Physician Burnout—More Than Meets the Eye

Physician burnout has been much in the news of late, and appropriately so. As many as one-half of primary care physicians are burned out, meaning they have become exhausted, cynical, depressed, and disconnected from the patients they care for.

Burned out physicians have higher rates of medical errors and, not surprisingly, lower patient satisfaction scores. More broadly, patients and society suffer because burned out physicians are twice as likely to leave their practices, either retiring or moving to non-patient areas like administration. To replace a departing physician can cost upwards of $1 million to their organization.

Source: Tanya Little – Flickr: 9 of 365 ~ Frustration CC BY-SA 2.0

Despite yeoman efforts to address the problems inherent in the medical health care system that contribute to burnout—such as doing away with excessively long work hours and having staff handle the electronic health records—one key cause of burnout is consistently overlooked. The patient. Certain types of patients, often referred to as “difficult patients,” regularly create the greatest problems for physicians. Nor is this a small problem:  15-20% of patients are in this category.

What are the features of difficult patients? Difficult patients tend to be depressed, anxious, narcotic-seeking, experiencing chronic pain, presenting with unexplained physical symptoms, and many are angry, scared, or resist effective care. Other features make patients difficult, but often are…

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