Healing the Healers: Giving Physicians Room to Breathe

American healthcare is at a critical crossroads. For the third year in a row, life expectancy in the U.S. — one of the wealthiest countries in the world — continues to drop. Our country is seeing the highest number of measles cases since the disease was considered eliminated in 2000, spurred in large part by the anti-vaccination movement. The ongoing opioid epidemic, increasing gun violence, the list goes on and on — our country has no shortage of public health crises.

In times of uncertainty, people look to their physicians for reassurance, guidance, answers and support. Medical doctors are considered among the most “honest and ethical” professionals in the U.S. It’s only natural that people want and need to hear from their physicians, especially when health and well-being is of concern.

So herein lies the big question. How are physicians expected to be the advocate patients need if they are in need of healing themselves? They can’t. Or at least it’s extremely difficult — and that’s a big problem. The well-being of our physicians is under scrutiny like never before, with good reason.

Over the past several years, physician burnout elevated to the national stage. The issue is widespread and growing. The Physicians Foundation’s “2018 Survey of America’s Physicians” found that 77.8% of respondents have feelings of burnout sometimes, often or always, up from 74% in 2016. According to the American Medical Association, the definition of burnout is “a stress reaction marked by depersonalization, emotional exhaustion, a feeling of decreased personal achievement and a lack of empathy for patients.”

Patients want their physician to empathize with them, to have the capacity to listen. The very definition of burnout removes this ability from physicians. Our emerging value-based approach to healthcare is moving away from acute care and focusing more on techniques that are going to produce long-standing results for patients to close that revolving-door effect.

For example, The New York Times recently published an article about the success of “motivational interviewing,” which trains doctors to discuss changes that might help people be healthier as opposed to “finger-wagging,” which hasn’t proven all that effective. The process involves exploring, guiding and choosing, rather than directing — essentially, the physician listening and communicating with the patient.

“With motivational interviewing, patients tend to rate their providers as more empathic and as better listeners,” according to the article.

Furthermore, the article found that physicians who practice this approach may also experience less burnout. According to Melissa A. Faith, a child clinical psychologist at Johns Hopkins All Children’s Hospital quoted in the article, “The providers tend to feel they are making a difference in patients’ lives.” However, in order to have this capacity to listen and focus on patients, physicians need room to breathe.

As a society, we expect a lot from our doctors — perhaps now more than ever, as technology has enabled the patient to be in the driver seat. Patients have the tools to advocate for their own health. Patients have a voice. And we want our doctors to help us stay healthy, we want them to guide us, to work with us, and we want them to listen. For that to happen, it’s time for medicine to start helping to heal physicians.

Physicians are overworked, bogged down with administrative tasks and saddled with unreasonable volume expectations. Technology and innovation can serve as a solution here, supporting physicians rather than adding to their burden.

For example, artificial intelligence (AI) can help physicians work fewer, more balanced hours tailored to patient demand — provide some breathing room, instead of working back-to-back overnight 12-hour shifts. AI can also help healthcare’s supply-and-demand problem: too many patients, too few doctors, long wait times. AI technology can help hospitals and health systems use their existing resources in a better way so that they can balance the needs of doctors, patients and healthcare operations in a way that’s beneficial for everyone.

Physicians are human; they are not machines, they do not have superpowers, they are not gods. But because medicine has built a culture that pushes physicians to the brink of exhaustion, beginning in residency, this basic fact gets buried. We expect the impossible. Yet it’s pretty simple: If physicians are healthy and happy themselves, which comes from a sustainable and balanced work environment, they can be the advocate patients are looking for. When we give doctors breathing room, they can then help heal the societal problems that are making us all sick.

Suvas Vajracharya, Ph.D., is founder and CEO of Lightning Bolt Solutions, which automatically generates 3 million hours of balanced physician shift schedules for hospitals each month. Prior to founding the company, he worked as a staff scientist at the Los Alamos National Labs, scheduling massively parallel supercomputers.

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