The American Medical Association recently published a story that found one in five physicians are likely to leave their current practice in the next five years and one in three health professionals plan to reduce their work hours within the next year.
Study Findings
The AMA article cites a study published in Mayo Clinic Proceedings: Innovation, Quality & Outcomes, entitled “COVID-Related Stress and Work Intentions in a Sample of U.S. Health Care Workers.” The cited study had more than 20,000 respondents at 124 institutions. It found that intent to reduce hours was highest among nurses (33.7%; n=776), physicians (31.4%; n=2914), and advanced practice providers (APPs; 28.9%; n=608) while lowest among clerical staff (13.6%; n=242) and administrators (6.8%; n=50). Burnout, fear of exposure, COVID-19–related anxiety/depression, and workload were independently related to intent to reduce work hours within 12 months.
When it came to intent to leave one’s practice within two years, that intention was highest among nurses (40.0%; n=921), APPs (33.0%; n=694), other clinical staff (29.4%; n=718), and physicians (23.8%; n=2204) while lowest among administrators (12.6%; n=93). As far as reasons behind the intent to leave practice, burnout, fear of exposure, COVID-19–related anxiety/depression, and workload were predictors.
However, feeling valued by one’s organization was protective of both intent to reduce hours and intent to leave.
Interestingly, the COVID-19 load by county was not associated with the intent to reduce work hours or leave practice. However, what type of job an individual held did seem to have an impact. Christine A. Sinsky, MD, vice president of professional satisfaction at the AMA and lead author of the study, noted that medical assistants and nursing assistants dealt with “some of the highest degrees of COVID-related stress and that health care organizations nationwide are having a tough time filling medical assistant positions.” This change is leaving clinics short-staffed, which results in more stress and work added to the plates of other team members.
Dr. Sinsky also stated that “if even one-third to one-half of nurses and physicians carry out their expressed intention to cut back or leave, we won’t have enough staff to meet the needs of patients.” Such a loss might result in reduced access to health care for patients.
Can it Be Stopped?
Dr. Sinsky did acknowledge the importance of feeling valued, saying, “Feeling valued by one’s organization reduces the risk of health care workers intending to cut back their hours or leave altogether.” She continued on, “In addition to ensuring that workers feel valued, employers can focus on lessening the workload on physicians and staff.”
Some of the suggested changes by the AMA include: transparent communication, child care support, and rapid training to support deployment to unfamiliar units. Additionally, to combat the stress and burnout felt by health care professionals, employers and leaders can provide adequate personal protective equipment (PPE), create a supportive work environment, ensure access to confidential services for mental health, and reduce work overload through better teamwork and systems.
AMA Has Started to Take Steps
The AMA has previously studied issues causing physician burnout and has started to implement steps to better understand, and reduce, it. For example, the AMA’s STEPS Forward™ resources offer practical strategies to reduce workload and improve efficiencies. Some of the resources include how-to toolkits, playbooks, podcasts and webinars.