This article is a collaboration between 51˶ and:
CHICAGO -- Physician wellness should be a priority for all healthcare groups, and victims of burnout shouldn't be blamed for their situations, suggested backers of a new policy discussed at the meeting on Sunday.
The main thrust of the resolution is that "it isn't the individual that's responsible for burnout, but it may be the system," said William "Bill" McDade, MD, a member of the AMA's board.
While the AMA has substantial guidance around physician burnout, this resolution specifically recognizes efforts that the AMA can facilitate to "drive the betterment of the working environment."
The three-part resolution asked the AMA to urge healthcare organizations, including state and county medical societies, to create wellness plans aimed at curbing burnout; to study the concept of a "safety net" such as a suicide hotline that physicians and physician assistants manned by doctorate level mental health clinicians; and to lobby for a requirement that hospitals be required by accrediting groups to "confidentially survey" physicians in order to identify causes of "physician demoralization" and then create guidance to eliminate them.
McDade said the current report is focused on identifying "systematic deficiencies," and that specific solutions to burnout can and should be looked at as a separate effort.
It's estimated that between 300 and 400 physicians complete suicide each year, a rate higher than in the general population. (Multiple physicians and researchers have told 51˶ these figures are an underestimate or are dated.)
James Strebig, MD, an internist delegate from California, supported the resolution with one important tweak. He suggested that rather than asking hospital administration to conduct surveys on burnout, that this responsibility be left to the medical staff.
"Forgive me if I'm a little bit jaded with believing that hospital administrations will always do the right thing," he said.
Virginia Hall, MD, an ob/gyn delegate from Pennsylvania, suggested the committee go one step further in suggesting that an outside organization administer the survey.
"Even medical staff are sometimes controlled by the hospital," she added. (Hall noted a conflict of interest, in that her organization works with physician health programs and does substantial work on burnout.)
Krishna Sawhney, MD, a general and vascular surgeon at Henry Ford Health System in Detroit, said the AMA should form a caucus to develop strategies for addressing burnout. He stressed that the group should meet every time the AMA holds a meeting.
While most delegates responded enthusiastically to the report, M. Zuhdi Jasser, MD, a delegate from Arizona who works in private practice, who commented on his own behalf that, in contrast to his delegation's official position, he was "disappointed" with the resolution.
Jasser noted that the resolution caters towards institutions and ignores independent physicians.
"Those of us in small practice, we are the institution," he said.
Burnout is also an issue outside of hospitals, he said, stemming from having to report a vast number of measures, with unpredictable reimbursements based on those measures. This lack of financial security means physicians are less and less able to take a break from their practices and to be with family.
"This report, unless I missed it, doesn't address any of that," an exasperated Jasser said.
Delegates will vote on this and other policies during the AMA's House of Delegate session beginning on Monday.