ hands.”

Sharona Hoffman, the Edgar A. Hahn Professor of Law, co-director of the Law-Medicine Center and a professor in the department of bioethics at the university’s School of Medicine.

Nearly half of doctors—44%—in the United States report some degree of burnout, according to a 2017 Mayo Clinic study. Researchers commonly use a tool known as the Maslach Burnout Inventory to measure emotional exhaustion, depersonalization, and dissatisfaction with work accomplishments. Physician burnout can lead to depression, insomnia, marital strains, substance abuse and other mental and physical health problems.

In a new paper recently published in The Hasting Center Report, Hoffman, who has extensively studied physician burnout, outlined some of the major concerns: “Physicians reported that they make medical mistakes and provide suboptimal care to their patients resulting from burnout. Additionally, burnout contributes to workforce attrition, further intensifying the physician shortage problem in the United States.”

Key contributors to physicians’ discontent are electronic health-record systems. Hoffman pointed to a study, published in the Annals of Internal Medicine, that found that for every hour physicians spend with patients, they spend two hours on documentation. Electronic health records are heavily regulated, but Hoffman said that rather than consistently improving the quality and usability of products as intended, too many of the regulations “needlessly overburden clinicians.”

Addressing the concerns

To address physician burnout, Hoffman recommended a specific, regulatory approach:

Establish a reporting requirement for electronic health record adverse events “just as the (U.S.) Food and Drug Administration requires adverse event reporting with respect to devices it regulates.”

Including more extensive usability testing in the electronic health record certification process

Streamline and simplify regulations establishing reporting requirements for electronic health record and other matters;

Require health-care employers to measure physician wellness;

Update laws to offer incentives that encourage employers to address burnout; and

Invest in research on clinician well‐being.

For more information, contact Colin McEwen at colin.mcewen@case.edu.