One in five physicians say it is likely they will leave their current practice within two years. Meanwhile, about one in three doctors, advanced practice providers and nurses say they intend to reduce work hours in the next 12 months, according to recently published survey research.
Researchers based their findings on more than 20,000 respondents at 124 institutions across the country. They found that burnout, workload, fear of infection, anxiety or depression due to COVID-19 and the number of years in practice were associated with intent to reduce work hours or leave, says the article published in Mayo Clinic Proceedings: Innovation, Quality & Outcomes, “COVID-Related Stress and Work Intentions in a Sample of U.S. Health Care Workers.”
To researchers’ surprise, COVID-19 load by county was not associated with intent to reduce work hours or leave current practice. The AMA provided grant support for the study.
“While we anticipated that the stress of the pandemic would impact the people providing care, the extent of stress and the percentage of workers considering leaving is worrisome,” said the study’s lead author Christine A. Sinsky, MD, the AMA’s vice president of professional satisfaction.
“Our study demonstrates that the U.S. health care workforce is in peril. If even one-third to one-half of nurses and physicians carry out their expressed intensions to cut back or leave, we won’t have enough staff to meet the needs of patients.”
Dr. Sinsky noted that medical assistants and nursing assistants experienced some of the highest degrees of COVID-related stress and that health care organizations nationwide are having a tough time filling medical assistant positions. It’s leaving clinics shorthanded and adding to the work and stress of the rest of the care team, including physicians.
“To maintain access for patients and to prevent the remaining clinicians from being overwhelmed, we need to stem the loss of health care workers,” she said.
Make employees feel valued
This study—along with previous studies on burnout—show that there are steps organizations can take to retain employees. For example, the data showed that feeling valued was strongly associated with lower odds of reducing hours or leaving.
“Feeling valued by one’s organization reduces the risk of health care workers intending to cut back their hours or leave altogether,” Dr. Sinsky said. “In addition to ensuring that workers feel valued, employers can focus on lessening the workload on physicians and staff.”
The study offers some suggestions leaders can take to help prevent physicians and others from reducing hours or leaving the practice. For example, to help doctors and other health professionals feel valued, leaders in health care organizations can provide:
- Transparent communication.
- Support for child care.
- Rapid training to support deployment to unfamiliar units, which may demonstrate organizational appreciation to workers.
To combat stress and burnout, leaders can:
- Focus on providing adequate personal protective equipment.
- Create supportive environments.
- Ensure access to confidential services for mental health.
- Reduce work overload through better teamwork.
- Apply a systems approach to interventions aimed at improving organization culture and practice efficiency.
The study’s authors called for more research to investigate whether addressing predictors of burnout and emphasizing mitigators such as positive organizational cultures and making workers feel valued could avert a potential health care workforce crisis in the wake of COVID-19.
Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing, issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face.
The AMA’s STEPS Forward™ resources offer practical strategies to reduce workload and improve efficiencies. These include how-to toolkits, playbooks, podcasts and webinars. For example, the “Saving Time Playbook” provides guidance for removing waste from the daily work of physicians and staff. The Getting Rid of Stupid Stuff toolkit explains how an organization can initiate a program to solicit and respond to suggestions from front-line workers and the Taming the Inbox toolkit provides practical approaches to managing the inbox, the volume of which has exploded for many physicians during COVID-19.
By focusing on factors causing burnout at the system level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction.