Physician Burnout Charter Sets Framework for Change

A new set of guidelines and recommendations helps healthcare organizations establish policies and programs that promote physician well-being.

A charter published in the Journal of the American Medical Association promotes best practices and interventions designed to reduce physician burnout.

The charter was crafted to provide direction to health systems, hospitals, and physician practices seeking to increase the well-being of physicians, says Jonathan Ripp, MD, MPH, senior associate dean for well-being and resilience at Mount Sinai's Icahn School of Medicine in New York.

"We're trying to provide a framework for policymakers, so they can put practices in place that align with physician well-being. We are seeing large systems adopting these types of practices and policies," he says.

Physician burnout should be a top priority for leaders and staff on moral and practical grounds, Ripp says.

Related: Beating Clinician Burnout

"As a result of the work that physicians and other providers do, they have higher levels of depression and suicide. For this reason alone, physician well-being is important."

"But it's not just that. We now know that physician well-being has several ramifications for health systems: there's lower patient satisfaction, higher medical errors, increased physician turnover, decreased productivity, and increased malpractice," he says.

Physician turnover is financially draining, Ripp says. "If you take any intervention that decreases physician burnout, you are more likely to retain physicians at their practices. Probably one of the highest costs in healthcare is physician turnover. … Oftentimes when a physician leaves a practice, there is a several-month period when no one is in place and there is a shortfall of revenue."

To be effective, efforts to improve physician well-being must include the well-being of coworkers, he says. "We recognize that addressing physician well-being is not just about the physicians, it's about medical students, trainees, and all the members of the healthcare system."

Best practices and recommendations

The effort to draft the charter started in 2016. A medical and research group, the Collaborative for Healing and Renewal in Medicine, spearheaded the initiative. Ripp serves as co-chair of the group.

The charter was published March 29, in an article titled "Charter on Physician Well-being." The document has the support of several national associations, including the American Medical Association and the Association of American Medical Colleges.

The charter's best practices and recommendations are organized in three sections: societal commitments, organizational commitments, and interpersonal and individual commitments. Some examples of the recommendations are as follows:

• Healthcare organizations need to make a societal commitment to advocate for policies and rules that foster well-being. Influencing national policies can improve the well-being of physicians such as easing administrative burdens and improving mental health care for clinicians.
   
• Organizational commitment includes an engaged leadership team. Methods that leaders can try to boost physician well-being include having well-being initiatives in strategic planning, using organizational awareness efforts to identify well-being challenges, and adopting well-being metrics into assessments of organizational performance.
   
• Part of interpersonal and individual commitment is rooted in the emotionally demanding role of physicians such as enduring adverse events and patient deaths. Actions organizations can take to ease emotional pressure include adding coping skills to training and continuing education, as well as offering confidential debriefings during the workday.