The Real Costs of Provider Burnout and How to Lower Them

Physicians, hospitals and large provider groups are beginning to understand the high costs of physician burnout. The direct costs are exorbitant. The indirect costs are more difficult to calculate but may be even higher. Cost conscious organizations must buy into this simple truth — success and financial strength requires happy and engaged providers.

High provider turnover rates are extremely costly. There are both direct and indirect costs which must be considered.

Direct costs of provider replacement include recruitment costs, sign-on bonuses, moving expenses, workplace training, lost revenue waiting for provider numbers and licensing, printing of support materials, advertising, and many others. Presently, it costs $150,000 to one million dollars to replace just one provider depending on the specialty required.

The indirect costs of provider burnout result from:

• Decreased efficiencies
• Increased patient complaints
• Increased employee complaints
• Increase in errors and omissions
• Lost revenue due to increased absenteeism
• Complaints of hostile work environment
• Increase in the number of lawsuits
• Increased support staff turnover
• Bad reputation and PR

The direct causes of burnout are mismatches between the provider and the work environment. There are six major mismatches:

• Work Overload
• Lack of Control
• Insufficient Reward
• Breakdown of Community
• Absence of Fairness
• Conflicting Values

These have grown in scope, frequency and intensity over the past 30 years or more have led to the current epidemic of physician burnout. Immediate and ongoing steps should be taken to eliminate or dilute the effects of these six major mismatches. There are a number of reasons why this is imperative.

When physicians burn completely out they will often leave the practice of medicine altogether, usually before they intended. Even worse, some burned out physicians will act out with drugs, alcohol, other addictive behaviors, patient boundary violations, extramarital affairs and, most regrettably, suicide.

Physicians are more than twice as likely to kill themselves as non-physicians. Some 400 of our beleaguered and depressed colleagues commit suicide every year.

More patients, presenting with ever more complex medical issues with less time to adequately address them in a complicated, overly burdensome healthcare system with too few providers is a setup for disaster. The overall net effect is a loss of experienced and knowledgeable providers.

There is, of course, so much which can be done to mitigate, alleviate and prevent job related burnout. Physician wellness should become a top priority for the organizations who employ them. Lip service or stress management training is of little or no help in the long term. It is incumbent for providers to take the time and make the effort to better care for themselves in all of their life realms — mental, emotional, physical and spiritual.

A nationwide effort by all stakeholders must begin with earnest efforts to address provider burnout in systematic and comprehensive ways. Otherwise, we will continue to lose our best, brightest, and most dedicated physicians and ancillary health care providers.

Here is just a sampling of what needs to be done:

• More scheduled time with patients
• Part-time positions for providers
• Flexible clinic hours
• More physician control over scheduling
• More provider autonomy in decision making for patients
• Foster a sense of community among providers
• Regular face time with administrators/executives
• Honor individual providers' values
• Comp time for volunteering
• Perks for showing up and shinning
• Mentoring programs
• Provider wellness or resilience training/education/retreats
• Provide for individual coaching
• Organize outside activities for providers and their families
• Less bureaucracy and administrative duties

Addressing physician burnout is not only cost effective for hospitals and provider organizations, it also generates income. If physician turnover can be reduced by just one provider each year, programs to alleviate and prevent burnout can easily pay for themselves.

A happy provider workforce means happier patients, fewer patient complaints, fewer ancillary provider complaints, fewer mistakes, less lawsuits, and less provider turnover which all positively translates to the bottom line. Everybody wins, especially patients.

If the house of medicine is to burn it should burn brightly with a renewed sense of purpose and passion, not only for the well being of our patients but also for those who remain steadfast in providing their care.