The American Medical Association (AMA) launched a new program in September of 2019 – the Practice Transformation Initiative – to bolster their attempts to research and combat physician burnout within the healthcare community. Physician burnout is classically defined as a prolonged response to stressors in one’s life and can be measured along three axes: cynicism, exhaustion, and inefficacy [1]. Factors that increase susceptibility to physician burnout include lack of control in the workplace, inadequate recognition and reward, weak community support, perceived unfairness with work decisions, and conflicts with personal values that arise in the workplace [1]. Physician burnout is a central issue faced by the American medical community and is considered by many experts to be classified as an epidemic [2]. Literature has estimated physician burnout rates between 30% – 50%, with one study showing that 54.5% of U.S. physicians reported experiencing at least one symptom of physician burnout [3]. Other studies show increases in rates of physician burnout in surveyed institutions [4,5].
Physician burnout ultimately decreases engagement and joy within the workplace, leading to serious implications for physicians, their colleagues, and their patients [1]. Physician burnout has been associated with detrimental consequences for physicians on an individual level including depression, decreased life expectancy, and cardiovascular disease [4]. Additionally, burnout has a measurable economic impact on institutions and attempts to address this issue could have financial, moral and ethical benefits [6]. The main effect of burnout on patients is that it can increase depersonalization and absenteeism, which leads to poor physician-patient interactions [7].
According to AMA Board Chair Jesse M. Ehrenfeld, M.D, “Since 2013, the AMA has been leading the conversation on physician burnout with innovative research and bold advocacy aimed at removing obstacles and burdens that contribute to symptoms of burnout in 44 percent of physicians.” These efforts have generated positive change, adding to the large pool of research regarding the causes and implications of burnout; However, there exists a need to introduce transformative interventions combatting physician burnout and to understand what is most effective. The Practice Transformation Initiative seeks to fill this crucial need through a quadruple aim encompassing Research, Measurement, Action, and Recognition. The AMA will utilize it’s collaborative expertise to partner with institutions committed to the transformative goal of the Practice Transformation Initiative. [8]
The initial cohort of partner institutions include New Jersey Medical Society, North Carolina Medical Society, and Washington State Medical Association [9]. Collaborating institutions will utilize and field test transformative interventions tackling the physician burnout issue within a diverse range of clinical settings, serving to gain evidence on the effectiveness of these interventions. This valuable information will then be analyzed by experts and consolidated for online distribution with the medical community. The Initiative will also encourage institutions and practices to take action via utilizing AMA resources to combat burnout. In addition to online resources like their award-winning STEPS Forward module and the Mini Z burnout assessment survey, the AMA holds events like the American Conference on Physician Health (co-hosted by the Mayo Clinic and Stanford Medicine), which promotes well-being and health within the physician community. The AMA’s Joy in Medicine Recognition Program allows institutions to share their transformative practices and the Collaborative for Healing and Renewal in Medicine (CHARM) Charter on Physician Well-Being works to advancement and promote physician well-being. [8,9]
In summary, the Practice Transformation Initiative offers a diverse strategy to learn about the best ways to combat physician burnout and improve American medical institutions to prevent burnout for current and future generations of physicians.
Sources:
(1) Maslach, C. (2007). Burnout. PsycEXTRA Dataset. doi: 10.1037/e518532013-727
(2) West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016). Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet, 388(10057), 2272–2281. doi: 10.1016/s0140-6736(16)31279-x
(3) Shanafelt, T. D., Hasan, O., Dyrbye, L. N., & Sinsky, C. (2015). Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clinic Proceedings, 90(12), 1600–1613. doi: 10.1016/j.mayocp.2015.08.023
(4) Carmen, M. G. D., Herman, J., Rao, S., & Hidrue, M. K. (2019). Trends and Factors Associated With Physician Burnout at a Multispecialty Academic Faculty Practice Organization. JAMA Network Open, 2(3). doi: 10.1001/jamanetworkopen.2019.0554
(5) Ariely, D., & Lanier, W. L. (2015). Disturbing Trends in Physician Burnout and Satisfaction With Work-Life Balance. Mayo Clinic Proceedings, 90(12), 1593–1596. doi: 10.1016/j.mayocp.2015.10.004
(6) Shanafelt, T., Goh, J., & Sinsky, C. (2017). The Business Case for Investing in Physician Well-being. JAMA Internal Medicine, 177(12), 1826. doi: 10.1001/jamainternmed.2017.4340
(7) Lyndon, A. (2016, February). Burnout Among Health Professionals and Its Effect on Patient Safety. Retrieved from https://psnet.ahrq.gov/perspectives/perspective/190/burnout-among-health-professionals-and-its-effect-on-patient-safety
(8) (2019, September 5). Retrieved from https://www.ama-assn.org/press-center/press-releases/ama-fights-burnout-new-practice-transformation-initiative
(9) Siwicki, B. (2019, September 5). AMA launches Practice Transformation Initiative to combat physician burnout. Retrieved from https://www.healthcareitnews.com/news/ama-launches-practice-transformation-initiative-combat-physician-burnout
