Texas Health Organizations Address Physician Burnout Due to Pandemic – State of Reform

A recent study by the University of Texas Medical Branch (UTMB) found that nationwide physician burnout is increasing the frequency of premature retirements and attrition rates.

“Wellbeing Index data in 2021 shows the incidence of physician burnout to be around 55%, with 52% of respondents reporting emotional lability and a third of physicians reporting no not have enough time for their personal or family life, thus exacerbating the anticipated shortage of medical personnel,” the report read.

Identified in 1974 by psychologist Herbert Freudenberger, “burnout” in the context of healthcare refers to the state of stress and pressure experienced by healthcare professionals due to the emotional and physical impairment associated with employment.

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The study indicated that the trend is having adverse downstream effects on patients, physicians, trainees and healthcare organizations.

Burnout has negative impacts on patient satisfaction, medical oversight and errors, physician productivity, access to patient care, and administrative costs. According to the report, the total annual cost of burnout among healthcare managers – professionals who oversee the healthcare services provided by a particular medical department or facility – is estimated at $300 billion alone.

Source: Journal of Healthcare Leadership

Nowhere has this impact been felt more deeply in Texas than in rural communities. Currently, 40% of rural hospitals in Texas are vulnerable to closure, according to the National Rural Health Association (NRHA), one of the highest rates in the nation.

Kelly Cheek, head of the West Texas division of the Texas Rural Health Association (THRA) said the shortage of medical personnel continues to be the top priority for the health of rural communities.

“We see that there is only a lack of manpower. We are losing individuals. They come in, they leave the workforce, in health care and go into other fields, either out of burnout or just different factors,” Cheek said.

“The pandemic pressure on people leaving their profession completely is one of the biggest current challenges facing rural hospitals. … [Pandemic burnout] is a real struggle for these hospitals and clinics.

Hospital administrators across the state looked at a wide range of programs and workforce solutions to address burnout by examining the complex range of factors that cause burnout professional on an individual level, on a case-by-case basis.

Source: Journal of Healthcare Leadership

In North Texas, hospitals have been working with staff to provide them with the support they need to continue to be productive, such as time off, schedule rotations, financial support, and more.

The Dallas-Fort Worth Hospital Council (DFWHC) partners with more than 90 North Texas hospitals and is committed to creating programs to support physician and staff burnout. He recently approved a bipartisan bill in the US Congress to win workplace violence protections for healthcare professionals. The bill was introduced earlier this month and remains under consideration in the House committee.

The DFWHC has also focused on finding creative ways to attract young people to fill the void of older workers who have left the profession due to the pandemic, including easing visa restrictions for foreign workers, incorporating more technologies such as artificial intelligence in the delivery system and improving overall efficiency at administrative levels.

Stephen Love, CEO of DFWHC, said that without mitigation, the workforce shortage is expected to reach 3.2 million healthcare professionals by 2026.

“There is a [federal] bipartisan Health Workforce Resilience Act which deals with accelerating [prior] permissions,” Love said. “We have to support this. It’s not an easy solution. This is simply not the case. But I think when you look at the workforce, you have to ask yourself, “What are we dealing with now? We try to [create] a culture of healing. We try to make people feel a sense of well-being. We try to deal with burnout. And then we try to learn creative ways to recruit staff and also listen to the voice of the workforce.

According to a investigation of physicians conducted by the American Medical Association, one-third of respondents said prior authorizations had led to delays leading to serious health problems for patients.

Prior authorizations are taking a heavy toll on doctors, who say the paperwork has gotten out of hand. The average physician now has to seek approval for dozens of prescriptions and medical services from insurers to treat their patients, an administrative burden that contributes to burnout and costs medical practices valued $26.7 billion in time every year.

The United States Surgeon General presented proposals to help the 35% to 54% of physicians and nurses, and 45% to 60% of medical students and residents, reporting symptoms of burnout. He called on individuals, health care organizations, academic institutions, government and many others to help solve the problem.

Source: Journal of Healthcare Leadership

The Texas Medical Association presented Physician Benevolent Fund (PBF) and PBF Welfare Fund, support programs for physicians in need of financial assistance and mental health care. Through these, doctors practicing in Texas can receive financial support to treat conditions that interfere with their ability to practice medicine safely. Qualified physicians may also receive financial support to cover living expenses for their families while undergoing treatment.

Regional Health Education Centers (AHEC), a national organization of learning centers focused on improving the supply and distribution of healthcare professionals through strategic partnerships, places local interns and graduates in rural healthcare settings.

One of its workplace development programs encourages young people interested in health care to stay in and serve their community. West Texas Area Education Centers have placed hundreds of interns and graduates in rural health care facilities across the region and have experienced positive workforce retention rates.

“The West Texas Area Education Center serves 105 counties in the state of Texas. Federal funding is matched by state dollars through university appropriations,” said Cheek, who also leads West Texas AHEC. “AHECs are a very good resource and serve a very good purpose in terms of workforce development through certification programs. One of the things we’re really working on is trying to get students familiar with telemedicine and learning equipment.

Telemedicine is something people are going to start using more and more. It is important [that] these children can gain experience using [telemedicine] equipment and they can take it with them when they leave high school and pursue a career in health care.

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