Physician Burnout: A Hot Topic

Original story posted on: June 3, 2019

More than half of physicians have experienced burnout, according to WHO.

The World Health Organization (WHO) has classified physician burnout as an occupational phenomenon.    

The WHO is clear that this is not a medical diagnosis. There are some estimates that more than half of physicians have experienced burnout. This classification has generated many headlines on television as well as in newspapers. Burnout is characterized by emotional exhaustion and depersonalization in response to unrelenting stress. 

There are five causes for burnout: excessive workload, inefficient work, work-life imbalance, loss of autonomy and control, and loss of meaning from work. Physicians now deal with clinical documentation in the electronic health record (EHR) and obtaining pre-authorizations for patient care. Physicians spend approximately 785 hours on documentation for quality metrics, all of which is unpaid. Most physician activities are reported and monitored, which adds to the stress. The additional administrative time has impacted time spent with patients; in a recent survey, physicians said they spent49.2 percent of their time with the EHR versus 27 percent with patients. The workload is felt to be unrealistic by 40 percent of physicians. Burnout is a public health crisis.    

This is not just an American phenomenon. According to the Journal of the American Medical Association (JAMA), a recent study on burnout, featuring 182 reports across 45 countries, revealed that “there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality.” 

“These findings preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians,” the excerpt read.

Primary care physicians are also dealing with decreased compensation. Primary care physicians are averaging $189,000 in annual salary, while specialists (e.g., orthopedic surgeons/cardiologists) are averaging $500,000. Physicians begin their career with $190,000 of medical school debt, on average.  

An estimated 400 physicians also commit suicide per year, twice the rate of the general population. Physicians are also suffering from post-traumatic stress disorder (PTSD) due to dealing with increasing numbers of mass shootings, terror attacks, and hate crimes. There is a financial cost to burnout as well. Medscape has estimated the cost of physician burnout to be $4.6 billion annually.

A suggested method of mitigating the workload is increasing the number of assistants. Medical scribes can assist in reducing physician administrative workload.

One organization, Novant Health, has developed a program to address physician burnout. This program provides support to each hospital-based physician who wishes to participate in the program, which assists physicians, nurses, and administrative leaders. The program focuses on resiliency and wellness. Approximately $2 million was initially spent to develop the program, which has assisted more than 800 physicians to date.

There are ICD-10-CM codes that may be associated with burnout. Unfortunately, ICD-10-CM is not specific to physician burnout. The diagnosis codes that capture this epidemic include:

  • F43.10 – Post-traumatic stress disorder, unspecified
  • F43.11 – Post-traumatic stress disorder, acute
  • F43.12 – Post-traumatic stress disorder, chronic
  • Z73.0 – Burnout
  • Z56.3 – Stressful work schedule
  • Z63.8 – Family estrangement
  • Z56.6 – Work-related mental stress
  • Y99.8 – Civilian work for compensation

More data is needed to capture the depth and breadth of this phenomenon, and to address it.

Programming Note:

Listen to Laurie Johnson report this story live today during Talk Ten Tuesday, 10-10:30 a.m. ET.

Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer

Laurie M. Johnson, MS, RHIA, FAHIMA is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an American Health Information Management Association (AHIMA) approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.

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