Physician burnout has serious economic implications

By Kate Madden Yee, staff writer

May 30, 2019 -- Physician turnover and reduced clinical hours due to burnout cost the U.S. approximately $4.6 billion per year, according to a study published online May 28 in the Annals of Internal Medicine.

The findings show that burnout's effects have serious economic consequences, wrote a team led by Shasha Han of the National University of Singapore.

"Traditionally, the case for ameliorating physician burnout has been made primarily on ethical grounds," the group wrote. "Our study provides tools to evaluate the economic dimension of this problem."

The prevalence of burnout among physicians is higher than in the general working population: A 2014 study found a physician burnout rate of 54%, almost two times the rate of other workers. And it has long been associated with negative clinical outcomes, Han's team noted.

"Studies have found that burned-out physicians have higher rates of self-reported medical errors, and their patients have poorer clinical outcomes," the group wrote. "Physicians with burnout are more likely to report an intention to reduce their work hours or to leave medical practice altogether. They also have higher absenteeism rates."

But the economic effects of burnout haven't been clear, making it difficult to assess the financial benefits of mitigating the condition. So the researchers used a mathematical model to estimate the costs associated with burnout as they manifest in physician turnover and/or reduced working hours at national and organizational levels in the U.S.

"We used cost as a metric because it is easily understandable by policymakers and organizational leaders and is typically an important data point they can use to make informed decisions, develop organizational strategy, and effect change," Han's team wrote.

The team used information from a 2014 national survey of 6,880 physicians to estimate the prevalence of burnout and data from the 2015 Consumer Price Index to estimate costs. The group created a study model that consisted of a simulated population of U.S. physicians in two age groups (< 55 years and > 55 years) and three specialty groups (primary care, surgical, and other specialties).

Han and colleagues found on the national level an annual average of $4.6 billion in costs related to physician turnover and reduced clinical hours attributable to burnout. At the organizational level, the cost associated with burnout related to turnover and reduced clinical hours averaged $7,600 per employed physician each year.

And these findings are conservative, since other burnout related costs -- such as poorer patient care, lower patient satisfaction, malpractice lawsuits, and disruption caused by turnover or absenteeism -- are difficult to measure, according to the team.

Han and colleagues hope the study will help not only hospital departments but also policymakers address the problem of burnout.

"Together with previous evidence that burnout can be reduced effectively with moderate levels of investment, our results suggest that a strong financial basis exists for organizations to invest in remediating physician burnout," the team concluded.

Copyright © 2019

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