Starting your first job after high school can be exciting – and a little scary. You’re learning new skills while trying to prove yourself, all while transitioning to adulthood. For some, this period of life can be the most exciting.
That’s not the case for family medicine physicians (FMPs), sometimes simply referred to as family physicians. These doctors, only three years out of medical training, report high rates of emotional exhaustion and depersonalization. The highest prevalence of burnout is in female FMPs under 40 years of age.
This burnout doesn’t necessarily diminish the more FMPs practice, either. According to Medscape’s most recent physician burnout and depression report, roughly half of all family medicine physicians experience burnout. A similar report found that about the same number of FMPs report being more burned out now than during the initial months of the COVID-19 pandemic.
If you don’t think this level of burnout negatively affects patient care, think again. Of the approximately 30 percent of FMPs who report being clinically depressed, 40 percent admit to being easily exasperated with patients, and almost 30 percent disclose that they’re less motivated to be careful with taking patient notes.
The Field of Family Medicine
Before we delve into common challenges FMPs face and the factors that add to their burnout, we’ll paint a broad picture of what these doctors do, how they’re different from primary care physicians (PCPs) and the disparity between female and male family medicine physicians.
In the United States, around 100,000 physicians practice family medicine. Unlike PCPs, who primarily specialize in internal medicine and mostly treat adults, FMPs typically provide a wide array of healthcare services to both children and adults. Their broad-based training enables them to care for individuals from infancy to advanced age, although most of the patients they see on a daily basis are adults.
Often the first contact for patients in their care journey, especially individuals with an undiagnosed health concern, FMPs treat a wide variety of ailments, provide continuing and coordinated care of varied medical conditions, offer preventative services through screenings and other services and help patients manage chronic diseases. Through these responsibilities and their ability to deal with the entire spectrum of medical issues, they help reduce overall healthcare costs by reducing complications and admissions.
These days, more women than men are entering the family physician workforce. However, even though they’re more likely than males to work reduced hours, employ domestic help at home and seek therapy to help reduce stress, these female FMPs report being burned out at a greater rate than their male counterparts.
The Reasons for — and Ramifications of — FMP Burnout
Just like doctors practicing in other areas, family medicine physicians point to bureaucratic tasks as the biggest contributing factor to burnout, followed by too many hours at work. Some FMPs reveal that those administrative demands make them feel less autonomous.
FMPs work an average of 52 hours per week, with the number slightly higher for practice owners. Common drivers of family medicine physician burnout include:
- Paperwork
- Feeling undervalued
- Frustrations with referral networks
- Difficult patients
- Medicolegal issues
- Challenges in finding work-life balance
A recent annual report on top issues facing FMPs added lack of staffing, inadequate reimbursement, supply shortages and third-party interference (i.e., prior authorizations) to this list. Not all family medicine physicians deal with the same obstacles, though. FMPs from FPs from Black, Hispanic and American Indian/Alaska Native racial groups are more likely to practice in disadvantaged areas compared with their White peers.
Like those FMPs in certain racial groups, family physicians who practice in safety net clinics are often at a higher risk for burnout. If you’re not familiar with what safety net practices are, the Institute of Medicine (IOM) defines them as “those providers that organize and deliver a significant level of healthcare and other needed services to uninsured, Medicaid and other vulnerable patients.”
What’s the consequence of FMP burnout? Unfortunately, there’s not only one.
As with other medical care specialties, burnout in family medicine physicians is associated with:
- Lower quality of care
- Loss of productivity
- Increased medical errors and costs
- Reduced patient satisfaction
- Higher absenteeism and turnover rates
- Adverse health behaviors
- Reduced adherence to treatment
As the American Academy of Family Physicians (AAFP) notes, burnout also affects FMPs’ ability to lead changes at the practice and healthcare system levels.
These burnout issues seem to be reflected in the declining number of U.S. medical graduates choosing to practice family medicine. The Medscape report mentioned above found that most FMPs would not recommend their child follow them into the same career.
Methods for Addressing Burnout Among Family Medicine Physicians
Understand and Apply Principles of Healthcare Consumerism
Many of you reading this blog likely already know that burnout is prevalent among family medicine physicians. What you might not know is how to effectively address this issue.
One way is by understanding the perhaps permanent trend of healthcare consumerism. If you’re able to understand the principles of this trend and apply them to your practice, you’ll likely maintain a high patient volume and increase your patients’ engagement and satisfaction, both of which can contribute to less burnout.
In addition to an emphasis on aspects of patient services such as convenience, accessibility and speed and the use of mobile technology, healthcare consumerism consists of patients “shopping” for doctors based on online reviews and searching for lower cost of care due to increasing health insurance deductibles and out-of-pocket costs. A growing number of healthcare consumers are accessing care from retail clinics and urgent care facilities, partly due to the level of price transparency they offer.
Consider Team-Based Care
Another way healthcare providers, including FMPs, can lessen physician burnout is by employing a team-based care model. The American Medical Association (AMA) describes this model as a collaborative system in which team members share responsibilities to achieve high-quality and efficient patient care. Such team members include:
- Physicians
- Nurse practitioners
- Physician assistants
- Nurses
- Medical assistants
- Front desk staff
- Other practice-specific staff, including pharmacists, behavioral health specialists, social workers, physical therapists or care coordinators
According to the AMA, these team members coordinate responsibilities such as pre-visit planning, expanded rooming and discharge activities and team documentation. The results of this team collaboration are workflow efficiency, patient satisfaction and the ability of physicians to better be able to connect with patients and remain focused on their primary task of patient care.
Utilize Well-Designed Healthcare Technology
Sometimes touted as the panacea for physician burnout, healthcare technology isn’t the best option if it comes with a lack of interoperability and a poor user interface. Some digital health tools — when not designed with the physician and patient in mind — interfere with direct patient care and unnecessarily increase doctors’ workloads.
At Epion Health, our patient experience solutions are built to help solve tough healthcare problems — including physician burnout. From digital check-in to telehealth and automated patient engagement, we offer products that are intuitive and easy to use. Plus, our vendor- and standards-agnostic technology are designed to solve those pesky interoperability problems.
