The Link Between Administrative Burden and Physician Burnout
Physician burnout is increasingly being studied as the epidemic reaches new and larger proportions. A 2016 article in The Lancet defined physician burnout as “a work related syndrome, involving emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment.” Affecting both training and practicing physicians, burnout has been attributed to limited resources, extended work hours, bureaucracy, lack of physician autonomy, increasing regulations on electronic medical records, and more. A common link in the causes of physician burnout is administrative burden, which is a blanket term for work that is bureaucratic in nature (patient charting, gaining prior authorizations, participating in continuing education, etc). The two are intertwined: administrative burden is a cause of increased physician burnout. What does this mean, then, for physicians and patients?
It is estimated that between 35-50% of all medical professionals possess some level of burnout and once experienced, studies show it tends to stick with them through the majority of their careers. This burnout leads to measurable increases in exhaustion in the workplace as well as depersonalization from work. These side effects can lead to decreases in the quality of care provided. A study published in the Annals of Internal Medicine showed that a 1 point increase on an emotional exhaustion score resulted in a 5% increase in reporting a medical error, while a 1 point increase in the depersonalization score had an 11% increase in reporting a medical error. Additionally, physicians who are experiencing burnout frequently had a 7% higher level of variability in their conduct and procedures, resulting in unequal work product and success. Burnout poses a risk to both patient safety and physician well-being.
On average, up to 25% of a physician’s time is spent on administrative duties. This takes away from their ability to deal with critical matters that involve patient care. Having this amount of time dedicated to work that is not clinical in nature is often discouraging and frustrating for the physician. In addition to being a leading cause of physician burnout, the opportunity cost of the total time spent on administrative burdens is estimated to be around 15.5 billion dollars annually. Administrative burden causes inefficiencies in both time and money in healthcare while playing a large role in the declining well-being of providers.
When the role of the physician is considered, administrative duties are often overlooked. As technology quickly progresses, more time is being exerted on non-clinical duties. In turn, this creates a large burden on physicians, and the resulting burnout has negative consequences. Combating burnout has no easy solution and there is a large gap in research, but considering high-level changes in the administrative duties of a physician as well as micro-level changes in time management and wellness has the potential to ease the burden that so many providers are feeling.
Maas, L., Geurtsen, et al. (2020). The Care2Report System: Automated Medical Reporting as an Integrated Solution to Reduce Administrative Burden in Healthcare. HICSS.
Tawfik DS, et al. Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Ann Intern Med. 2019 Oct 15;171(8):555-567. doi: 10.7326/M19-1152. Epub 2019 Oct 8. PMID: 31590181; PMCID: PMC7138707.
West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016 Nov 5;388(10057):2272-2281. doi: 10.1016/S0140-6736(16)31279-X. Epub 2016 Sep 28. PMID: 27692469.
Rodrigues H, et al. Burnout syndrome among medical residents: A systematic review and meta-analysis. PLoS One. 2018 Nov 12;13(11):e0206840. doi: 10.1371/journal.pone.0206840. PMID: 30418984; PMCID: PMC6231624.
Rao, Sandhya K, et al. The Impact of Administrative Burden on Academic Physicians: Results of a Hospital-Wide Physician Survey, Academic Medicine: February 2017 – Volume 92 – Issue 2 – p 237-243 doi: 10.1097/ACM.0000000000001461