Opinion: Tackling burnout in our healthcare workforce

“Definitive Healthcare last September found 145,213 healthcare workers to have left practice in 2021- 2022; half of them were doctors, 35,000 were nurse practitioners; and physician-assistants, physical therapists and medical social workers in thousands have joined the exodus,” writes Kutty.

“Definitive Healthcare last September found 145,213 healthcare workers to have left practice in 2021- 2022; half of them were doctors, 35,000 were nurse practitioners; and physician-assistants, physical therapists and medical social workers in thousands have joined the exodus,” writes Kutty. Pixabay

By AHMED KUTTY

Published: 07-17-2024 6:00 AM

Ahmed Kutty, MD lives in Peterborough.

A recent paper in the Journal of the American Medical Association dated June 25 (page 2,067) reporting on a study in 2020 said one in five physicians in the U.S. intended to quit practice in the next two years, and a follow-up survey in 2021 showed a grimmer picture with 40% voicing similar intentions. Dr Mark Lenzer, a co-author and director of the Institute For Professional Worklife at Hannepin Healthcare in Minneapolis is quoted as saying, “With the way medicine is practiced today it is just barely sustainable.”

The report under ‘Medical News & Perspectives’ titled “To Fix Burnout, New Initiatives Go Beyond Worker Resilience and Put Onus on Health Systems” accurately reports the impact the COVID-19 pandemic had on physicians, nurses and other professionals comprising the healthcare workforce. However, Dr. John Howard, director of the National Institute for Occupational Safety and Health (NIOSH) says, “These problems did not arise overnight.”

Stigma associated with mental health and institutional barriers impede clinicians from seeking help when they need it most. The electronic health record (EHR) is cited as the biggest driving force. In March 2022, Congress passed the Dr. Lorna Breen Healthcare Protection Act, named after an emergency medicine doctor who died by suicide during the pandemic. NIOSH released a National Plan for Health Workforce, added on to the Change Maker Campaign by the National Academy of Medicine (NAM); and the Lorna Breen Heroes Foundation published ‘Impact Wellbeing Guide.’ March 18 was designated National Health Workforce Wellbeing Day. These collaborative efforts are funded by the American Rescue Plan Act of 2021.

Definitive Healthcare last September found 145,213 healthcare workers to have left practice in 2021- 2022; half of them were doctors, 35,000 were nurse practitioners; and physician-assistants, physical therapists and medical social workers in thousands have joined the exodus.

While a critical shift from an individual-based effort at self-care to an institutional and system-wide approach for the well-being of these highly trained professionals constituting precious manpower resources is recommended to stem the tide, none of the seven actionable measures recommended include naming, let alone attempting to address issues at the core of the rot.

Loss of professional autonomy, a source of pride in the work promoting mostly joyful acceptance of the long hours and disruptive work-life balance by the young folks entering careers in healthcare for centuries, and assurance of a deserved compensation level, all upended by the advent of the Brave New World ruled by humongous and powerful commercial enterprises, decimating a once revered profession, beginning in the late 70s.

Once the doctors, nurses, pharmacists and other healthcare professionals can be rescued from being “a cog in the wheel of the profit-making machine,” it is not too late to expect resiliency towards healing and bouncing back as proud, dedicated and competent caregivers individually and as team players at their institutions. Policy makers, private institutional leaders, professional societies and publicly-funded research organizations like the National Institutes of Health will be well-served if the corrosive effects of “putting profits over patients” is firmly grasped and tackled vigorously head-on. Otherwise, the current situation is unsustainable indeed!

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Engaged citizenry confronting the formidable forces of corporate conglomerates like big insurance, big hospitals and big pharma, will find them intimidating. Margaret Meade said, “Never doubt that a small group of thoughtful committed citizens can change the world; indeed it is the only thing that ever has.”

Small yet impactful steps could start with joining a campaign to protect Traditional Medicare (TM) from the ravages of Medicare Advantage (MA), a profiteering empire currently controlling 51% of our eligible seniors, birthed by the Medicare Modernization Act of 2003 that opened the flood gates for privatization. Unless stopped, Medicare as we have known since its inception in 1965 will cease to exist soon or will survive as an emasculated version of the popular and acclaimed program that has publicly funded healthcare for seniors and the disabled.

Educating seniors nearing Medicare age on the pitfalls of Medicare Dis-Advantage like using experience instead of community rating at enrollment, and dis-enrollment hassle among others, and on how MA depletes the public Medicare Trust Fund for private gain, is a first step on this miles-long journey. Fortifying TM by expanding coverage to dental, vision and hearing services must be advocated for in tandem. Extending the benefits of drug price regulation like insulin at $35 to all Americans, expanding Medicaid coverage in all states and seeking insurance for opioid and other substance-use disorders are arenas of struggle eminently worthy of joining the battle for.

Studies show that efforts by a swathe of the public striving for healthcare justice are conducive toward mitigating this scourge of despair-induced burnout malady afflicting our world-class healthcare professionals. Power concedes nothing without struggle, it never has and never will: quoth Frederick Douglass.