Physician Burnout Costs Healthcare System $4.6B a Year, Study Finds

Samara Rosenfeld
MAY 28, 2019
physician burnout
Photo/Thumb have been modified. Courtesy of Sokolove Law.

Physician burnout costs the U.S. healthcare system approximately $4.6 billion a year, according to findings published today in the journal Annals of Internal Medicine.
 
Burnout-attributable costs at the national level ranged from $2.6 billion to $6.3 billion, with 95% of the cases ranging from $3.7 billion to $5.3 billion, according to the multivariate sensitivity analyses conducted by researchers from Mayo Clinic and the American Medical Association.
 
The costs ranged from $4,100 to $10,200 per physician at the organizational level, with 95% of the cases ranging from $6,100 to $8,700.

“These results suggest that economic costs attributable to physician burnout in the U.S. are substantial,” wrote the study authors, which also included experts from the National University of Singapore and Stanford University.
 
On a national scale, physician burnout accounts for an estimated $7,600 per employed physician each year, varying from $3,700 to $11,000 per physician, the study found.
 
Burnout-attributable costs tend to be greater in physicians younger than 55 years old.
 
The findings suggest that there might be economic value for policy and organizational expenditures directed at reducing burnout.


Calculating Physician Burnout Costs

Researchers developed a mathematical model using research findings and industry reports to estimate burnout-associated costs related to physician turnover and reduced clinical hours at the national and organizational levels.
 
The team chose to focus on turnover and reduced clinical hours because they directly affect the net supply of clinical capacity, which is an important consideration for strategic planning at both levels.
 
The model measured the cost attributable to burnout — the difference in costs for these outcomes observed and the corresponding costs if physicians did not experience burnout — as the primary outcome.
 
Researchers analyzed a hypothetical population of U.S. physicians stratified into six segments comprising two age groups, younger or old than 55 years, and three specialty groups: primary care physicians, surgical specialties and other specialties.
 
Data sources included research published in peer-reviewed journals that directly measured the parameters and contained segment-specific estimates.
 
The research team estimated burnout prevalence from a 2014 national survey of more than 6,800 physicians which assessed the level of burnout and short-term career plans. Researchers assessed outcome prevalence and odd ratios for intended reduction in professional effort from the same survey.
 
A 2013 survey conducted by Cejka Search and the American Medical Group Association measured the annual turnover statistics.
 
To measure the outcome of reduced clinical hours, the team estimated conditional probability parameters that mapped from intended to actual reduction in hours.
 
The researchers accounted for two cost components associated with physician turnover: cost associated with physician replacement and the lost income from unfilled physician positions.
 
Physician replacement cost represented search costs, hiring costs and physician startup costs. The researchers used a 2015 report from the Association of Staff Recruiters, a 2016 report by a search firm and a 2004 study of physician turnover in a U.S. academic medical center.
 
The team conducted three groups of sensitivity analyses: a rerun of the model using alternate modeling assumptions, univariate sensitivity analyses and multivariate probabilistic sensitivity analyses.
 

The Consequences of Physician Burnout Costs

“As the co-CEO of one of the largest consortiums of medical groups in the world, I believe that Han and colleagues’ estimation of the costs of physician burnout in the U.S. is a fresh and much-needed exploration of the economic effects of this condition,” wrote Edward M. Ellison, M.D., from Kaiser Permanente.

Ellison wrote that healthcare must assess the association of physician well-being with quality, patient satisfaction, medication errors and other patient safety outcomes as the economic and human impact of physician burnout continues to be studies.
 
If physicians leave their practice, it could result in patients going to a different one, resulting in further revenue losses, the study authors wrote.
 
But technology might be able to play in role in helping physicians feel more satisfied and less burnt out. When technology works, physicians love it. Technology can increase patient engagement and decrease wait times if implemented and used properly.

Ellison wrote that optimization of technology, specifically the electronic health record, is key to providing greater opportunity for physicians to regain time in their day and connect with their patients, enhancing the joy of practice.
 
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